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Reduced fetal growth

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My wife 33 years & 58 kgs wt. is 27 weeks 4 days pregnant as on 19.12.13. On 18.12.13 after checking our Doctor told that there is nothing to be worried only the growth of the baby is a bit less.He prsecibed B Protin DF(2 teaspoon with one glass of milk), Susten 100( twice per day) in replacement of Susten 200(twice per day) and Tidilan 10(twice per day) along with Folinext(one per day), Thyronorm 25(one per day), Sandocal 500(one per day),Bizfer XT(one per day). Two T.Toxoid injection had already been injected on 11.11.13 & 19.12.13 respectively. Kindly provide your valuable comments and suggestions on the same.

Category: OBGYN

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Category: Infertility Specialist
 32 Doctors Online

Hello
Thanks for your consult at DoctorSpring.com.

As no ultrasound scan was done, your doctor's comments would have been based on the clinical examination only.

Please go for an ultrasound scan to confirm whether there is indeed any problem in the fetal growth.

Regarding the prescription -
1. B Protin DF is protein powder which is a must for pregnant women for good fetal nutrition.
2. Susten is progesterone which is given to prevent preterm labour .
3. Tidilan is also given to reduce the uterine contractions and reduce risk of preterm labour.
4. Folinext is folic acid which is a must during pregnancy.
5. Thyronorm must be given as there must be mild elevation of the TSH level. Please provide me the values so I can comment on this medication.
6. Sandocal is calcium and Bizfer XT contains iron - both are absolutely essential for consumption by pregnant women.
Tetanus toxoids have been given as per schedule.
Right now -
Please have an ultrasound scan and Colour Doppler also if ultrasound shows any problems or suspicion.
Take all the medications as prescribed.
Have atleast 4 - 5 litres of liquids daily and good nutritious diet rich in protein ( meat, liver, paneer, tofu, egg, milk, curd, beans, legums, dry fruits, nuts )

Keep good record of fetal movements ( count for 1 hour each after breakfast, lunch and dinner - total of all 3 hours should be more than 10 )
Ensure that following investigations have been done -
1. CBC ( complete blood count ) , blood sugars, TSH, urine examination every 4 - 6 weeks
2. HIV, HBsAg, HCV, VDRL
3. Triple marker at 16 - 18 weeks
4. Anomaly scan at 20 weeks.
5. Thalassemia screening

All the best.
Please feel free to ask for further clarifications.


Patient replied :

As per her last USG report dated 22.10.13, the following foetal parameters are noted in the USG report as :Foetal heart rate :149 B.P.M 1.Biparietal diameter = 4.1 cm(Corresponds to 18 weeks 4 days) 2.Femur Length = 2.8 cm(Corresponds to 18 weeks 5 days) 3.Abdominal circumference = 13.2 cm(Corresponds to 18 weeks 5 days)and the Estimated foetal age = 18 weeks 4 days(approx) . Her L.M.P is 10.06.2013. Based on the said USG report observations as mentioned hereinabove please provide your valuable comments whether the foetal growth at that point of time is ok or not and whether it grows at that pace or it may increase or decrease as after this USG our Doctor till date i.e. 23.12.2013 did not prescribe any furter USG


Hello,

Based on the scan done on 22.10.13, her growth was perfectly corresponding to the gestational age.

As your doctor has recently commented that the growth is not optimum , please have a repeat ultrasound scan and a Color Doppler if the scan shows some abnormality.

All the best.


Patient replied :

Recently her blood sugar level had been tested and the result is found as 146 mg/dl, our doctor advised to avoid rice and consume it for only once a day,sweets and potato to be avoided. Kindly provide the diet chart based on her abovementioned sugar level as what food she will intake and what food she will prohibit to consume, please provide a diet chart for the same.


What blood sugar was this - fasting, postprandial or a glucose challenge test ?
All suspicious values should be confirmed by a proper OGTT ( oral glucose tolerance test ) and HBA1C.
Please get these two tests done and do upload them to me also.
She should take -
3 servings of grains and cereals daily - Wheat, bran, Soyabean, Ragi, Jowar, Bajri, Brown rice
5- 6 servings of green leafy vegetables and fresh vegetables - potatoes, sweet potatoes to be avoided
4 - 5 servings of fresh fruit - avoid mangoes, grapes, watermelon
3 - 4 servings of protein - dal, paneer, tofu, chicken, fish, egg
Iron rich foods - liver, beetroot, spinach
Calcium rich foods - skimmed milk, curd, paneer
have 5 - 6 small meals instead of 2 - 3 big ones.
Drink plenty of fluids.
Avoid sugar, excess salt, pickles, ketchup, processed food, eating outside, fried food, white rice, ghee .
All the best.


Patient replied :

this is postprandial one, will she had to count the foetal movements


Yes, I already mentioned that, and the method to do so, in the first reply.
That is essential if the doctor has detected a problem in fetal growth.

Regards
Dr Aarti

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Admin Message -
With 3 follow-ups, your consult is now complete. I hope the interaction with the MD was fruitful. If you have any further queries, you could initiate a new consult.

Wish you good health
In-house Physician


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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