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Pregnant. Growth Scan Showed Heart Rate 163 And Expected Weight 2.67 Kg. Suggest Daily Routine And Is Surgical Delivery Safe?

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Posted on Fri, 19 Jul 2013
Question: My wife is 35+ week pregnant. We have done the growth scan recently which shows heart rate of 163 and expected weight of 2.67 Kg. I am not sure how to attach the scan copy of report here. Please suggest if the baby growth is satisfactory. Also she is unable to have food properly as acidity has increased also bodyache. Please suggest how to maintain daily routine during final weeks of pregnanacy. Doctor has suggested to go for surgical delivery by 38th week. I am not sure if surgical delivery is safe on mothers health for longterm. Suggest also.
doctor
Answered by Dr. Aarti Abraham (2 hours later)
Hello Mr. XXXXXXX

Thanks for writing in.

The scan report can be uploaded using the option given at the top right hand corner of the page, below the details provided by you.
The expected fetal weight at 35 weeks is 2. 595 gms, with a margin of 200 - 300 gms.
So your baby's weight is well within the normal range.
Also, normal fetal heart rate varies from 120 - 160 beats per minute, so the heart rate is also normal.
I can see no indication for surgical delivery ( Cesarean section ) at 38 weeks.
I would appreciate if you can ask your gynecologist and provide more details regarding the reasons for such a suggestion on his / her side.
A normal vaginal delivery is definitely safer and more comfortable both for the baby and the mother, unless there is some serious reason for a surgical delivery such as - abnormal position of the baby, large size of the baby compared to mothers pelvic capacity, placenta lying in the lower segment, previous surgical delivery etc.
The uterus grows with the baby particularly in the last month of pregnancy, so it is common to experience discomfort, anxiety, acidity and bodyache, because of the pressure of the growing uterus.

A few pointers and tips for the final weeks of pregnancy are -

1. Continue to walk around slowly for atleast 15 - 20 minutes , particularly after meals, as it helps in digestion, if there is no warning of preterm delivery.
2. Remain stressfree, as you are soon going to enjoy motherhood, by whatever route, and stress would harm you and the baby.
3. Continue taking lots of liquids and water ( buttermilk, nimbu pani, coconut water )
4. Have small frequent meals. Your stomach capacity is less due to pressure by the growing uterus, so break up your meals into five or six small meals for better digestion.
5. Do not eat outside and do not eat oily, greasy , spicy food. Limit your intake of tea , coffee and cold drinks , as they lead to acidity.
6. Keep a gap of atleast 3 hours between your last meal and sleeping. If you get hungry in the meantime, have a glass of milk .
7. Indulge in the antenatal exercises taught to you to facilitate a vaginal delivery.
8. After the 37th week, if there is no risk in the pregnancy as told by your doctor, you can have sexual intercourse also.
9. In the ninth month, the baby has almost completed its development, with the lungs and the brain continuing to mature. The weight of the baby continues to increase at an even more rapid pace, with weight gains of up to a third of a pound per week being commonplace. Please maintain your nutritional intake, concentrating on protein XXXXXXX foods . A typical diet would include -

6 – 11 servings of whole-grain bread and grains
2 – 4 servings of fruits
4 or more servings of vegetables
4 servings of dairy products
3 servings of protein XXXXXXX foods - chicken, fish, egg, milk, cheese, paneer, tofu, nuts, whole grains.

10. Limit your intake of sugar and salt - keep it to a minimum.
11. Do not remain standing for prolonged periods of time.
12. Maintain a watch on the baby 's movements. After breakfast, lunch and dinner, lie down on your left side and try and keep track of the baby's movements. The total of the 3 hours movements should be atleast 10. Report to your doctor if you perceive less fetal movements or inordinately excessive and vigorous movements, as both are a sign of fetal distress.
13. Watch out for signs of preterm labor, such as cramping pain in the uterus, leakage of watery fluid, bleeding / spotting etc.
14. Decide where you wish to deliver, and keep your relatives and schedule planned, to avoid confusion and panic at the last moment.
15. Obtain a list of required items at the time of delivery from the hospital, and keep your maternity bag handy.

Take care, and feel free to discuss further.
All the best with parenthood !












Above answer was peer-reviewed by : Dr. Vasanth
doctor
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Follow up: Dr. Aarti Abraham (1 hour later)
Thanks for your reply. I have uploaded the scan copy of report. Please have a look and suggest.
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Follow up: Dr. Aarti Abraham (8 minutes later)
Also there is a fear that its extemely painful under normal delivery and mother can give up midway which might lead to complicaiton. i heard about induced normal labour. Please suggest about this.
I also heard that under surgical method one injection is pushed which leads to lifelong spinal cord pain. Please suggest if this can be managed through physiotherapy.
doctor
Answered by Dr. Aarti Abraham (2 hours later)
The ultrasound report is absolutely normal.
There is nothing to worry.
Normal delivery is painful, but there are methods to reduce the pain.
You can go for epidural anesthesia where an injection is given to reduce the labour pains.
It is safe, and lots of mothers go for it.
It is better than voluntarily going in for the surgical method of delivery.
Also, lifelong spinal cord pain is not a must.
Sometimes, some women experience post injection pain, but it is definitely manageable with physiotherapy and massage.
Please do not have undue stress.
Normal vaginal delivery is most safe and most women are able to resume their normal activities from the second day onwards.
Even if you require Cesarean section for some real indication, it is nowadays a common surgery , without major complications.
Go along with the medical advice given to you in full faith, and enjoy safe parenthood.
All the best !
Above answer was peer-reviewed by : Dr. Vasanth
doctor
default
Follow up: Dr. Aarti Abraham (16 hours later)
doctor prescribed either Neksium 40mg twice daily before meal for 2 weeks or Pan40 to be taken for her high acidity condition. Please suggest which one is safer to take.
doctor
Answered by Dr. Aarti Abraham (1 hour later)
Neksium is Esomeprazole and Pan 40 is Pantoprazole, both are the same class of drugs.
Both are US FDA Pregnancy Category B drugs.
You can take either drug, as both are equally safe in pregnancy and equally effective for acidity.

Take care
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6004 Questions

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Pregnant. Growth Scan Showed Heart Rate 163 And Expected Weight 2.67 Kg. Suggest Daily Routine And Is Surgical Delivery Safe?

Hello Mr. XXXXXXX

Thanks for writing in.

The scan report can be uploaded using the option given at the top right hand corner of the page, below the details provided by you.
The expected fetal weight at 35 weeks is 2. 595 gms, with a margin of 200 - 300 gms.
So your baby's weight is well within the normal range.
Also, normal fetal heart rate varies from 120 - 160 beats per minute, so the heart rate is also normal.
I can see no indication for surgical delivery ( Cesarean section ) at 38 weeks.
I would appreciate if you can ask your gynecologist and provide more details regarding the reasons for such a suggestion on his / her side.
A normal vaginal delivery is definitely safer and more comfortable both for the baby and the mother, unless there is some serious reason for a surgical delivery such as - abnormal position of the baby, large size of the baby compared to mothers pelvic capacity, placenta lying in the lower segment, previous surgical delivery etc.
The uterus grows with the baby particularly in the last month of pregnancy, so it is common to experience discomfort, anxiety, acidity and bodyache, because of the pressure of the growing uterus.

A few pointers and tips for the final weeks of pregnancy are -

1. Continue to walk around slowly for atleast 15 - 20 minutes , particularly after meals, as it helps in digestion, if there is no warning of preterm delivery.
2. Remain stressfree, as you are soon going to enjoy motherhood, by whatever route, and stress would harm you and the baby.
3. Continue taking lots of liquids and water ( buttermilk, nimbu pani, coconut water )
4. Have small frequent meals. Your stomach capacity is less due to pressure by the growing uterus, so break up your meals into five or six small meals for better digestion.
5. Do not eat outside and do not eat oily, greasy , spicy food. Limit your intake of tea , coffee and cold drinks , as they lead to acidity.
6. Keep a gap of atleast 3 hours between your last meal and sleeping. If you get hungry in the meantime, have a glass of milk .
7. Indulge in the antenatal exercises taught to you to facilitate a vaginal delivery.
8. After the 37th week, if there is no risk in the pregnancy as told by your doctor, you can have sexual intercourse also.
9. In the ninth month, the baby has almost completed its development, with the lungs and the brain continuing to mature. The weight of the baby continues to increase at an even more rapid pace, with weight gains of up to a third of a pound per week being commonplace. Please maintain your nutritional intake, concentrating on protein XXXXXXX foods . A typical diet would include -

6 – 11 servings of whole-grain bread and grains
2 – 4 servings of fruits
4 or more servings of vegetables
4 servings of dairy products
3 servings of protein XXXXXXX foods - chicken, fish, egg, milk, cheese, paneer, tofu, nuts, whole grains.

10. Limit your intake of sugar and salt - keep it to a minimum.
11. Do not remain standing for prolonged periods of time.
12. Maintain a watch on the baby 's movements. After breakfast, lunch and dinner, lie down on your left side and try and keep track of the baby's movements. The total of the 3 hours movements should be atleast 10. Report to your doctor if you perceive less fetal movements or inordinately excessive and vigorous movements, as both are a sign of fetal distress.
13. Watch out for signs of preterm labor, such as cramping pain in the uterus, leakage of watery fluid, bleeding / spotting etc.
14. Decide where you wish to deliver, and keep your relatives and schedule planned, to avoid confusion and panic at the last moment.
15. Obtain a list of required items at the time of delivery from the hospital, and keep your maternity bag handy.

Take care, and feel free to discuss further.
All the best with parenthood !