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What is the treatment for underweight baby during pregnancy? - Online Doctor Chats

Date : 19-Dec-2013
User rating for this question
Very Good Posted in: Pregnancy
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2572 Questions
Doctor:How can I help you today
User:My wife entered pregnancy period of 9 month
User:Doctor dealing her case today gives surprises and concern to us
Doctor:what did she tell
User:she tells foetal wt (as per today's sonography report) is not good. its average or under wt. becoz m/c error is considered as +/- 10%. Wt as per report is 2845 gm
User:previously delivery date was given 15/17 Dec.. Now after today's sonography, date is coming to 26 dec
User:i m typing the remarks of sonography report:
User:1) single, live, intrauterine foetus in vertex presentation
User:2) gestational age corresponds to 36 weeks +/- 5 days
User:3) expected delivery date 26 Dec 2013 +/- 7days
Doctor:There is nothing much to worry
Doctor:Delivery usually happens + or - 2 weeks from expected date
Doctor:Mostly it happens around 1 - 2 weeks before due date
Doctor:It is a very natural and thus unpredictable process
Doctor:Doctors can just make an educated guess
User:Also, on bold it is written: mild oligohydramnios with 2 weeks disparity betwn LMP & USG parameters may s/o IUGR
Doctor:2.8 kg weight is within normal range
Doctor:normal range starts from 2.5 kg at birth
Doctor:50% of babies have below 3.5 kg weight
Doctor:mild oligohydramnios in last stages is also ok
User:Amniotic fluid is slightly less AFI- 6.2 CM
Doctor:Your wife may take high calorie diet from now on
Doctor:like home-made sweet dishes prepared from ghee, etc
User:BPD 91 mm compatible with 37 wks 3 dys
User:head circumference 328 mm, compatible with 37 wks 2 dys
User:abdominal circumference 318 mm compatible with 35 wks 6 dys
User:femur 70mm. compatible with 36 wks 0 dys.
Doctor:Your wife can also take calcium supplements
Doctor:Are the organs normal
User:no foetal anomalies are seen in head, neck, trunk or limbs at this stage
User:no e/o cord is seen around the neck
Doctor:Your wife should be given hygienic food and clean drinking water
User:cervical length measures 3.9 cms. internal OS is closed
Doctor:Nutritious food is needed
User:all above write was from sonography report.
Doctor:Mostly the report seems ok
Doctor:It seems that the baby does not have enough fat on his abdomen
Doctor:That is why the abdominal circumference is low
Doctor:otherwise she may go into labour at any time
Doctor:She needs to take adequate diet
User:But, I don't know why Dr. dealing this case after seeing the report saying.. I can't take the risk.. too much risk is associated
Doctor:What is the reason she is giving
User:My wife is taking all nutritious diet and maintain hygiene
User:Dr is telling there is lack of fluid around foetus which is suffocating
User:the baby which is risky..
User:wife is taking all the calsium supplements from last 2-3 months
Doctor:I feel that the report is ok
User:1) Argipreg (L-arginine & proanthocyanidin granules) consuming 1 XXXXXXX per day from last 1 month
Doctor:Why is she been given this medicine
User:Dr told foetus wt is concern.. initially it was 1254 gms at starting of 7 months 2) Coral calcium & Cholecalciferol tablet
User:3) Astyfer
User:4) Mother hiorliks
Doctor:Mild oligohydramnios is common and fetus mostly survives through it
User:than what is the matter.. we are shocked with Dr reply
Doctor:I have doubts about argipreg
Doctor:Such medicines may have known or unknown sideeffects
Doctor:Yes since she is treating your wife
Doctor:she needs to take decision on the safer side
User:today she again suggested for astymin-m
Doctor:I think you can trust her decision for treatment, but should not worry unnecessary
User:we couple are very much in tense...
User:actual delivery date was after 15 dec.. now Dr is telling to immediately get caeserian done
Doctor:I think you can be rest assured that this pregnancy will have a good end-result
User:my wife wt is 47 kg.
Doctor:that is a low weight
Doctor:Even caesarians are safe nowadays
User:what should be our stand? we should wait for 15 dec n check for normal delivery or go what dr is telling
Doctor:If you have the delivery in todays date, the baby will be normal
User:10 days back.. dr was assuring that seeing the development, delivery seems to be normal
Doctor:there are tests availble to check if baby is under stress
User:nw she is almost saying i ll not take any guarantee for baby..
Doctor:I think Imay have confused you more by saying that the report seems normal
Doctor:My suggestion will be to take a second opinion from another gynecologist
Doctor:she will be able to examine your wife and will be in a better position to advise you
User:markets are now commercialized.. new gynecologist here in mumbai never refers before reports.. they ll again ask for fresh sonography n all
Doctor:Maybe go to a civil hospital and check
User:shall i wait till 15 dec.. ?
Doctor:Since in private hospital they may end up commercializing
Doctor:I think it is safe to wait
Doctor:just be careful and stay in regular touch with the doctor
User:i have given all report details and medicines she is consuming.. take ur time and advice if there is any abnormality? i am waiting..
User:if really fluid is not sufficient?
User:take ur time.. please go thro the details
Doctor:AFI of 6.2 is borderline
Doctor:It may mean that she may need induction of labour at term
User:my dr has told.. if u wants to wait for normal delivery its totally ur risk.. i am recommending caeserian soon
Doctor:it is not an indication for cesarean
Doctor:since low baby weight is present too
Doctor:It may be for some other reason as well and not just oligohydramnios
User:she asks my wife.. if movement is felt by her 4-5 times in a day. the answer was obviously yes.
Doctor:Thus I suggested to take another opinion so that we do not take unnecessary tension or risk
Doctor:from your description, baby seems ok
Doctor:If she takes high calorie diet, the weight of baby may increase
Doctor:like high fat diet
Doctor:pasties, cakes, pinnies, ladoos etc
User:is it necessary?
Doctor:Sorry what is necessary
User:means to consume fatty diet,,
Doctor:It is a must to take high calorie diet in last month and during breast feeding period
User:since the wt of baby is normal
User:ok noted dr.
Doctor:Baby always puts up fat in the last month
Doctor:your wife is already low weight
Doctor:thus the baby may be low weight
User:ok dr.
Doctor:she needs high calories like butter, ghee, cheese, sweets etc
Doctor:milk at least 2 glasses should be taken
User:what about the less fluid around baby?
Doctor:It usually happens due to less urine formation by the baby
User:how that can be controlled and what is the normal range?
Doctor:but the ultrasound showed normal kidneys
Doctor:We cannot control it
User:ok.. is it less in quantity?
Doctor:She can take the fluid from crushed raddish leaves 1 tbsp a day
Doctor:its good for kidneys
Doctor:not really
Doctor:less than 5 is less
Doctor:6.2 is borderline
Doctor:increased water intake by mother may help
Doctor:give her pure water to drink
User:ok dr. Dr. pz suggest.. shall i wait till 15 dec.. or let her admit for caeserian in couple of days?
Doctor:If it was me in her place, I would wait
Doctor:But some people maynot want to take the risk, they may opt for caesarian, which is also sfe
Doctor:I would go to doctor every 2 days to check for fetal activity and heart sounds
Doctor:Maybe go to another gynecologist in government hospital setting to take second opinion
User:that has been checked.. even nurse has finger checked.. it was normal
Doctor:fetal heart sounds with a machine need to be checked frequently even in normal pregnancies
User:ok.. i ll take 2nd opinion as well
User:does she need rest.. or walking is good
Doctor:walking is good for 20 min a day
Doctor:other times she may rest or walk around as she feels like
Doctor:I hope I was of some help
Doctor:Do you have any questionÉ
Doctor:welcome back
Doctor:I am Dr. XXXXXXX here
Doctor:how can I help you?
User:hi, have u gone through above chats?
Doctor:not yet, do I need to?
User:yeah.. please.. i want to take ur opinion.. pz go through the discussion n provide ur recommendation.. take ur time.. m waiting..
User:need ur advice to get tension free sleep...
Doctor:I have gone through the entire chat
Doctor:and i have read your report
Doctor:AFI of 6.2 is considered borderline
Doctor:but the weight gain in the baby is not adequate
Doctor:which means there is some growth restriction
Doctor:that means your baby is not getting enough blood supply from the mother
Doctor:you need to do some tests immediately, that is in the morning itself to see how baby's heart rate changes with uterus contractions
Doctor:that is called NST
Doctor:along with that you should also get a Biophysical profile done to see how good the blood circulation is in your baby
Doctor:in my opinion, going for the cesarean section is the best option
Doctor:that is because, if the baby has compromised blood supply and heart rates drop during uterine contractions
User:it does not cover under sonography report?
Doctor:then your baby will have irreversible brain damage
Doctor:and you can even lose your baby, if you opt for normal delivery
Doctor:normal sonography does not include these tests
Doctor:these are special tests to look for how heart of the baby reacts to stress
Doctor:and how good the blood supply is to the brain of the baby
Doctor:I would not take any chance
Doctor:I would opt for cesarean section in such a case
Doctor:because cesarean section is safe
User:any abnormality sign u observed in the report details above..? my dr dind'nt told anything on this.. She was jus telling fluid is very less.. fluid is very less rest seems to be ok
Doctor:fluid is less, and the baby's weight gain doesn't see to be good
User:on oct 2-3 it was 1254 gms.. today it is 2.8kg
Doctor:2500gm at 37 weeks is just normal, but always remember, the sonographic estimation of weight can give +/- 10% weight difference
Doctor:Okay, I saw you had mentioned 2.5 kg somewhere
Doctor:2.8 kg is okay
Doctor:but ultrasound estimation is not accurate
Doctor:it can be lower than that
Doctor:and if the weight is less than 2.5 kg, then it will be a bigger problem
Doctor:so please get the two tests I suggested
User:i should wait till 15 dec atleast or ..?
Doctor:No, you can not wait
Doctor:I told you to get these tests done tomorrow
User:ok. dr
Doctor:Reducing fluid means your baby is not getting enough blood to the kidneys
Doctor:that itself is enough to decide
User:movement of the baby is felt by wife several times a day
Doctor:but I am giving you enough reasons
Doctor:As a doctor I can only suggest and advice, it is upto you to decide
Doctor:I have made it quite clear what needs to be done
Doctor:I can not go on repeating the same things
User:ok dr on 2nd oct report, amniotic fluid is adequate mentioned..
Doctor:your wife is feeling the movements now, if you wait till 15th, that is another 11 more days, it might be too late
User:how it is reducing day by day?
Doctor:it is a two month old report, does not have any value now
User:ok.. fine dr. will do the test tmrw as adviced
Doctor:I have already mentioned that, if the blood supply to the kidneys of the baby reduces then the amniotic fluid reduces
Doctor:because amniotic fluid is nothing but baby's urine
User:how much would be the average costs involved in these tests..?
User:in mumbai locality
Doctor:Less than 1000 total for both tests
Doctor:NSt will be around 100
Doctor:and Biophysical profile will be around 500 to 800
Doctor:is there anything else
User:ok fine dr. for such a valuable advice during this critical situation..
User:thanks a lot..
Doctor:You are welcome
Doctor:take care
User:bye n take care
Doctor:and wish you all the best
Doctor:and congratulations in advance
Question is related to
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