In the “Small Baby Clinic” we see women whose baby is either small of showing signs of slowing growth after 32 weeks of pregnancy. This includes any baby who has an estimated weight on ultrasound below the 10th centile (in the bottom 10% of the population for weight), or a baby of any weight with a decrease in their tummy measurement over time. Having a small baby can affect up to 8-10% of women. Most babies who are small in late pregnancy are well at birth and remain so after they are born. But some small babies develop difficulties in the womb and need to be delivered before their due date.
At each appointment we perform an ultrasound scan, in order to assess baby’s size (depending on when your last scan was) and we plot it on growth charts. We also look at the amniotic fluid around your baby, and the blood flow through their brain and the umbilical cord. In some cases we recommend you to have electronic fetal monitoring using a computerized CTG (cardiotocography). This is is similar to what women have in labour to monitor babies’ heartbeat. It can tell us how the placenta is functioning and indicate baby’s wellbeing.
Most babies who measure small are growing normally. However, we cannot always distinguish on ultrasound between a baby that is small but appropriately grown and a baby who has a small size due to their placenta not working as well.
The plan of your care will be explained to you at each visit. Depending on our findings, we may advise for an earlier delivery. Overall, we try to avoid intervening in pregnancy and we promote conservative management. We support shared-decision making, and every decision will be individualized to you.
If there is an increased risk of the placenta not working well, and therefore a slightly higher risk of compromise to the baby, then we may advise delivery before your due date. It is unlikely that we will recommend delivery before 37-38 weeks of pregnancy.
The service is run by specialist obstetricians and supported by consultants in fetal medicine. We also train doctors and student doctors in the clinic.
In our clinics we are looking for new ways through research to improve the care of pregnant women and their babies. We have explored ways to identify which babies are at a higher risk of compromise and where earlier delivery is indicated.
You will be given the choice to participate in research. All our research projects have been formally reviewed by an ethics committee. It is up to you to decide whether or not to take part after listening to the team member who will discuss the study with you and provide an information leaflet. If you decide not to take part in research it will not in any way affect the care you and your family receive.
If you want to find out more information about having a small baby, you can visit the Royal College of Obstetricians and Gynaecologists’ website