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

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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

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