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Dr. Andrew Rynne

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Pregnancy scan showed underweight fetus. Suggested for aminomix Infusion. Is this safe?

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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 5999 Questions

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Posted on Mon, 21 Jan 2013 in Pregnancy
Question: Hi my wife is currently on 24 weeks and 3 days and latest scan report shows the following report BPD 67 MM, HC 220MM, AC 178MM, FL 46 MM and total weight is 650 gms. Doctor is saying baby is underweight and wife needs to have Aminomix Infusion once in 2 times per week for 2weeks.

Let me know whether this needs to be done.She is taking D-Protien plus, Rhenamine Granules and having regular diet
doctor
Answered by Dr. Aarti Abraham 1 hour later
Hello XXXXXXX
Thanks for your query.

I am attaching the normal fetal growth parameters at 24 weeks :

EFW ( estimated fetal weight ) - 670 gms.
BPD - 60 mm
HC - 220 mm
AC - 201 mm
FL - 46 mm.

These values are derived from averages derived from the general population.
A variation of +/- 10 % are to be expected, and is normal.

As you can easily see, your baby falls in the normal range, except for the AC ( abdominal circumference ) which is less than normal.

For growth restriction to be defined, the AC should be less than 2.5th percentile, which is not the case in your baby. However, the baby is at risk of developing that later on. This Type of growth restriction, is called asymmetrical, it affects the baby later on in pregnancy, and is less serious than the other type which affects the baby early on, and affects all systems. Here, the brain and vital systems continue to grow at a normal rate.
This type of growth restriction is due to factors not within the fetus, like placenta ( pertaining to blood supply ) or maternal diseases or , at times, idiopathic. Some babies are also constitutionally small, and face no problems. Others face problems like low birth weight, breathing difficulty, infections and various other complications.

You have not commented on the amniotic fluid volume in the ultrasound, as that is an important factor also.

Maternal protein and amino acid supplementation are a known way to improve the baby's growth. So, apart from the granules and the protein powder, it is also beneficial to go for the Aminomix ( amino acid ) infusions as advised by your doctor.

These lead to increased protein and amino acid supply to the baby, and possible improvement.
However, your wife is only 24 weeks, and has a long way to go, so there should be vigorous monitoring of the baby with ultrasound and color Doppler to gauge the severity of growth restriction.
She should also take nutritious diet, all supplements as advised, take adequate fluids daily and while lying down, should prefer to lie on the left lateral side ( increases blood supply to the baby )

Take care and feel free to ask for further clarifications.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Aarti Abraham 16 minutes later
Thanks for your reply.Where I can find amniotic fluid volume in the report.

BTW is this something serious which we need to worry for. Any specific reason for AC growth to be less
doctor
Answered by Dr. Aarti Abraham 56 minutes later
Hi again,

Sure, the amniotic fluid would have a specific comment in the ultrasound report. You can scan it if you find it difficult to locate it.

At present, the situation is borderline, as the AC is yet not less than 2. 5th percentile, but definitely lagging behind the other parameters. If the condition worsens with time with serial measurements on ultrasound, then you need to worry, and some intervention is needed.

As I mentioned, this is an asymmetrical growth restriction. Symmetrical growth restriction occurs right since beginning, and all parameters are affected, plus it is due to intrinsic defects or problems in the baby.

But in your case, in asymmetrical growth restriction, the restriction occurs later on, and is due to factors OUTSIDE the baby, such as placental factors ( hampering blood supply ), chronic maternal disease, such as hypertension, diabetes, renal disease etc.

Your gynecologist would have thoroughly evaluated your wife and the baby for knowing the exact cause of the problem.

Take care.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Aarti Abraham 2 hours later
Hi again,

Thanks for your reply again. Whether the Aminomix Infusion needs to be done ASAP.

Doctor has told to be done within two weeks
doctor
Answered by Dr. Aarti Abraham 2 hours later
Hi,
As you mentioned earlier, The infusion was recommended twice a week for the next two weeks.
It cannot be given all at a time, so that duration is perfect, as prescribed by your practitioner.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
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