Sujivan clinic & day care

Hello!

I am Dr. Gunjan Bhola. Today we are going to discuss decreased fetal movements. Usually, this is the main notion as many patients are not able to perceive movements or if they perceive movements then they are not able to check whether the movements are adequate or not. Movements are usually felt after 28th week of pregnancy and the movement of the baby increases and it reaches a plateau stage at 32 weeks and then it remains almost the same. There is a myth that as the baby grows the movements decreases. But it is not so. Usually, when the person is walking the movement felt by the mother are less as compared to when she lies down or she is in a quiet environment. While she is busy the movements are perceived less. So it is taken as if the movements are less during the day and more during the evening or night. Why fetal movements are important?

They are important because you are supposed to keep a track of them whether the movements are there or not. You don't need to really count them but the movement should be there throughout the day in a regular pattern which has been previously felt. If there are no movements or decreased movement after 28 weeks you need to tell your doctor about it and you might need to come to the hospital. You might need to get your heartbeat checked. If there is any problem in the heartbeat or if the mother has some other risk factors associated like if the age of the mother is more than 40 or it is less than 18 or there is a history of diabetes, hypertension or it is the history of decreased growth of the babies. These are few of the risk factors in which there are chances that the movements can be decreased and then we need to monitor that the baby is growing fine and there is no other risk factor for the baby. Usually, these movements are seen on a CTG also.

CTG is a continuous topograph in which we take a trace of the baby's movement. Any changes related to the heartbeat with movement- increase in heartbeat seen or decrease heart rate seen with the movements is taken and it is evaluated for a span of 20 minutes whether the baby is fine or is there any problem. Movements can cause an increase in heart rate in the baby and it is seen on the CTG that it is healthy or not. We need to have an ultrasound done to rule out the problem and to see whether the water volume is okay around the baby. Usually, after all these things the woman is reassured and the woman is told that she needs to keep a close follow up. Otherwise, if this is only one episode of decreased fetal movement, she can be assured that there are no other risk factors associated so she can relax. If this pattern repeats, if she has repeated episodes of decreased fetal movements then it needs to be evaluated further to see whether the baby has achieve maturity and every everything is normal. If there is any problem then the suitable action regarding the delivery or if she requires, an urgent C-section has to be taken.

Thank you!

Hi,

I am Dr. Gunjan Bhola, Gynaecologist. I have 15 years of experience. Today I will discuss fibroids. They are a kind of benign tumors in the uterine wall. There are different types of fibroids. Fibroids represent as heavy bleeding, pain in the lower abdomen and it can be a cause of infertility. The size of the fibroid as important as the location of the fibroid. If a patient has the pain in the lower abdomen, we usually advise them to get an ultrasound done. In a married patient, we advise a transvaginal scan because we want to see the size of the fibroid, location, is it affecting the endometrial cavity or not. What other changes like whether it is single or multiple.

The fibroid which is growing outside basically labeled as subserosal. It can grow in a bigger size without causing any symptom. But the risk is if they grow in size then it might have to be removed. Today, we have the option of medical treatments with fibroids. They are successful but still conflicting report is there. The usual fibroids are a benign tumor and they don't have any malignant transformation. There is only a 1% chance of any cancer association. But because of another symptom, they might have to be removed.

Thank You.