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Pregnant. What is the cause of increased impedance in middle cerebral, umbilical and uterine arteries?

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Dr. Sree Gouri SR

OBGYN

Practicing since :2006

Answered : 5162 Questions

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Posted on Tue, 11 Dec 2012 in Pregnancy
Question: Hi. my wife is 32 week 4 days pregnant and we have got the obs Doppler done recently. The feta tone, breathing and movement shows normal. FHR =146 bpm. Placenta is anterior, upper segment grade II-III. Cervical length is 4.6 cm, XXXXXXX os is closed. BPD-8.1cm-32w4d, HC-29.2cm-32w2d, AC-28.3cm-32w3d, FL-6.1cm AUA-32W2D, EFBW- 1964gms. COLOR DOPPLER : MCA-RI-0.8 PI-2.4, UA -RI- 0.6 PI-1.4: FETAL AORTA -RI-0.7PI 1.8. Ublical vein does not show pulsation. evidence of early diastolic notch is seen in left uterine artery.
RIGHT ATERINE ARTERY RI - 0.5,PI 0.7; LEFT UTERINE ARTERY RI-0.7 PI - 2.1: DUCTUS VENOSUS RI-0.6 PI 0.8. OPINIONOF ULTRASONOLOGIST: Single live intrauterine fetus of 32w2d maturity with borderline increased impedance in mca and umbilical arteries. Increased impedance in left uterine artery with early diastolic notch.
kindly suggest and help how to overcome this so that we can have a healthy baby in normal way. No obvious fetal anomaly seen.
doctor
Answered by Dr. Sree Gouri SR 1 hour later
Hi,
Thanks for the query.

The increased impedance in these middle cerebral, umbilical and uterine arteries occurs due to causes like:
-Maternal causes like hypertensive disorders, anemia etc.
-Fetal causes like growth retardation, distress, anomalies etc.
-Placental causes like abruption, previa.
-In case of less liquor etc.
As according to the Doppler report we can exclude fetal and placental causes, there is possibility for hypertension or anemia in mother or less liquor etc.
So if there is any abnormality in these things let her take treatment accordingly.
Along with that she has to:
Take adequate rest preferably in left lateral position
Stress and strain to be avoided
Plenty of oral fluids, nutritious salt restricted diet to be taken
Regular antenatal checkups, biophysical profile examination to the baby etc to be done.
With this basic care she can avoid possible complications and can continue the pregnancy.

Hope I have answered your query. I will be available to answer your follow up queries. If you are satisfied with all my answer, please rate the answer after closing the discussion.
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sree Gouri SR 14 hours later
Thank you Doctor for your timely answer.
Our practitioner has started hermin injection (200ml) along with a bottle of glucose and had asked my wife for bed rest. Today was the fourth dose of the injection and will continue till friday after that she has asked us to go for an ultrasound. We are following the same practice , just want to know that will and if this will help the baby to gain weight and will be able to have a timely delivery (delivery date 28/12/12) and will the baby be healthy? Secondly our practitioner was saying that we might have to go for a cegerean before time, will it affect the health of our child. Kindly reply?
doctor
Answered by Dr. Sree Gouri SR 5 hours later
Hi,

Hermin injection contains amino acids when they mixed with 5% dextrose and infused that will help in increasing the amniotic fluid level.
This will also help in the growth of the baby.
Usually after crossing the 36 completed weeks the chances of baby survival outside the uterus will increase.
So delivering one week or ten days before the expected date of delivery will not affect the baby much.
Wish you Good Health, If you are satisfied with my response please rate the answer after closing the discussion.
Take care.

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