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What does this ultrasound report during 37 weeks of pregnancy indicate? - Online Doctor Chats

Date : 08-Jan-2015
User rating for this question
Very Good Posted in: Pregnancy
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User:Hello -

My wife XXXXXXX (covered by the same policy that I hold) is 38 weeks 3 days pregnant. Based on the latest scan, her AFI is 20.0 and there is a mention of a loose cord around the neck. I have few questions based on this:

1. Is this considered normal? What are the things to watch out for in this scenario (both for the slightly increased AFI and for the cord around neck)?
2. Does this impact normal vs C-section delivery? How.
3. What is the chance the delivery can be normal - I hear the baby forms and comes out of the loop often. Should we take another scan to check the cord? If so, when can I do that?

FYI, the LMP is 26-Mar-2014 and the EDD is 02-Jan-2015.

Let me know if you have any questions before answering the above.

Thanks much for the response.

XXXXXX
Doctor:Hi
User:My question is related to recent ultrasound scan reports for my wife. I did a scan on 17th Dec (when my wife was 37 weeks 6 days) and showed AFI of 20.0 (polyhydramnios) and showed a loose cord around fetal neck.
Doctor:ok
User:My doctor recommended another scan and I did another scan on 22nd Dec (38 weeks 4 days) and showed AFI of 15-17 (adequate) and did not show any cord
User:I am confused which report to trust now.
User:My doctor thinks, since the report is showing polyhydramios, we should go for c-section. but not having a reliable report is concerning..
User:what are your thoughts?
Doctor:I would like to be sure about the cord
Doctor:Polyhydramnios is not much of a worry
User:during the second scan, we specifically said the radiologist to look for the cord and he said it is not around the neck
Doctor:With polyhydramnios you can go for normal delivery
Doctor:Probably the cord came off
Doctor:but it may wrap again
User:would the additional fluid gushing out during normal delivery not an issue? and will not impact the baby's health?
Doctor:It will gush out from a c-section as well
User:ok. if it may wrap again, should we go for another scan when there is an indication (labor pain or leaking of amniotic fluid) to decide c-section vs normal?
User:i would like to avoid an emergency c-section in case of any issue. thats why trying to be sure
Doctor:Yes
Doctor:A repeat usg is indicated to confirm the findings
User:ok. just to confirm, what is the definition of polyhydramnios? above what level is considered polyhydramniotic?
User:i think breaking of amniotic fluid is not desirable and it may warrant an emergency c-section, right? sorry if this is not correct understanding..
Doctor:When AFI is more than 24
Doctor:I agree with you
Doctor:Breaking the amniotic fluid may not be advised
User:ok. so the AFI of 20 is not a concern, right?
Doctor:Its not a concern
User:ok, thanks so much doctor. this is helpful. I guess in that case, we will wait for an indication and then perform another scan.
User:I am also assuming multiple ultrasound scan is not harmful for the mother or the baby, right?
Doctor:Also keep checking with ongyn
Doctor:USG not harmfull for baby
Doctor:or mother
User:sounds good. thank you so much again doctor
Doctor:Thanks for comsulting me
Doctor:Take care
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