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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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In What Case Cesarean Delivery Is Needed ?

My wife is 38 weeks pregnant . Here is a brief summary of our situation: Our doctor is suggesting that we should go for Cesarean delivery immediately, as she sees no chance of normal delivery. She gave her the following reasons for this: 1. baby head is free 2. cervix length is 3.5 cms 3. Loose cord around the neck. Please suggest us if these reasons are good enough for us to decide for cesarean delivery?
Tue, 20 Jul 2010
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General & Family Physician 's  Response
The delivery of a full-term newborn refers to delivery at a gestational age of 37-42 weeks, as determined by the last menstrual period or via ultrasonographic dating and evaluation. The normal length of a cervix during pregnancy is 3 centimeters or greater, so your 3.5cm cervical length is within normal limits. A vaginal ultrasound is the most accurate way to measure a cervix. From 32-34 weeks gradual cervical shortening begins, so a measurement of less than 3 cm can be normal in the last trimester.Cervical dilatation alone does not confirm labor, since many women will demonstrate some dilatation (1-3 cm) for weeks or months prior to the onset of true labor.
True labor will usually be determined by observing the patient over time and demonstrating progressive cervical changes, in the presence of regular, frequent, painful uterine contractions.

Loose cord around the neck is a very common event, occurring in about one third of all births. The cord becomes wrapped around the neck during pregnancy as the baby moves around.The umbilical cord is covered with a thick protective coating known as Wharton's Jelly. This is like gristle in texture and prevents the baby from compressing the arteries and vein that run through the cord. So the cord being wrapped does not usually pose a problem for baby.
Engagement of the head normally occurs before the onset of labour in the primigravid (first pregnancy)woman but may not occur until labour is well established in a multipara(more than one pregnancy).
Your treating gynaecologist is the best person to decide on the ceasarean delivery as the doctor has done a physical examination on her...Discuss with your gynaecologist...
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In What Case Cesarean Delivery Is Needed ?

The delivery of a full-term newborn refers to delivery at a gestational age of 37-42 weeks, as determined by the last menstrual period or via ultrasonographic dating and evaluation. The normal length of a cervix during pregnancy is 3 centimeters or greater, so your 3.5cm cervical length is within normal limits. A vaginal ultrasound is the most accurate way to measure a cervix. From 32-34 weeks gradual cervical shortening begins, so a measurement of less than 3 cm can be normal in the last trimester.Cervical dilatation alone does not confirm labor, since many women will demonstrate some dilatation (1-3 cm) for weeks or months prior to the onset of true labor. True labor will usually be determined by observing the patient over time and demonstrating progressive cervical changes, in the presence of regular, frequent, painful uterine contractions. Loose cord around the neck is a very common event, occurring in about one third of all births. The cord becomes wrapped around the neck during pregnancy as the baby moves around.The umbilical cord is covered with a thick protective coating known as Wharton's Jelly. This is like gristle in texture and prevents the baby from compressing the arteries and vein that run through the cord. So the cord being wrapped does not usually pose a problem for baby. Engagement of the head normally occurs before the onset of labour in the primigravid (first pregnancy)woman but may not occur until labour is well established in a multipara(more than one pregnancy). Your treating gynaecologist is the best person to decide on the ceasarean delivery as the doctor has done a physical examination on her...Discuss with your gynaecologist...