Preparing For Labor – The Mom Experts

Placental Positions and their Impacts on Healthy Pregnancy

The Mom Experts — Mon, 20 Feb 2023 17:33:28 +0000

In This Article

What is the placenta?

The placenta is a temporary organ formed during pregnancy. It is attached to the uterine wall and connects to the baby through the umbilical cord. It helps the fetus grow properly by channeling the nutrients and oxygen from the mother. The placenta and the umbilical cord act as the baby’s lifeline while in the womb.

Placenta position in the womb

How is it formed?

It is a temporary disc-shaped organ. It consists of tissue mass and is rich in blood vessels. It grows alongside the fetus to aid in the nourishment, growth, and development of the baby in the womb.
The placenta begins to develop when the fertilized egg implants into the uterine lining. Once implanted, the umbilical cord grows from the placenta to the baby’s navel.
Placenta develops around three weeks into gestation and is visible in ultrasound scans by ten weeks.
The placenta grows from a few cells into an organ that will weigh about one-sixth of the baby’s birth weight throughout pregnancy.
Placenta develops around three weeks into gestation and is visible in ultrasound scans by ten weeks.

What is Placental migration?

The position of the placenta changes as the uterus stretches and grows in pregnancy.
Even though initially the placenta occupies 50% of uterine space, as pregnancy advances, the uterus expands and the baby grows and occupies the entire space. Due to this, it appears as the placenta shrinks with gestational age.
In the third trimester, as the baby moves down the uterus, it stretches and pulls, which causes an upward movement of the placenta away from the cervix (opening into the birth canal, through which the baby moves down at birth).

What are its Functions?

Placenta passes nutrients, oxygen, and antibodies pass from the placenta through the umbilical cord to the baby.
It removes harmful waste substances and carbon dioxide from the fetal bloodstream.
The placenta keeps the mother’s blood separate from fetal blood. It also obstructs the passage of bacteria and viruses, thus protecting the fetus from infection.
Placenta produces and secretes hormones like estrogen, progesterone, oxytocin, and lactogen directly into the bloodstream to support pregnancy and fetal growth.

When is it removed?

The placenta is removed within 5 to 30 minutes after childbirth through uterine contractions. This occurs in the third stage of labor.

What are placental positions?

The placenta develops where the fertilized egg implants and can grow anywhere in the uterus. However, the position where the placenta lies is a significant factor that affects the growth and development of the baby. It directly impacts the mother in labor and delivery. The placenta’s exact location, alignment, and positioning in the uterine lining are first recorded in the ultrasound scan at around 20 weeks of gestation.

Anterior placenta

How does an anterior placenta look inside the womb?

The placenta grows in the front wall of the uterus, closest to the abdomen.
This is one of the normal placental positions which do not have any direct negative impact on the mother and fetus.
The anterior placenta acts as a barrier or cushion which prevents the mother from feeling the movement.

Posterior placenta

How does a posterior placenta look inside the womb?

The placenta grows in the back of the uterus towards the spine
Fetal movements are easily felt by the mother in this placental position.
Posterior placenta is optimum for delivery as it facilitates the baby to move easily in the birth canal.

Lateral placenta

Placenta implants to the lateral walls of the uterus, either on the right or left side of the womb.
Not so common, but relatively safe placental position for the baby and mother.

Fundal position

The placenta is attached to the top region of the uterus, in between the two fallopian tube openings.
Fundal position is normal and has no significant ill effect on the baby’s development or delivery.

Low-Lying Placenta

Normal and low-lying placenta

The placenta attaches to the lower portion of the uterus in such a way that it covers all or part of the cervix (which opens into the birth canal).
The placenta lies less than 2 cm from the cervical opening.
This placental position is unfavorable and can cause complications later in pregnancy.
However, all low-lying placenta as diagnosed in the 20 weeks ultrasound scan does not progress into placenta previa in the third trimester. Instead, the placenta may realign, and move away from the cervix, when the baby grows. This is because the uterus lining thins and stretches in the third trimester.
But when the placenta fails to move upwards, it continues to block the baby’s way out during childbirth. This condition is called placenta previa.
Low-lying placenta is still a normal functioning placenta, hence the fetus is fully grown and healthy.
However, placenta previa needs more medical attention, lifestyle changes, and a planned cesarean.

Summary

Placental positions play a significant role in the growth and development of the fetus as well as ensuring healthy childbirth. Under normal circumstances, anterior, posterior, lateral, and fundal positions are favorable for normal delivery and healthy babies at birth.

The low-lying placenta position is a concern that needs continuous medical monitoring and prior assessments to evaluate the extent of the negative impact it can have on the mother and baby.

References

1.https://flo.health/pregnancy/pregnancy-health/complications/fundal-placenta-position

2.https://www.babycenter.com/pregnancy/your-baby/the-placenta-what-it-is-and-how-it-works_400 05564

3. https://www.whattoexpect.com/pregnancy/placenta

Low Amniotic Fluid ( Oligohydramnios ) – What to expect?

The Mom Experts — Mon, 20 Feb 2023 17:20:28 +0000

In This Article

What is amniotic fluid?

Amniotic fluid is a warm, thin, pale yellow fluid that surrounds the fetus. It is highly significant for the fetus’s safe development and adequate growth during pregnancy. It is a blend of hormones, immune system cells, nutrients, and secretions from the fetus. An optimum amount of fluid should be present in the amniotic sac. Too low or too high quantities of amniotic fluid are considered adverse for the baby’s growth and development.

What’s its significance in fetal well-being?

Amniotic fluid is important in maintaining optimum conditions for the development and survival of the fetus in the womb. This fluid fills the amniotic sac as early as 12 days after conception.

Amniotic fluid cushions the baby and allows free floating of the umbilical cord.
Prevents the baby’s body from compressing the umbilical cord against the uterine wall.
Amniotic fluid quantity signals how well the fetal urinary system is working since the fetus excretes urine directly into the fluid.
It helps in lung development, maturation of the digestive system, and the sufficient growth of muscles and bones in the fetus.
Amniotic fluid covering maintains a stable fetal temperature stable.
It protects against infection.
This protective covering also keeps the baby safe from influences outside the womb.

How is the amniotic fluid index measured?

The amniotic Fluid Index (AFI) is a standardized indicator to assess the amount of amniotic fluid in a pregnant woman’s womb.

The ultrasound scans determine the level of Fluid in the amniotic sac.
The quantity of fluid varies with gestational age and from woman to woman. At 20 weeks 350 ml of fluid (approx) is standard. Around 25 weeks it is 670 ml of fluid, t at 32 – 36 weeks 800 – 1000 ml, and at 40 weeks, 550- 600 ml is considered normal.
Other two methods to estimate the fluid levels are AFI (Amniotic fluid index) calculation and MVP (Maximum vertical point) calculation techniques. An average reading as per AFI should be 8- 24 cm. Less than 8 cm of AFI is considered low. The average reading as per MVP should be 2 – 8 cm. Less than 2 cm of MVP is considered low.

What is oligohydramnios?

Oligohydramnios

Oligohydramnios is a condition where the amniotic fluid is less than expected for the baby’s gestational age.

This low fluid condition is diagnosed by ultrasound scans, probably around 18 – 20 weeks of gestation.
Oligo means little, and hydra means water. Amnios is the membrane around the fetus or amniotic sac
Amniotic fluid in the womb increases as pregnancy progresses until around 34- 36 weeks. After that, it starts to decline as pregnancy reaches its full term. However, an ultrasound scan reading with AFI less than 8 cm and MVP less than 2 cm is considered a low amniotic fluid condition.

What are the common symptoms of oligohydramnios?

Oligohydramnios present little or no symptoms in many women. However, the cues on fluid level inadequacy are picked up by the scheduled prenatal ultrasound scan readings.

The uterus measures smaller than anticipated for the baby’s gestational age.
Poor maternal weight gain.
Abnormal fetal heart rate
Reduced fetal activity and growth.
Frequent fluid leakage from the vagina.

Be aware of the type of vaginal leakage. Vaginal fluid flow could be the leaking of amniotic fluid, urine, or an increased vaginal discharge. Usually, amniotic fluid leakage is a large gush of clear, warm watery fluid from the vagina without any odor, with small tinges of blood. Whereas, an increased vaginal discharge is normally a thick white or yellow sticky-smelling fluid. If not sure, refrain from self-diagnosis. Seek medical intervention.

What are the causes of oligohydramnios?

The main causes of oligohydramnios can be both fetal and maternal.

Maternal factors

Dehydration in the mother.
Placental abnormalities, where the membranes rupture much earlier before the onset of the actual labor
Health conditions of mothers like preeclampsia, diabetes, obesity, and high blood pressure.

Fetal factors

Urinary tract or kidney-related birth defects in the baby
Post-term baby that is above 40 weeks of gestational age.
Chromosomal abnormalities.

How does it affect a healthy pregnancy?

Potential Risk associated with oligohydramnios depends on the gestational age of the pregnancy. A low amniotic condition when diagnosed early in pregnancy will have more ill effects.

When diagnosed as early as the second trimester, there is a risk of developing birth defects, miscarriage, or even stillbirth of the fetus.
Oligohydramnios can lead to labor complications as there isn’t enough fluid for the mobility of the fetus which in turn could lead to constriction of the umbilical cord during birth.
The risk of preterm labor is much higher.
Lack of sufficient amniotic fluid causes labor contraction to be more painful, breathing difficulties, and distress in the baby at the time of birth.
Higher chances of intrauterine growth restrictions in the fetus.
Improper lung development called pulmonary hypoplasia is another ill effect on the fetus.
Due to less fluid to move around, the fetus will have restricted mobility that may develop tightness in the joints which affects the development of bones and muscles.

How to handle a low amniotic fluid condition?

Ultrasound scan to diagnose oligohydramnios

Oligohydramnios need no medical treatment when diagnosed at the end of a full-term pregnancy.

More prenatal check-ups and close monitoring of the amniotic fluid levels will be sufficient to have a safe childbirth.
Eating healthy, hydrated, and adequate rest is very important.
Always watch out for any signs of infection like foul-smelling vaginal discharge, pain, or discomfort in the pelvic area.
Keeping a check on comorbidities like hypertension, and diabetes is necessary.
A planned C Section becomes mandatory along with amnioinfusion. It is a transfusion of saline water into the uterine cavity using a catheter placed in the cervix to replace the low levels of amniotic fluid.
Check with the gynecologist to know about additional screening procedures like high-resolution fetal ultrasonography, fetal echocardiogram, and a doppler ultrasound to diagnose the fetal heartbeat, and kidney functions and to evaluate the placental functioning.

References

https://www.babycentre.co.uk/a568740/low-amniotic-fluid-oligohydramnios
https://medlineplus.gov/ency/article/002220.htm
https://my.clevelandclinic.org/health/diseases/22179-oligohydramnios

Everything you need to know about Fetal Assessment

The Mom Experts — Mon, 20 Feb 2023 17:05:44 +0000

A fetal well-being assessment is done to check the growth and development of the baby. It is also done to assess any risks to the fetus in-utero. It consists of special tests done to screen high-risk factors that may affect the fetus. Furthermore, it also ensures satisfactory growth and well-being of the fetus. Some of these tests or checks like kick counting are required to be done by all mothers after a certain point in pregnancy, as advised by your Ob-gyn. However, other tests are done only in special conditions where the pregnancy is a high-risk one and the fetus needs additional monitoring.

When are these tests normally done?

These tests are normally done in the 3rd trimester, usually 30 weeks onwards. They are done on a biweekly basis. However, these can be done earlier or more frequently when the pregnancy is a high-risk one and requires close monitoring.

What are the tests done to assess fetal well-being?

A battery of clinical and biochemical tests are done at every visit to assess fetal growth. These clinical parameters include maternal weight gain, blood pressure, uterus size, and fundal height with documentation of abdominal girth.

The biochemical tests are done to assess fetal lung maturity via amniocentesis which is done by removing the amniotic fluid. Don’t worry, it is a very simple and safe test.

Apart from these tests, a few special tests are done in the later part of pregnancy to screen for any high risks.

What special tests are done?

These tests are recommended by your ob-gyn

1. Fetal movement assessment

One simple and cost-effective way to assess a baby’s well-being in the womb is to keep a track of the baby’s movements. This can be done in the comfort of your home and can be done by all mothers regularly after 26- 28 weeks or as advised by your Ob-gyn.

Your ob-gyn might also give you a baby-kick chart for you to notify every time you feel your baby kick. This helps you to note the pattern of your baby’s movements and report accordingly.

2. Non-stress test (NST)

This test is done to assess fetal distress by taking the Fetal heart Rate (FHR) in correspondence to the Fetal movements.
It is an OPD-based procedure. A belt is tied around your belly and the fetal heart rate is monitored.

Result of the test –
Reactive/ Reassuring NST indicates that 2 or more accelerations are seen over 20 minutes. It indicates that the baby is healthy.
If the result is Non-Reactive, it indicates that the baby is in distress. This could be due to a lack of oxygen or that the baby was asleep. In such cases, a repeat test needs to be done, or the baby is stimulated by passing sound through the abdomen.

3. Biophysical profile

It is a scoring system that uses 5 parameters to evaluate fetal wellbeing.

Fetal breathing movements
Fetal Heart Rate
Fetal body movements
Fetal muscle tone
Amniotic fluid amount
Result of the test

Each of the parameters is given a point of 0 or 2, and the total is calculated.
A total score of 8- 10 is reassuring. A score of 6 is considered neutral (neither reassuring nor non-reassuring) and a repeat test is recommended.

4. Modified biophysical profile

It is the same as the BPP in many aspects. It includes NST and an amniotic fluid assessment done via ultrasound. Furthermore, it is hassle-free and provides the same test result with respect to fetal wellbeing as the BPP.

Result of the test
Amniotic fluid assessment is done via ultrasound and NST is done as mentioned earlier. As stated above, if the test result is non-reassuring, it means that the fetus is not getting enough oxygen.

5. Doppler umbilical artery

It is another fetal well-being assessment test that records the flow of blood in the umbilical artery. When used in conjunction with other tests, it gives an idea of fetal growth and development.

This test is done along the same lines as the other tests. The mother lays down, and sound waves are passed over the abdomen. The computer picks up the image and shows it on the screen. The results are assessed accordingly.

Result of the test
A normal blood flow in the blood vessel of the umbilicus indicates a normal fetus. Any abnormal flow in the umbilical artery indicates oxygen compromise to the fetus.

References

The content and editorial team at TME strives to bring to you the most authentic and trustworthy information. Our sources are very reliable, ranging from Medical health professionals, health organizations, and real-life experiences. We believe it is equally important for you to know the source and credibility of our information.

https://www.acog.org/womens-health/faqs/special-tests-for-monitoring-fetal-well-being

How to Recharge yourself during your 3rd Trimester

The Mom Experts — Mon, 20 Feb 2023 11:38:51 +0000

The third trimester is the last leg of your pregnancy. It comes with many changes to your body. It also comes with a number of hormonal and lifestyle changes. All these factors can lead to feeling unsettled and anxious. You may also experience moodiness and bouts of sadness. Don’t worry, all these reactions are normal to happen. All you need to do is keep yourself mentally recharged during your third trimester!

What exactly happens during the third trimester?

This is a time of many changes happening!

Both your body and the baby go through drastic changes during this trimester. Your pregnancy is now at its full peak and the fetus is fully developed. But to reach this final point, many changes happen.

You are now fully showing. You are likely to gain weight during the third trimester, which can in turn lead to stretch marks.
You may experience hair issues such as dry hair due to increased hormonal excitement to the hair follicles.
Backaches, swelling of joints (edema) and leg cramps become more apparent in the third trimester.
You may also start to experience false contractions, known as Braxton-Hicks contractions.
You may have bouts of crying spells or mood swings due to the hormonal changes taking place.

Why am I feeling this way during my third trimester?

Pregnancy can be hard on one’s mental health

Many people think that pregnancy is just about what happens to a woman’s physical state. This is not true. Pregnancy also takes a significant toll on mental health. You face stress not only from what is happening within you, but also from what is going around you.

Feeling conscious about your body image is very common during pregnancy. This is especially true for the third trimester.
There is a lot of hormonal upheaval happening inside you. So you may experience mood swings such as irritation, sadness, unexplained anger and even crying spells.
Feeling dreadful and anxious during the third trimester is also common. There is just so much happening, and you are approaching the due date too! Overthinking and overanalyzing the future is natural to happen.
Some women experience a prolonged period of sadness during their third trimester. This can be due to prenatal depression.
Prenatal depression comes with symptoms of insomnia, moodiness, fatigue, and feelings of worthlessness. This condition is fairly common, with 13 percent of pregnant women experiencing it.

How to do mental health hygiene

Just like we take care of our body by doing personal hygiene, we can do the same for our mind. Mental health hygiene means taking out some daily time for yourself for your mental needs. This can be taking time for your hobbies or just having a ten-minute breather. We’ll tell you some easy ways you can do daily mental health hygiene.

Check if your basic needs are being met

Are you getting proper sleep?

A happy mind resides in a happy body. If you are not getting proper sleep and diet, it will reflect on your mental health. Make sure you get at least 7-8 hours of sleep during the night. Also, pay attention to what you are eating. Fatty and greasy food is likely to make you feel bloated. They also can trigger your inflammation and worsen any depressive symptoms you are having.

Give yourself positive affirmations

Give yourself positive affirmations

Having negative thoughts during the third trimester is common. Questions such as “Will I be a good mother?” or “Will my marriage change after pregnancy?” are bound to occur. Take time to stand in front of the mirror in the mornings/before bed and just admire yourself for at least five minutes. Repeat to yourself positive affirmations, and remind yourself that you are a gorgeous, strong, and powerful woman.

Be mindful of your emotions

Spend time with yourself and your baby

You will experience a myriad of emotions during your third trimester. While it is important you don’t overthink and overanalyze them, it is also important you manage them. One way you can do this is by being mindful of them. This means when you are experiencing intense emotion, say anger, you try to focus on ‘How’, not ‘Why’. By focusing on the reactions you are having, you can manage them into healthier outlets. But if you only think of ‘why I am feeling this way’, you may end up feeling more aggravated.

Meditate, exercise, relax

Join TME’s free Yoga sessions!

You can do many simple meditation exercises to help with intrusive thoughts and overthinking. Exercise is also a good way to release happy hormones like serotonin and dopamine. You can also relax without doing meditation and exercise. Hobbies are a great way to engage your mind in productive activities. Some hobbies you can consider are: learning a new language, yoga, or starting your blog!

Some more practical tips from TME mothers and experts

Journaling: Just get a small journal or a notepad and start detailing your days. You can also write about the things that are happening around you.
Mandala Art: Don’t let the pictures on the internet scare you! It is actually very easy to do. TME has special classes where you can learn it as well.
Knitting: Sounds old-fashioned, but it is great for grounding your intense emotions. You also get to make cute wearables for your soon-to-be-born baby!
Reading good books: TME has a curated book list that you can read in your free time.
Set a worrying time: You can assign 30 minutes of ‘worry time every day. In this time slot, you can focus on everything that makes you stressed. Outside this slot, try not to think about things that stress you outside that ‘worry time
Get ready for the baby’s arrival: Some women feel better if they are prepared – so read, join classes, and educate yourself about pregnancy, birthing, and postpartum. Like you are doing right now by reading TME’s curated blogs!

Where do I get help from?

With TME, you get hands-on community support right through your phone!

Besides going to a counselor, you can also join a peer community. Many Indian women find themselves isolated, especially in nuclear families. By joining a peer community, you can share your experience with similar pregnant women. You will also get to learn from experienced mothers who have gone through everything you are going through. One such community is our TME community, and get 24/7 support and resources for your third trimester. It is completely free to join, with peer-to-peer and expert support

Every pregnancy is unique and so are its challenges. Which is why you need someone who understands you and can support you along the way. Click Pregnancy Birth & Beyond to explore our tailored pregnancy care plan, offering expert guidance and continuous support throughout your journey.

Join Pregnancy Birth & Beyond

References

https://www.hopkinsmedicine.org/health/wellness
https://www.beaumont.org/conditions/prenataldepression
https://www.iberdrola.com/talent/mental-hygiene
Best Hobbies for Pregnant Women that Benefit Baby, Too!

How do I know If my baby’s Head is Engaged?

The Mom Experts — Mon, 20 Feb 2023 11:29:55 +0000

A baby’s head is said to be ‘dropped’ or engaged when it descends lower into your pelvis.
In medical terms, engagement of the head occurs when the largest diameter of the head, crosses the pelvic brim. It is a welcome sign, as labor can occur anytime soon.

How to know if the head is engaged?

Did you notice that your baby bump looks smaller than the previous day? Fret not, as this indicates that your baby might have just entered the lower pelvis.
The first sign of baby head engagement is a drop in the pregnancy belly. You may notice that your belly seems to have shifted downwards in the final weeks. This is mostly due to the head being engaged.

Another sign that most mothers will like is improved breathing. Your baby no longer impinges on your diaphragm, letting you breathe better.

It gets more difficult to walk for longer hours. Your waddling gait has also gotten less graceful than before.

As the baby descends lower into the pelvis, it presses on the bladder and rectum. This leads to frequent toilet trips and constipation.

You may notice an increased dull pain sensation in the lower back and pelvic region.

When does Head Engagement occur?

Every pregnancy is different in its own way.

There is no rule of thumb as to when the baby’s head should get engaged.

Mostly for first timers, the baby’s head engages in the last weeks of the third trimester. Ideally by 36- 37 weeks, but it can occur as early as 34 weeks as well. However, in subsequent babies, the head engages later in the third trimester and can occur even during labor.

Also note that both scenarios are perfectly normal. If the baby’s head is not engaged, it could also mean that it is a non-preferred position for delivery, like breech or occipito- posterior (back of the baby facing the mother’s spine).

Classes of engagement

Have you wondered what your Obgyn checks every time you enter their office in the last trimester? They check how much the baby’s head has descended into the pelvis based on how many fifths the baby’s head has dropped.

5/ 5: Head is within the abdomen, hence, not engaged
4/ 5 OR 3/ 5: The head is descending into the pelvis, but not engaged yet
2/ 5 OR less: Head is engaged

Tips for getting the baby’s head engaged sooner

Practice prenatal yoga

The baby’s head gets engaged in the last trimester of pregnancy. This depends on a lot of anatomical and environmental factors, including the baby’s size and amniotic fluid. However, here are some tips that help with the descent of the head.

Staying physically active by walking regularly. A brisk walk of 40- 60 minutes is proven to be beneficial
Practicing prenatal yoga – malasana, duck walk (under expert guidance)
Exercises that help align the pelvis – cat and camel exercises (especially, for breech babies)
Squats, but under your Ob-gyn’s consultation

How long will it take for labor to set in after engagement occurs?

Labor is fast approaching!

Babies have a mind of their own! So, it cannot be predicted with certainty when the engagement occurs and when labor starts. However, engagement only means that D- day is arriving.

Some women develop contractions and go into labor even before the head is fully engaged. The powerful contractions help the baby’s head to get engaged and also get delivered. However, if you notice other signs of labor, do consult your Obgyn immediately.

Conclusion

A baby’s head is said to be engaged when it drops lower down into the pelvis. This occurs in the last leg of 3rd trimester in most women, while in some it can occur even after the labor sets in. Once engagement occurs, the baby bump seems to descend lower and the out-of-breath feeling decreases.

Regular walks and prenatal yoga with pelvic stabilizing exercises help with the baby’s descent. Though it is neither a sign of labor nor a sign of impending labor, it is prudent to seek an Obgyn/ midwife’s consultation in the last trimester. This helps to know the status of the baby’s position and the degree of head descent.

Placental Abnormalities – How does it affect a Healthy Pregnancy

The Mom Experts — Mon, 20 Feb 2023 11:08:10 +0000

In This Article –

What is the importance of the placenta?

Placental abruption

Placenta accreta

Placental insufficiency

Retained placenta

Infarcts in the placenta

Placenta previa

Summary

What is the importance of the placenta?

A healthy placenta is vital for fetal development and uncomplicated childbirth. Under normal circumstances, a healthy, well-defined placenta attaches to the upper segment of the uterine lining, without obstructing the cervical opening, thus formulating an easy pathway for childbirth.

However, specific placental abnormalities in the anatomy and the position of the attachment in the uterus can render the placenta inefficient in performing its functions. These functions include nourishing the fetus and transmitting nutrients, oxygen, and antibodies through the umbilical cord.

1. Placental Abruption

The difference between an attached and detached placenta

In placental abruption, a partial or complete placenta separates from the inner walls of the uterus during pregnancy, before childbirth
Since the placenta detaches early from the uterus, the fetus is deprived of adequate nutrients and oxygen, leading to growth retardation in the fetus.
If the placental separation is detected, hospitalization and close monitoring are compulsory.
If the gestation has reached 34 weeks or above, then a planned C Section is carried out to remove the baby from the placental abrupted womb safely.
Emergency medical attention is needed to effectively handle severe blood loss and preterm delivery.

Symptoms

Heavy Vaginal bleeding, dark red in color, after 20 weeks of gestation.
Severe abdominal pain
Uterine contractions
Decrease in fetal movements
Nausea

Causes

Abdominal trauma
Uterine defects like tumors, fibroid
Maternal diseases like hypertension, and diabetes
Cigarette smoking
Abnormality like circumvallate placenta, where the placenta is thickened and spread over a smaller surface area along the uterine lining.

2. Placenta Accreta

How it looks from inside

Placenta attaches too deeply into the muscular layer of the uterine wall rather than the uterine lining. Therefore, separating the placenta from the uterus during labor is difficult.
Frequent ultrasounds and close monitoring by the obstetrician are needed. This is to control the excessive bleeding during labor and to avoid the risk of a hysterectomy (Removal of the uterus) because of a deeply invasive placenta.
Depending on how deeply the placenta has grown into the uterine wall, it is called either placenta increta (embedded on the muscle wall) or placenta percreta (grows into nearby organs).

3. Placental Insufficiency

Also known as uteroplacental vascular insufficiency. It is an uncommon but complicated condition where the placenta is not fully developed and doesn’t function well.
A malformed placenta with too thick or thin membranes, and improper blood vessels, will not be able to supply oxygen, and nutrients to the baby from the mother’s bloodstream.
Diagnosing an insufficiency is crucial to avoid the risk of vaginal bleeding in the mother during labor or birth defects in the baby post-birth.

Effects on the baby

Less fetal movements
Undernourished fetus
Low birth weight
Premature childbirth

Causes

Gestational Diabetes
Hypertension
Blood clotting disorders
Maternal Anemia
Unhealthy lifestyles, smoking, alcohol consumption

4. Retained placenta

Different types of retained placenta

Under normal circumstances, the placenta is expelled within 5 to 30 minutes of childbirth. But when a part or whole of the placenta remains trapped in the womb, this condition is called the retained placenta.
When left untreated, it can cause serious complications like infection and excessive blood loss in the mother.
When the uterus fails to contract enough to expel the placenta, it remains loosely attached to the walls. This is called placenta adherens.
Sometimes placenta detaches from the uterus but doesn’t leave the body, as the cervix closes too early. This is called the trapped placenta.
Immediate surgery is done to remove the remaining placenta from the womb if a retained placenta is detected in an ultrasound scan.

Symptoms

Fever in mother after childbirth
Foul-smelling tissue discharges from the vagina post-birth
Heavy vaginal bleeding
Severe abdominal pain

5. Infarcts in the placenta

Placenta has some areas of dead tissues, called infarcts. These dead tissues reduce the blood flow in those areas.
This improper blood flow to the fetus results in poor growth and inadequate development.
Pregnancy-induced hypertension is known to increase the number of infarcts within the placenta.

6. Placenta previa

Complete Placenta previa

This is a placental position abnormality, where a part or whole of the placenta covers the opening of the cervix during the last trimester.
Under ideal conditions, the placenta should be near the upper segment of the uterus, so that the entrance of the cervix (opening into the birth canal) is cleared for childbirth.
However, when the placenta is blocking the cervical opening, normal vaginal delivery is not possible.

Classifications based on the position of the placenta

Low-lying placenta – the placenta attaches within 2 cm from the cervical opening
Marginal placenta previa- Placenta borders the opening, but does not obstruct the cervix.
Partial placenta previa – Placenta slightly covers the cervix
Complete placenta previa – placenta covering the entire portion of the uterus into the cervix.

Symptoms

Light or heavy bright red-colored vaginal bleeding in the second trimester, usually after 20 weeks into gestation. Placental abruption too has to bleed around the same weeks but is categorized with heavier, dark red vaginal bleeding.
Uterine contractions and low pelvic cramps
Fetal infection, low growth rate.

Causes

Previous uterine surgeries cause scar tissue in the uterine cavity.
Bad lifestyle choices by the pregnant mother like smoking, and alcohol consumption.
Increased maternal age
Previous history of the low-lying placenta.

Effects

Placenta previa prevents the descent of the fetus into the birth canal during labor. Hence, a planned C-section delivery at 34 weeks or above is necessary.
Close medical monitoring is required to avoid the complications of premature labor and hemorrhage in the mother.
Even though placenta previa blocks the baby’s way out in labor, it doesn’t restrict fetal growth or movement in any stage of pregnancy

Treatment

There is no cure for placenta previa. Early diagnosis, few precautions on lifestyle modifications, and restrictions on strenuous physical activity are how placenta previa is managed throughout the pregnancy.
Suggested lifestyle changes include
right amount of rest
refraining from physical activities like exercise, lifting weights, and jogging.
In case of severe bleeding, hospital admission is needed for emergency medical care and blood transfusions
Good sleep position, providing pelvic rest, and avoiding any uterine triggers like sexual intercourse can help manage placenta previa
Frequent monitoring of the mother’s and baby’s vitals through ultrasound scans is needed.

Summary

Throughout the pregnancy, the placenta grows and changes shape. Vaginal bleeding in the second and third trimesters is the most common sign of an underlying placental abnormality. Abdominal pain, uterine contractions, and severe back pain together with low fetal movements require immediate medical attention. Treatment depends on the severity of the placental disorder, gestational age, and maternal health. Early diagnosis helps to have a better understanding of the risk involved and plan a c-section well in advance.

References

https://medlineplus.gov/ency/article/000900.htm
https://www.babycentre.co.uk/a830/low-lying-placenta-and-placenta-praevia
https://www.webmd.com/baby/what-is-placental-abruption
ttps://www.medicalnewstoday.com/articles/324554

Fetal Movements

The Mom Experts — Mon, 20 Feb 2023 10:40:13 +0000

Feeling your baby move inside you is the most awaited and exciting part of your pregnancy journey. Fetal movements are a positive indication that the fetus is growing well in size and strength inside the mother’s womb.

In This Article –

What is fetal movement?

When will you start to feel your baby move?

How does baby movement feel at different stages of gestation?

How often should you feel the baby’s movement?

Why are you not feeling your baby move?

How to count a baby’s kicks?

How important is your baby’s movement for a healthy pregnancy?

When to raise a concern?

What Is Fetal Movement?

Baby’s movement inside the womb stimulates muscle growth and development, the flexibility of joints, shaping and strengthening of bones, and also helps in the development of the central nervous system.
Starting with subtle flutters and feeble squirms, these fetal movements eventually progress into well-defined, distinct full-blown kicks.
As your pregnancy progresses, you get to familiarise yourself with the pattern of your baby’s movements and pick out any cues of change in your baby’s movements.

When Will You Start To Feel Your Baby Move?

The very first signs of the baby’s movements are normally felt by the mother around 18 to 24 weeks of gestation.
For the first-time mother, it may take around 20 weeks or above to recognize these subtle movements of fluttering called quickening.
Experienced mothers can recognize baby movements as early as 16 weeks.
Don’t panic if you haven’t felt any recognizable movement for 20 weeks. Wait for a few more weeks. Reach out to an obstetrician if you reach 26 weeks without any feeling of baby movement.

How Does Baby Movement Feel At Different Stages Of Gestation?

The type of baby movement you feel varies with the stage of their development. Let’s see how those kicks feel at different weeks in your pregnancy journey.

Fetus at 9 weeks

At 9 weeks – It is unlikely for the mother to feel any fetal movements as early as nine weeks. But, your baby’s limbs are moving together as a single unit, and are visible in ultrasound scans.
At 13 weeks – The baby is moving his arms and legs separately, kicking and responding to skin touch. Even now, your baby is too tiny and deeply cushioned inside the comfort of your womb, making it difficult for you to recognize any of those movements.
At 16 to 20 weeks – During these weeks, you may be able to feel a fluttering, swishing, rolling, tumbling sensation or a tiny kick. This is quickening. Usually, women have registered this early sensation as “Butterflies fluttering in the tummy”, “Goldfish swimming”, “popcorn popping’ and ‘ hunger pangs”.
At 25 to 32 weeks – The gentle kicks, fluttering, and slow squirming movements change into more distinct, sporadic, stronger, sharper kicks. By this time, there is plenty of space for your baby to move around as your womb is filled with an ample amount of amniotic fluid. These movements are definitive and form a pattern or rhythm.

Fetus at 32 weeks

At 32–35 weeks – The movements are maximum around 32 weeks, then get slower but more powerful. As the baby grows, he takes up space in the uterus and his movements are restricted due to confined space.
At 36 weeks and above – By this time, you may feel more rolls and stretches than kicks and punches. This character change in movement is because of limited space availability in the uterus. The baby shows a bicycling movement of both feet called stepping, as he is getting ready for labor.

How Often Should You Feel The Baby’s Movement?

An active baby is a healthy baby

Remember, an active baby is a healthy baby. Movements in your baby are similar to exercising to promote healthy bone and joint development. There is no fixed rule or formula to define a baby’s movements and conclude it as “normal”. Just as every pregnancy is unique, every baby has an activity routine of his own. However, as the pregnancy progresses, you will be able to get an understanding of your baby’s routine. When this pattern is set, any slight change in the baby’s activity can be easily picked up by the mother.

Why Are You Not Feeling Your Baby Move?

Your scan reports indicate right fetal activity, But still, you are not able to feel it yourself. That’s normal in certain circumstances.
Usually, first-time mothers begin to recognize quickening only after 20 weeks and above. That’s because of a lack of experience in pinpointing those faint, subtle fluttering sensations or because of the tight abdominal muscles.
Certain drugs, smoking, and alcohol sedate the mother and fetus, thus making the movements not easily realizable by the mother.
Low amniotic fluid during the early stages of gestation is another reason that prevents the mother from feeling fetal movement
The anterior placenta, where the placenta lies in the front wall of the womb, may act as a cushion-like barrier and absorb the impact of the baby’s movement.

How To Count A Baby’s Kicks?

Talk to your baby, sing, and keep it as a bonding time with your baby.

Kick counts are a valuable tool for monitoring a baby’s health. It is normally done every day at the same time, after 28 weeks of gestation, preferably.
Choose a time when you are least distracted. Get into a comfortable resting position. Either lie down on your left side or sit stretched with your legs popped up.
Slowly relax your breath and concentrate on your baby. Keep your hands over your belly. Count your baby’s activity. It could be stronger pushing, kicking, or shallow squirming or any slightest movement the baby makes needs to be noted. As a thumb rule, note how many movements the baby makes in an hour. An average of ten movements per hour can be taken as a counting benchmark.
If you are not able to feel at least ten movements around an hour or so, then try having a quick snack, sipping some water, lying on your side, and trying to count the baby’s activity again.
Remember, kick-counting shouldn’t make you stressed. When you are familiar with the pattern of a baby’s movement, counting kicks could be a fun activity to do every day. Talk to your baby, sing, and keep it as a bonding time with your baby.

How Important Is Your Baby’s Movement For A Healthy Pregnancy?

Baby’s movements are also a way in which your baby communicates with the world outside. Generally around 20 weeks, most fetuses have a biologically timed rhythmic activity. Regular movements are an indication of a baby’s well-being. But, if there is a sudden change in pattern, it’s an early sign of distress.

The baby’s movement gives clues about the baby’s position from where the kicks are felt. Head down, babies kick stronger on one side and towards the top of the bump. Breech babies with feet below will kick at the bottom of your bump.
Some factors for decreased fetal movements are intrauterine growth retardation (IUGR), Fetal growth restriction (FGR), and Small for gestational age (SGA) babies. These conditions need more detailed medical interpretation.

When To Raise A Concern?

A change in your baby’s usual movement can indicate an underlying concern, especially in the third trimester. When you have doubts about kick counts and realize your baby is more inactive, not responding to any stimuli, immediate medical intervention is appropriate.

Remember, there is no other advanced scientific screening technique than a mother’s instincts. It is honest and strong, and never ignores it. If you perceive any significant change in your baby or if simply your gut instincts say so, just follow it- Get medical care immediately.

Concerned about monitoring your baby’s movements? Gain valuable insights from our experienced gynecologist. Explore further by clicking Pregnancy Birth & Beyond programme for expert guidance and information.

Join Pregnancy Birth & Beyond

References

https://www.ncbi.nlm.nih.gov/books/NBK470566/
https://www.babycenter.com/pregnancy/your-baby/fetal-movement-feeling-your-baby-kick_2872
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0922-z
https://www.freepik.com