Hi,

Thanks for your query.
XXXXXXX debris or particulate matter is observed during a trans-vaginal sonogram in the first and second trimesters in 4% of pregnancies. This may rise up to 88% by 35 weeks of gestation as the pregnancy advances. The cause of this particulate matter in the third trimester is mostly the vernix caseosa or the meconium, but this does not necessarily indicate fetal distress. Therefore, your doctors are right in maintaining watchful expectancy as there is no need to change the antenatal management in this situation.

Counting of fetal movements is done to detect any fetal jeopardy early. For this, you can choose any time of the day which is comfortable to you and when you feel the baby is active. Make yourself comfortable, lie in left lateral position, take a note pad and note down the fetal movements until you reach the tenth count and note the time taken to reach ten movements. Normally, ten movements are observed in two hours. If you cannot get the required number of movements, you can check at some other time of the day after eating or drinking and taking some rest. If yet, the number of movements are less, you should immediately report the matter to your doctor.

If you count at random times of the day and yet get the normal fetal kick count, there is no need to worry at all; your baby is fine. You can count any number of times in a day or stick to particular times. So long as you can count properly, it does not matter. You can as well count once in the morning and once in the evening and yes, on an average, a normal count on both the occasions indicates a healthy baby.

Hope I have answered your query. Please feel free to contact if you need further clarifications. I will be happy to help.

regards,
Shanti.V.

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Hi XXXXX

Thanks for writing back.

The length of the cervix is good for this stage of pregnancy and it does not show any shortening. As per the sonogram, the os is also closed. So, it looks like the cervical priming has not yet started and there is time for dilatation. Before the onset of labor, some symptoms known as pre-labor signs are experienced; there is excessive vaginal discharge sometimes with streaks of blood as the membranes get separated from the wall of the uterus (show), there is increased tightening of the abdomen with pain radiating to the back and the thighs as the cervix starts getting effaced and dilated, diminished movements as the baby descends and the presenting part gets engaged, increased bladder and bowel activity and sometimes secretions from the breast.

During the third trimester, after 36 weeks of gestation, the uterus expands sideways to accommodate the baby and this puts pressure on the ligaments and muscles of the abdomen. This may lead to pain in the back as the spine bears the weight. Separation of the pelvic joints in advance as a preparation for labor can cause pain in hips and over the pubis. If the tightening persists in spite of rest and emptying of bladder and bowel, please contact your consultant. Threatened pre-term labor should be excluded in such a situation, though you are almost term. You may also need to get tested for any vaginal or urinary infection as a cause.

Please take adequate rest preferably in left lateral position. Please avoid any form of stress and eat well.

Hope I have clarified your query. Please get back if you need more clarifications. I will be ready to help.

regards,
Shanti.V.

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