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Hey baby

Thursday, November 03, 2016

Worried about your pregnancy going all the way to extra innings? Kripa Kataria tells you what you need to know about passing your pregnancy due date and the after effects

Right when you’re reaching your due date, you’re bombarded by phone calls. Concerned friends and relatives want to know if you’re feeling uncomfortable, whether you’re in pain and if you’re absolutely sure you’re not in labour yet. So, it’s not surprising that when your due date has come and gone and you’re still waiting for those contractions, you’re going to be a little worried. However, ignore the well meaning advice and listen to your doctor. And, if you’re still worried, here are a few things you should know about late deliveries.

“EDD (estimated due date) is calculated by adding 280 days (40 weeks) to the first day of your last menstrual cycle (assuming that you have a 28-day cycle). On average, only 5% of births take place exactly on the estimated due date. Most babies are born within a week (either side) of the estimated due date. A normal pregnancy can last anywhere between 37 and 42 weeks,” says Dr. Sonali Gaur, MD of Obstetrics & Gynecology at Nanavati Super Speciality Hospital. However, some women can’t remember the first day of their last period (we suggest getting a smartphone application to help out here) or aren’t exactly sure when they conceived. So, ultrasound images are used to help with the age of the embryo or foetus. However, the results aren’t always accurate. They are, as it is generally referred to, an educated guess, or a ‘guesstimate’. The most common cause of post-term pregnancy is an error in calculating the due date.

Dr. Bandita Sinha, gynaecologist and obstetrician at Fortis Hospital & Apollo Clinic in Navi Mumbai, tells us, “The reasons for an overdue pregnancy are not always clear. However, when you’re some way past your due date, several changes occur in your body. Placental and hormonal functions are already prepared for delivery, but if a woman does not go into labour within the stipulated time, there could be complications. These imbalances increase the risk for both the mother and the child. According to biology, all placental and hormonal changes are meant to work only up to 40 weeks. After 40 weeks have passed, your body will begin to reduce the work it does to nourish the baby, whether the mother has delivered the child or not.” So there is always a risk involved if you are overdue. However, there may not be any real cause for concern. Consult your doctor for proper medical advice.

Recent research has shown that post-term delivery may come with certain risks. The placenta is the link between the mother and the baby. Post-term infants are at higher risk of problems related to glucose metabolism, which can lead to increased birth weight. They are also at higher risk of inhaling meconium (faecal waste); this can cause breathing problems or infection at birth. Dr. Sonali explains, “Prolonged pregnancy is associated with foetal, neonatal and maternal complications. After 42 weeks, the placenta may not work as well as it did earlier during the pregnancy. Also, as the baby grows, the amount of amniotic fluid (liquid surrounding the baby) may begin to decrease. There is also a higher risk of meconium aspiration and cesarean delivery. So, your doctor may advise induced labour if you’re well past your due date.”

Artificial labour or induced labour is when the mother is medically made to go into labour if the doctor thinks that it is safer for the baby to be born rather than to continue with the pregnancy. Many obstetricians induce labour when they are certain that a pregnancy is past 41 weeks and the cervix is ready, or even sooner if there are complications. They may also choose to perform tests once or twice a week until labour begins, to find out whether your baby is healthy in your uterus.

A prolonged pregnancy isn’t always a sign that your baby wants to stay there longer, or that the baby is comfortable if it’s kicking a little less. If you’re past the 42-week mark, you should visit your doctor. “The most important thing to look out for is movement. The kick count is important; this can be tracked on your own and at home. A kick count is a record of how often you feel your baby move. Healthy babies tend to move about for the same amount of time every day. If you think your baby has been moving less, you need to see your doctor to get it checked. They will then run tests such as electronic foetal monitoring to make sure that everything is alright.

Dr. Sonali suggests looking out for these signs of post-dated pregnancies:

  •  There may be a reduction in foetal movement before your delivery.
  •  A reduced volume of amniotic fluid may cause a reduction in the size of the uterus.
  •  Meconium-stained amniotic fluid may be seen when the membranes have ruptured, which is indicated by leaking of a green liquid.
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