35w5d - Sonographer Makes Mistake, Hilarity Ensues

Yesterday was my first appointment with my regular OB since the "holy-shit-he's-tiny" ultrasound. The tone was decidedly less peppy than in my previous checkups. I got tested for Group B Strep a week early just in case they made the call for baby boy to make a slightly premature exit. We went over worst case scenarios and just "ok" case scenarios which, from my doc's perspective, seemed to be middle path we were headed down. No induction next week unless absolutely necessary but induction likely in the 38-39 week range. Basically normal except he'd be a small guy.

After we somewhat somberly went through everything, I asked to review the individual measurements taken at the ultrasound two weeks ago. Every time the sonographer took a measurement that afternoon - circumference of the head, abdomen and length of the femur - a corresponding gestational average would come up. I saw immediately that his abdomen circumference was lagging behind. The measurements for his head and femur, however, produced dates that were pretty much right on par with my dates. While lying on the ultrasound table with warm jelly smeared across my belly, I was reassured that at least those things were measuring at about average. When we met with an OB afterwards, she told us that his head had measured 6th percentile, his femur at 8th and his abdomen at 3rd. Somehow with the weight calculation he averaged to 17th percentile.  I expressed my confusion, first on how 3, 6 and 8 average to 17 (I mean, I'm no math genius but still) and then as to why the head and femur measurements on the screen would show him to be at least close to average and then come back in the single digits. She explained that the algorithm used to determine the average percentile was complex and took into account many other measurements. I was too sad and worried to push the issue any farther. Usually, I'll press on until I fully understand but in this case, I felt that I just needed to go home and sit with my news. Or lie on my bed and groan feeling generally horrible which is what I actually did.

Yesterday, I had the wherewithal to dig into it more. I didn't want to perseverate on numbers, I explained to my regular OB, but I did want to understand and not feel like a passive patient. I told her what I had seen on the screen and that the numbers didn't make sense to me. She started to spout the same answer about the complex nature of the algorithm but I could see her questioning her words as she said them. Then she stopped and carefully re-read the chart. "Well, this is a potential game changer," she said. "The sonographer entered your due date as 4/02. Your actual due date is 4/12. I'm having them rerun these calcs immediately." Ten days is a big difference in fetal development. Three quarters of a pound, lots of lung development. Depending on where that delivery date falls, ten days can be the difference between going home the next day and a week in the NICU.

THIRTY EIGHTH PERCENTILE, bitches. That's where he's averaging right now. Not 17th. Not a belly at the 3rd percentile. He falls well within the "normal" range for fetal development. His abdomen is still a little small but not to the extent that they're concerned. My follow-up ultrasound was cancelled. I'm back on track to deliver when he's fully cooked, no more talk of early induction.

So that was a fun two weeks. We scrambled to get the nursery done for a potentially early arrival from our long-awaited roommate. I ate too much ice cream in an ill-advised attempt to force him to grow with the gentle coaxing of Ben & Jerry. Guess what? Still kinda lactose intolerant. It took a lot not to wallow in feeling like I was failing Parenting 101 by neglecting to feed my fetus. Oh, they need to eat? Like every day? Shoot. I was constantly kinda stressed, kinda sad, but still very hopeful. I felt in my bones that things would be ok, I just didn't know what our version of ok would look like. And now, total and utter relief. I should be more angry at the ultrasound tech but honestly, she made a really basic, human mistake. She entered "0" instead of "1." I'm pretty sure I do things like that on a daily basis. Now, my job doesn't have quite the stakes that hers has but I am understanding. Things could have spiraled into a lot of very unnecessary interventions but fortunately that didn't happen. I'm the one that insisted  on human caregivers.