Patient's Query
Hi doctor,
I am 29 weeks pregnant. Yesterday, I had an ultrasound and the impressions are single live intrauterine fetus of 29 weeks gestation with posterior placenta of grade 2 maturity with adequate liquor with active fetal movements. Cervical length 1.5 inches, FHR 150 per minute, AFI 5.7 inches, EFW is 2.8 lbs, 51 ST centile, with normal Doppler flow parameters with head low down well approximated to LUS. I was given IV Ferium 0.3 fl oz as my hemoglobin is 9 g/dL. Nuchal translucency, nasal bone, double marker test, glucose test and anomaly studies were normal. I am very much worried that my doctor suggested me to take complete bed rest as head is very low down to uterus and it may lead to preterm labor. I was given injection Betnesol two doses 24 hours apart on yesterday and today. Please suggest me the precautions which I should take to avoid preterm labor and also suggest me diet during this term.
Hi,
Welcome to icliniq.com.
I went through your query.
Your report is absolutely normal. The head in the current scan is low down but at this stage, the baby keeps moving around. At present, it is down and the next moment it could be up or even in breach. So, the position of the baby is not very significant at this stage. The chances of preterm labor can be determined by the cervical length, which in your case is absolutely normal. Anything less than 1.3 inches could because of concern. Normally, it is around 0.9 inch when we say that preterm delivery is very likely. You can be assured about that.
Your doctor's advice is also correct and valid, it is just that you need to take care of yourself. Do not do activities which can induce the cervix to ripen this early. For example, do not do squatting movements, avoid intercourse, avoid walking, avoid lifting a heavy load, etc. Basically you should avoid movements which would further push the baby downwards. But, it is not necessary to be on total bed rest. If you repeat the scan in some time, you will notice that the baby may be in a totally different location and position.
Patient's Query
Hi doctor,
Thank you very much for the quick response and detailed explanation. But, over the past three monthly visits I was informed that the baby is in head down position with spontaneous fetal movements. Should I concern about it?
Hi,
Welcome back to icliniq.com.
The information is good only. Most likely your baby till the end will be in head down position and then you can go for normal delivery. Position has no further meaning than that. If head was up, that too at term, then your doctor would have thought about doing an operation as then normal delivery is risky. Whereas preterm is concerned, as long as you are not doing very heavy physical work, have no abdominal pain or shooting pain. As your ultrasound shows cervical length of more than 1.3 inch, you are absolutely safe. So, do not worry and be relax. Take plenty of fluids and good diet.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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