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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Pregnant, Ultrasound Shows Grade 3-4 Maturity. Right To Do C-section?

My wife is 37 Week pregnant based on conception date (which we are 100% sure). Her Ultrasound now indicates 39 week pregnancy and placenta is indicated as grade III to IV maturity (previous US couple of weeks back, indicated placenta maturity at grade II). Our Gynac is suggesting us to do c-section at earliest and definitely before 25 October (in week s time from now). We have 1st baby by c-section only 4 years ago. Please advise is it right to do c-section as early as 23 October and whether that will be fulll term? Any complications because of grade III to IV maturity placenta? and does placenta matures so fast (from grade II to grade III/IV in 2 weeks)? Appreciate your assistance. Thanks..
Wed, 24 Oct 2012
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Infertility Specialist 's  Response
HELLO SIR,
Well if you are very sure of her dates and she had got normal monthly cycles, then the appropriate date might be 37 weeks.The ultrasound dates can vary plus or minus 3 weeks in third trimester, so dont worry. Rather if you calculate the dates from the first trimester, they are the the most accurate of a variation of 1 weeks.
I think if the rest of the USG parameters are normal including a normal biophysical profile, there is no hurried indication of caesearen section . Elective C-section is a option if you want ,and you can perform it now or after a week as you desire i.e 38 weeks, and there will be no problem with the fetal maturity since we assume 37 completed weeks as term if the lady is sure of her dates having a normal monthyly cycle or as calculted from her first trimester scan.
As regards placental grading, I think its a subjective finding that can vary .Well a grade 3 placenta is expected at your gestational age and nothing to worry about it. Good luck,bye

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Dr. dhara shah's  Response
hi welcome to hcm.see as her usg indicate its 39week then it is more reliable .and first cs section then there is increase chance to be cs section plus placenta on maturity so early bleeding may occur all are combined indicate for cs section so do follow ur doc advice.
thanks
dr.dhara
dhara.shah84@yahoo.in
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Pregnant, Ultrasound Shows Grade 3-4 Maturity. Right To Do C-section?

HELLO SIR, Well if you are very sure of her dates and she had got normal monthly cycles, then the appropriate date might be 37 weeks.The ultrasound dates can vary plus or minus 3 weeks in third trimester, so dont worry. Rather if you calculate the dates from the first trimester, they are the the most accurate of a variation of 1 weeks. I think if the rest of the USG parameters are normal including a normal biophysical profile, there is no hurried indication of caesearen section . Elective C-section is a option if you want ,and you can perform it now or after a week as you desire i.e 38 weeks, and there will be no problem with the fetal maturity since we assume 37 completed weeks as term if the lady is sure of her dates having a normal monthyly cycle or as calculted from her first trimester scan. As regards placental grading, I think its a subjective finding that can vary .Well a grade 3 placenta is expected at your gestational age and nothing to worry about it. Good luck,bye