QuestionQUESTION: FIRST : SORRY , I DON'T SPEAK AND WRITE ENGLISH VERY WELL:
i'm very concerned because i'm having painless contractions since early 20 WGA ,(i thought it were fetal movement instead of contraction because were very frequent:4-15 per hours description: like a hard peak in right side of uterus)that pattern don't change with the following treatment:
last week i said again this concern to my dr and decide do a NST .there appear the contractions and decide to hospitalize with 2 loading dose of MGSO4, terbutaline 1 dose , and MGSO4 maintenance dose for few hours plus Procardia XL 60 mg every 12 hours and two doses of celeston for lung maturity,now i'm only on procardia xl 30 mg wevery 12 hours.today (32 7/7 wga)i went to the office and my Dr perform a pelvic exam ,he said that he can move the baby easily so i asume she is not engagement yet and perform US ( discused next weeks w/me)and send me home w/complete bed rest due to threatening of premature labor.
1-I AM VERY CONCERNED BECAUSE I HAVE A BROWNISH MUCOUS SECRETION SINCE PELVIC EXAM DONE THIS AFTERNOON
2-ALSO CONCERNED BECAUSE I CONTINUE TO HAVE SAME PATTERN OF NO PAINFUL UTERINE CONTRACTION SINCE 20 WGA TO NOW ..EVERY TIME I WAKE UP, MOVE, TALK BY PHONE, STAND UP. W/ EMOSIONS ETC...
3-I DON'T KNOW HOW TO FEEL CALM BECAUSE MY FIRST PRENATAL VISIT WERE AT 13 WGA DUE TO I HAD MENSES BEFORE AND DRINK A LOT DURING THIS FIRST TRIMESTER IN PARTIES, TAKE DALMANE (CATEGORY X)AND ATIVAN IN OCCASIONS ...MY dR SAID IT IS NOT IMPORATNTE BECAUSE I WAS NOT AN ALCOHOLIC PERSON,ANYWAY I DON'T FEEL LIKE I AM ENJOYING MY PREGNACY AS WELL
THANKS IN ADVANCE.
ANSWER: First, the brownish discharge you have noticed is a normal reaction to pelvic examinations. As your pregnancy progresses, your cervix swells with extra blood vessels, and any disturbance, even sex, can cause some minor bruising and spotting. This is usually nothing to be concerned about, unless it does not stop within a day or two.
If you are still having these mild contractions, even with the heavy tocolytic regimen you have been on, the important question to ask is, Are the contractions affecting your cervix at all? Has your doctor noticed any dilation on pelvic exams? Has he seen any "funneling" of your cervix on ultrasound? If not, then I personally would not worry about the contractions anymore. Drink lots and lots of water (dehydration can trigger mild contractions), but otherwise if there is no change in your cervix then there is nothing to worry about. Some women just have what is termed an "irritable uterus" that contracts more frequently prior to labor. I happen to be one of them!
I know it's hard to relax when you know you've consumed "toxins" early in pregnancy. Our society tends to overreact to these things. Occasional drinking really does not have a great effect on the fetus; as your doctor said, it is heavy, daily drinking that causes things like Fetal Alcohol Syndrome. As for the category X drugs you took, a full Level II ultrasound to check on your baby's development may help reassure you. You are far enough along that most problems related to your first trimester "indiscretions" would show up on ultrasound with a good technician.
Try to relax. As you noted, these early contractions can be related to your emotions, and your baby can sense your emotions as well and receives your stress hormones through the placenta. Try to find some distracting things to enjoy, whether it's reading, sewing, or some other hobby you like. Good luck!
---------- FOLLOW-UP ----------
QUESTION: today 34 1/7 WGA
hello , thanks for answer my question so quicky, now i have another concern,sorry to make so many questions... your explanation make me feel better...yesterday were my follow up consult and now the doctor said me that my belly is not growing as well
previos US(01/28/2008)-->EFW:1993(4 lb 6 oz)
HC:29.32cm (32w3 d+-21d)
AC:29.05 cm(33w0d+-21d)
HC/HA:100.96(96-111 %)
one week later:US(02/4/2008)-->EFW:4 lb 0 oz ONLY (don,t have the rest of information)except: Average gest, age:34 w
Amnotic fluid :OK, doppler placenta:OK ,breech presentation ,no engagement,respiratory exercises presented but the DR send me to do a NST because if my belly is small(it is really small) i loss 7 pound in 16 days . fortunally the NST was very reactive , he send me home and informed me that my baby is not growing very well as espected ,i have next visit in one week to check theratening premature labor and growth follow up by US.
my baby is moving well, i'm concerned because
1- how is possible that she can loss 6 oz instead of gain oz????
2-How is possible that she loss 6 on and the average GA (i thnk by US because my lmp was uncertain)match exactly w/ my GA (BY FIRST US)=34 weeks!!!
3-why my belly is so small? , me and my husband are tall??
4- is it possible to be related with the alcohol that i consumed in the first trimester when i did'n noticed that i was pregnant(i'm no alcoholic but first trimester i moved to another country and i consume alcohol several time in parties and celebrations and in 3 ocassion was a lot!!)
is my baby IUGR?????
thanks in advance
Answer1. The difference in your baby's "weight" between the two ultrasounds could be a product of different techs making different measurements more than anything else. They can't actually put your baby on a scale and get a real weight. What they do is take a few key measurements from different parts of the body, and use that to estimate a weight. If one tech's measurement was a little different from the other's, they could get those different weights. It doesn't necessarily mean your baby actually lost weight; this would be exceedingly out of the ordinary.
2. "Gestational age" when computed by ultrasound uses the exact same measurements used to compute the weight. The measurements are basically plotted on a graph. If your baby weighs 4 pounds, then they will look at a chart, and see that the average weight at 34 weeks is 4 pounds, so they estimate gestational age to be 34 weeks. Again, this can vary depending on the tech doing the measurements. It can also vary depending on your particular baby. Just like children and adults, babies vary in size and shape, even before birth. You can have tall, skinny babies, short, pudgy babies, and everything in between. That's why these measurements are so unreliable this late in pregnancy. Every baby is different.
3. Again, your fundal height measurement on the outside of your belly is an estimate, it can vary from day to day and depending on who measures you, and it can vary depending on how your internal organs are arranged and what position your baby is in. It really has no direct bearing on your baby's size; the most important thing is that you continue to gain weight and size on your own curve. If your baby is in the posterior position, or if your uterus is tilted back a little bit, that could cause your measurement to be a little smaller. Even your height can factor in here, because your pelvis may also be roomier and allow baby more room to grow below the measurement line.
4. Occasional alcohol consumption early in pregnancy does not carry a great risk for growth restriction later in pregnancy, especially if you stopped drinking once you became pregnant.
Here are some important things to keep in mind and ask your doctors about when the subject of IUGR comes up. First, as I said before, every baby is different. Maybe you just grow smaller babies. There is no way to know this for sure. Just having a smaller-than-average baby does not mean there is a problem. Second, ultrasound measurements in the third trimester can be notoriously inaccurate, sometimes as much as 2 pounds or more wrong. Third, IUGR is usually more of a problem if a) baby's personal growth curve has changed, or there is other evidence of distress, or b) baby has asymmetric IUGR, with the head and abdomen growing at different rates (another sign of distress). Make sure you discuss all of these points the next time you see your doctor, and hopefully you can get some reassurance.
