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Done with ultrasound scan. Advised to take Aminomixn infusion. What could be the possible reason for low baby weight?

Mar 2013
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Practicing since : 1998
Answered : 5625 Questions
I had ultrasound scan on 24 th week 3 days. Baby's weight was 517. BPD - 58, HC - 206, AC - 169 and FL - 41 mm.I am adviced to take Aminomix infusion twice a week. Placental Doppler was done on 20th week and it was normal. Chromosomal screening for Gaussian markers, downs syndrome risk and Edwards and Pataus syndrome risk was checked at 12 weeks. It was low risk.

Fetal weight at 16 weeks - 137 g
Fetal weight at 20 weeks - 300 g
Fetal weight at 24 weeks - 517 g

What could be the possible reason for low baby weight? I am vegetarian. My husband weight was 2kg and I was 3.5 kg when born. Could this be genetic that baby is small? I had indigestion problem and I could not take protein for 8 days , would that resulted in decreased weight gain at 24 weeks???
Posted Fri, 6 Sep 2013 in Pregnancy
Answered by Dr. Aarti Abraham 45 minutes later
Thanks for writing to us.
Normal fetal measurements at 24 weeks are -
BPD ( biparietal diameter ) - measures the width of the head of baby - 60 cm +/- 6 cm.
HC ( Head circumference ) - measures around the head of baby - 220 + / - 20 cm.
AC ( abdominal circumference ) - measures around abdomen of baby - 201 + / - 20 cm.
FL ( femur length ) - length of thigh of baby - 45 + / -4 cm.
As you can see, most of your baby's parameters fall in the normal range, apart from the Abdominal circumference.
The normal baby weight at 24 weeks should be 670 gms, and the 10th percentile is 556 gms.
This means that of all babies born, less than 10 % babies are less than 556 gms. at 24 weeks.
Hence, your baby weight is definitely quite less.
This is called IUGR ( intra uterine growth restriction ).
The main reason for such is obviously constitutional, that is, small babies are born to small parents.
However, such growth is overall small, in your case it is asymmetrical IUGR, where preferentially vital organs like brain ( head ) grow normally, but the abdomen does not grow.
The reasons for this could include -
1. Nutritional deficiency - specifically less of protein intake by the mother.
2. Genetic or chromosomal abnormalities in the baby due to which the baby is underweight - less likely in your case, as the screening so far is normal.
3. Decreased amniotic fluid around the baby.
4. Chronic maternal diseases like hypertension, renal diseases, jaundice, prolonged illness, fever, starvation etc.
4. Placental abnormalities due to which blood supply to baby is compromised - again the COlor Doppler is normal, so this is less likely.

Hence, most probably cause for IUGR in your case could be decreased calorie intake.
However, Color Doppler should be repeated every 4 weeks till 28 weeks, and then 2 weekly to rule out risk to the baby, due to decreased blood supply.
The management now would be -
1. Increased calorie intake, particularly proteins . Non vegetarian protein is the best, but since you are vegetarian, eat a lot ot nuts, dry fruits, paneer, tofu, dal , egg if possible.
2. Increase fluid intake ( you have not commented on the amniotic fluid in the ultrasound report ) atleast 4 - 5 litres per day.
3. Take Aminomix as instructed.
4. Have small frequent meals, do not go hungry for more than 3 hours.
5. Lie down in the left lateral position when you sleep, and keep watch on baby movements.
6. Have a detailed anomaly scan to rule out abnormalities in the baby.
7. Monitoring of baby growth with periodic ultrasound and Doppler as recommended.
8. Careful measurement of blood pressure, weight, blood sugars, hemoglobin etc. to look for any maternal diseases.

Take care.
Please feel free to discuss further.
Above answer was peer-reviewed by
Follow-up: Done with ultrasound scan. Advised to take Aminomixn infusion. What could be the possible reason for low baby weight? 4 hours later
Thank you Doctor.
I would like to add few below details

This is IMSI conception. Success with the first try.

Hope you are referring to Liquor as Amniotic fluid in the scan report and it is given as Normal.

As it was Invitro conception (hormonal injections susten was given initially and now am being given Progress depot weekly) and I was found to be prediabetic on GTT (157 post 2 hrs) during treatment commencement, monitoring sugar level before conception and it is in control with meal plan till now. I am not on Insulin.

Blood pressure is monitored on my every visit and it is always within 120/70 or 120/80. Blood sugar taken on 24th week scan showed 96 post 2hrs of breakfast. Blood test was taken and below were the values

Hemoglobin - 10.6 (Doc increased dose of iron tablet now). In the third month, it was 12.6, now reduced to 10.6

WBC - 0000 ( had indigestion and slight throat pain which settled with Gelusil and Salt water gargling). Doctor said this is slightly high but we could see it after some time.. Will there be any infection without symptoms?

I am constantly putting 2 to 3 kgs every month. I started off with 71 and now at 80 (at the end of 24th week).

Fetal echo was taken on 23rd week and it is as well fine.

I am taking 3 litres of water, I will make it to 5 litres.

Thank you
Answered by Dr. Aarti Abraham 2 hours later
Hi again
Congratulations on your IMSI pregnancy !
Yes, amniotic fluid is commonly called liquor, and if it is normal, it is a positive sign.
Continue with the diet control for the prediabetes.
BLood pressure monitoring also should be continued.
It is common to get slightly decreased hemoglobin readings as pregnancy advances, as water level in the body increases relatively.
Continue iron supplements, if possible, include non vegetarian sources of iron and protein in your diet.
Generally, there is no infection without symptoms.
You can have the WBC count repeated after a few weeks, but if the symptoms are gone, there is no cause for worry.
Weight loss on your part does not necessarily mean that the baby is gaining weight too.
In fact babies of overweight mothers are also sometimes growth restricted.
Make sure your diet is healthy and XXXXXXX in protein , that does not mean you have to overeat.
Too much weight gain will also result in hypertension and worsening of diabetes.
Continue with regular colour doppler.
Increase fluid intake to atleast 4 litres - 5 litres per day ( can include water, buttermilk, nimbu pani, coconut water, soups etc.)
Avoid eating or drinking outside stuff.
Take care.
Above answer was peer-reviewed by
Follow-up: Done with ultrasound scan. Advised to take Aminomixn infusion. What could be the possible reason for low baby weight? 3 hours later
Thanks a lot Doctor. It clarified many of my doubts. I am sharing with you my diet , please assist by reviewing it.


7 am - Milk (150 ml) with D protein 2 spoons.
8 am - Breakfast ( Idly/ Dosa / Rava upuma / Goduma dosai)
9 am - 1 pomegranate
10 am - Oats kanji one tumbler or sathu maavu kanji one tumbler
11.30 am - Beans and carrot soup
12 noon - Lunch - 2 bowls of rice with dal/ sambar and curd, vegetable curry
3 pm - 6 to 7 badam, handful of groundnut , 2 dates
4.30 pm - Milk (150 ml) with D protein 2 spoons.
5.30 pm- 1 egg white & panneer curry / Sundal
6.30 pm - 1 XXXXXXX
8.30 pm- 2 bowls of rice with sambar and curd
10.00 pm - Milk (150 ml) with D protein 2 spoons.

Midnight if hungry , - dates and badam / XXXXXXX / Banana
Answered by Dr. Aarti Abraham 56 minutes later

You are taking enough protein.
Increase your intake of heme containing foods.
Take lots of beetroot, methi, palak ( spinach ), chana, walnuts etc.
The soup can contain beetroot, tomatoes, spinach also.
Try taking multigrain rotis also.
Increase intake of vitamin C by taking oranges, strawberry, kiwifruits, amla etc.

Above answer was peer-reviewed by
Follow-up: Done with ultrasound scan. Advised to take Aminomixn infusion. What could be the possible reason for low baby weight? 14 days later
Hello Doctor,

I had my ultrasound scan after 4 Aminomix infusions. Here are the readings.
Scan corresponds to 26 weeks 6 days.

AC - 206
HC - 242
FL - 48
BPD - 66
Estimated fetal weight - 850 +/- 50 g

Please review the above values and advice on the level of improvement. I am following the above said diet. I am asked to go for 2 more Aminomix (weekly once). Next scan slated in 29 week.

I noticed there has been a drastic increase in my weight (from 80 to 84). Doc says it is because of Aminomix infusion.

I am left with min 9 to 10 weeks for delivery and my drastic weight gain rate bothers. Will I develop any heart related complications or any other complications because of such weight gains?

Is there any way by which I can control my weight without compromising baby's nutrition? Should I take rice or can I do without rice and stick to rotis alone?

My cervix length is 3 cm , Normal os closed. It used to be 4.3 (or above 4) till 24 weeks. Is cervix length dynamic ? will it again increase in my next visit or will it reduce? I also noticed that baby head was down when scan was taken. Would this cause reduced cervix length measurement? Doc says it is fine... Still I am worried because of decrease in reading. This is my first conception.. No abortions or preterm delivery till now....

Thank you
Answered by Dr. Aarti Abraham 6 hours later
Brief Answer:

Detailed Answer:
Hello again XXXXXXX
The 10th percentile weight at 27 weeks is 876 grams, so the IUGR is still persistent.
The AC is also slightly lagging behind as earlier.
The improvement is not as expected, however go for further Aminomix infusions as advised. Sometimes, it takes more time for the improvement to occur.
The weight gain is indeed more, Aminomix would not cause such drastic weight gain.
You should reduce the intake of rice, potatoes, sugar, full fat milk etc.
Stick to whole wheat or multi grain rotis ( without ghee ), increase green vegetables, fruits, dal, paneer as advised.
Also, reduce the amount of cooking oil in your food.
Do not take excess salt in the diet.
You can use Low sodium salt ( eg. Dabur XXXXXXX salt )
Excessive weight gain can lead to development of high blood pressure and diabetes during pregnancy, and pose risk with delivery also.
Try to curtail the weight gain.
Cervical length is dynamic, and the readings differ between observers, and as long as it is normal, do not worry. Also, you should be worried if it further gets reduced, or shows signs of funelling or opening up.
The baby's head is normally down, it normally occupies the pelvic, so do not worry.
As you do not have history of abortions or preterm deliveries, do not worry unless you have consistently decreasing cervical length, signs of funelling, and symptoms such as cramps , lower abdominal pain and backache, excessive discharge, sensation of pressure in the pelvis etc.
All the best.
Above answer was peer-reviewed by
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