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Dr. Andrew Rynne

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Suggest the safest delivery option post fetal distress detections between weeks 29 and 34?

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Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 4846 Questions

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Posted on Tue, 29 May 2018 in General Health
Question: Hello doctor, I had asked you few questions previously regarding fetal measurements, fetal movements, B12 levels etc.

Brief history about me: I am currently in UK and at 36 weeks pregnant, previously two early miscarriages and one ectopic and right tube was removed, this one is with IVF. I had reported three episodes reduced fetal movements between 29 to 34 weeks.

Because I had reported Reduced Fetal movements, and I am too much worried and anxious about the baby, hospital here has offered me an option to induce me for labour at 38 weeks.

According to them:
Option 1 - They can induce me for labour at 38 weeks. They say it is safe to do but has increased chances of using forceps, increased labour pain. They will monitor fetal distress and act in adverse event.

Option 2 - I can ask them for Cesarean at 39 weeks. Cesarean here is not preferred unless medically required or needed in emergency. They said before 39 weeks cesarean has risk of baby breathing problem, lower IQ, breast feeding difficulties, asthma, increased risk to infections. After 39 weeks risks are lowered but mother can have usual surgery risks.

Option 3 - wait for natural labour.

I am confused and worried. I want my baby without any complications and risks. The labour, induced or natural, may have some unforeseen complications. I read on internet some horror stories that difficult labour can damage baby's brain or even still birth.

I want to go for Cesarean if you think it will be more safer for the baby. It will not be easy to convince the hospital for Cesarean but they will listen to my concerns.

1> Is Cesarean more safe for baby then natural or induced labour?

2> Do I have to wait until 39 weeks for Cesarean or at 38 weeks is as safe as 39 weeks?

3> Are there any serious complication for me with Cesarean?

4> Any future fertility, conception or pregnancy affected by Cesarean?

5> I have Hypothyroidism and I take Levothyroxin. Does this affect the complications in natural or Cesarean delivery?

Please reply as soon as you can.

Thanks in advance.
doctor
Answered by Dr. Deepti Verma 45 minutes later
Brief Answer:
Caesarean at 39 weeks can be done

Detailed Answer:
Hi dear,
I have gone through your question and understand the concerns.
1.Both Caesarean and Normal delivery, whether induced or spontaneous, are safe for the baby , depending upon the obstetrical and medical condition.
2.elective Caesarean is safe at 39 weeks of pregnancy, as earlier surgery can lead to neonatal respiratory distress.
3.No, the usual surgical risks like hemorrhage, infection, anaesthesia complications are there, however the risks are almost minimal.
4.No, future fertility is minimally affected.
Chances of Caesarean section, placenta previa are increased in next Pregnancy.
5.No, if thyroid levels are under control, then there is no effect on the surgery or anaesthesia.
Hope you found the answer is.
Regards
Dr Deepti Verma
OBGYN
Maternal and fetal medicine specialist
Above answer was peer-reviewed by : Dr. Prasad
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