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35 weeks pregnant. Will it be safe fort baby to get delivery early?

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hello mam i am XXXXXXX here.my edod is 8th dec 2012 according to my lmp that is 1st mar 2012.everything was going well with my pregnancy..till around last week i felt less fetal movements.color doppler showed everything normal.but afi 8-9cm.my gynaec gave me 3 courses of alamine drip every third day and alamine forte capsules.she also gave me steroid injectons.she s saying we may have to plan delivery early.just want to know will it be safe for baby to get delivered so early?is c section only option for my case?this is my first pregnancy
Posted Wed, 21 Nov 2012 in Women's Health
 
 
Answered by Dr. Asra Ishtiaq Ahmed 2 hours later
Hello there.

Thanks for writing.

If your LMP is 1st march, 2012 then you are 35 weeks which is definitely early to deliver and not completely safe.

Cesarean section is not the only option to deliver if you have only low AFI as problem.

AFI refers to the total fluid content around the baby.
If your colour doppler showed just a low AFI with no other abnormalities like decreased fetal growth, blood flow changes of increased resistance in the vessels or reversed Systolic/Diastolic( S/D) ratio then its NOT an indication for urgent termination of pregnancy.

You can get a non stress test/ cardiotocography (fetal heart rate tracing ) done to see for any fall in heart rate. This is because low AFI can cause decreased fetal heart rate by umblical cord compression.
IF CTG is normal, then there is no indication for a delivery now.

Besides an AFI below 5cm is considered serious for urgent intervention.

You can do a weekly follow up with ultrasound and biweekly follow up with CTG to ensure your baby is safe.

35 weeks is not too early but definitely its not a fully mature baby.
You were given steroids to ensure that your baby's lung develop completely in case you need to deliver.

Cesarean is not the only option.
You can use drugs to induce uterine contractions which can make you deliver normally.
There might be risk of fetal distress during your normal delivery as you have slightly less fluid which can make you land into a cesarean section.

But doing a cesarean section with an AFI of 8cm is no rule provided you have no other indications of c-section.

Your doctor just told you the possibility of cesarean. You can definitely discuss with her the reason before its decided.

You should take plenty of fluids atleast 8 glasses per day to increase the fluid around your baby.
Keep a strict record of your baby movements.
Also regular check of Blood pressure and weight is essential.

Take care.
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Follow-up: 35 weeks pregnant. Will it be safe fort baby to get delivery early? 22 hours later
yes mam everything on color doppler was normal..blood supply and all.weight gain is also consistent..i am just scared that how much risk is there to my baby.and atleast how many weeks will be safe fr delivery?and on my last visit that ws 2 days back.heartrate n everythng ws normal.kindly tell me if mine is not the rarest of rare case..i am just getting worried.

thanx
 
 
Answered by Dr. Asra Ishtiaq Ahmed 20 minutes later
HELLO THERE.

ANY DELIVERY AFTER 37 COMPLETED WEEKS IS CONSIDERED SAFE FOR THE BABY AS THEN THE BABY IS FULLY MATURE.

NO , YOURS IS NOT A RARE CASE. SLIGHT DECREASE IN FLUID IS COMMON.
ONLY THE CAUSE OF FLUID DECREASE NEEDS TO BE ASCERTAINED. SLIGHT AMOUNT OF DECREASE CAN BE PHYSIOLOGICAL AND DUE TO INDIVIDUAL VARIATION.

BUT WHEN IT GETS SIGNIFICANT, CAUSES LIKE HYPERTENSION( RAISED BLOOD PRESSURE), FETAL GROWTH RESTRICTION AND CERTAIN CONGENITAL ANOMALIES
(RENAL ANOMALIES) OF THE BABY NEED TO BE RULED OUT.

THESE MUST HAVE ASCERTAINED DURING YOUR ULTRASOUND.

THE BEST THING IN YOUR CASE IS YOU ARE NOT HAVING ANY ASSOCIATED CONDITION LEADING TO DECREASED AMNIOTIC FLUID.


YOU NEED TO TAKE ALL STEPS TO ENSURE THAT YOUR PREGNANCY GOES WELL.
AVOID UNDUE STRESS.
TAKE GOOD SLEEP.
TAKE GOOD AMOUNT OF FLUIDS AND HEALTHY DIET.
COUNT FOR THE BABY MOVEMENTS DAILY.
REGULAR (WEEKLY) ANTENATAL CHECK UP WITH YOUR DOCTOR.

KEEP A CHECK THAT YOU ARE NOT PASSING WATERY FLUID FROM YOUR VAGINA AS THIS INDICATES THAT YOUR BAG OF WATER HAS RUPTURED WHICH CAN LEAD TO LOW FLUID.

REPEAT YOUR ULTRASOUND WEEKLY TO ASSES THE FLUID.

TRY GETTING CTG (NON STRESS TEST) ATLEAST WEEKLY.

IF THE FLUID DECREASES FURTHER (BELOW 5CM), YOU NEED TO BE DELIVERED.

TAKE CARE.
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