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Dr. Andrew Rynne

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Pregnant. Found presence of intrauterine notching. Should I be concerned?

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Dr. S Patra

OBGYN

Practicing since :2011

Answered : 4047 Questions

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Posted on Thu, 14 Feb 2013 in Pregnancy
Question: Hi, I am 25 weeks pregnant & my doctor seems to be a bit worried, since i have a little bit of notching & baby seems to be on the small pertcentile! For now I'm on bed rest & trying toeat and drink a lot! I've had 3 healthy pregnancys & all were over 6 lbs. Do i need to be concerned? and does bed rest really help for this problem? Thanks in advance!
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Answered by Dr. S Patra 2 hours later
Hello,

Thanks for writing to us.

I have gone through your history in details and the presence of intrauterine notching concerns me.
Persistent intrauterine notching causes restriction of growth of the baby and leads to small percentile baby. It is called Intrauterine Growth Retardation (IUGR).

There are certain complication associated with IUGR especially baby with lower than 3rd percentile. These includes stillborn (due to low oxygen & nutrients), prone to jaundice & meconium aspiration during delivery, premature baby with preterm delivery, susceptible to infection after birth, cerebral palsy in some cases, etc. They are also prone to develop heart disease, diabetes, high BP in later life.

Bed rest is only helpful in preventing preterm delivery at to make you continue till term (36 weeks onwards). In addition, you may need betamethasone injection after 30-32 weeks for better lung maturity and to avoid fetal distress during delivery. Daily Fetal Movement Count (DFMC) is ideal monitoring tool for baby's well-being.

Follow some basic things to improve IUGR condition:
1) Take Healthy protein XXXXXXX diet (Milk/Meat/Fish/Pulses/Beans/Nuts/lentils, etc.) with extra 350 Kcal/day than usual and eat leafy vegetables & fresh fruits. L-Arginine supplements are very useful.
2) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
3) Take an adequate bed rest and preferably 10-14 hrs daily in divided schedule.
4) Maintain personal hygiene including breast & genital care with proper washing.
5) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing.
6) Certain things should be avoided like any type of sexual activity/ intercourse, long journey/stepping uneven surface and high heel shoe (risk of fall on ground with preterm delivery) etc.
8) Do periodic check up as per schedule. Repeat scan is needed in later month to assess growth & development of fetus.
9) Continue Iron/calcium supplements and other nutrients.
10) Periodic measurement of Weight gain and blood pressure.

Hope I have answered your query. If you have any further questions I will be happy to help.
Wish her good health and successful motherhood.

Regards,
Dr. Soumen

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. S Patra 5 hours later
thanks for your advice, i just have a few little questions, you wrote that i should take 10-14 hours bed rest daily, in other words all day bed rest? that alone stresses me and gets me in a very low mood.i'm a very outgoing person & needs to get fresh air by going out every other day! As of IUGR (dont think thats my issue) my doctor said that baby is doing very well in there , very active just on small side, both of us r pretty much on the small side! ultrasound showed some measurements in the 11% 36% and 2 things in the 5th% as of all other suggestions i basicly do!My blood pressure is perfect & so is my weight gain! Thanks! Waiting to hear from u shortly.
doctor
Answered by Dr. S Patra 3 hours later
Hello,

Thanks for follow up query. I am giving answer according to your query.

As you are carrying IUGR/small percentile baby, then there is risk of preterm delivery sometimes if you are involved in heavy work/ long journey. For that reason, you should take at least 10 hrs bed rest daily. You can divide your resting schedule & not take 10 hrs continuously. At that time, you can read something or watch movie or listen music etc to elevate mood level.

All above things (that you wrote) are indicating fetal well being in healthy manner. So follow all suggestive measures as I described in my previous reply for better growth & development till the term.

If you do not have any clarifications, you can close the discussion and rate the answer.

Take care of yourself and be well.

Regards,
Dr Soumen
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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