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Bismillah... pg td ade check up dgn pakar HPJ Doc Hashliena.. Alahai... AFI melebihi 10... GOOD... CTG Reactive... GOOD... RI - 0.65... GOOD... PI - 1.01... GOOD..

Doc Hash : Ok Zuriani... masuk was Ahad nti (24.3.2013) then esoknye kite pecahkan ketuban (35wks 6dys)...

Haku : Hrmm.. doc bleh x sy nk masuk 25hb? Sy nk p sopink bj bby dlu...

Doc Hash : Awk dtg dlu kite buat CTG then tgk camne eh?

Haku : Ok (x bestnye!)

p/s : x smpat la nk sopink utk NB bby nie gamaknye.. haish...

Low amniotic fluid (oligohydramnios)

What is amniotic fluid?

Amniotic fluid fills the sac surrounding your developing baby and plays several important roles:

Video

Inside pregnancy: Weeks 15 to 20

 

A 3D animated look at a baby in the second trimester of pregnancy.

 

• It cushions your baby to protect him from trauma (if you take a tumble, for instance).
• It prevents the umbilical cord from becoming compressed, which would reduce your baby's oxygen supply.
• It helps maintain a constant temperature in the womb.
• It protects against infection.
• It allows your baby to move around so that his muscles and bones develop properly.
• It helps the digestive and respiratory systems develop as your baby swallows and excretes it and "inhales" and "exhales" it from his lungs.

Where does amniotic fluid come from?

During the first 14 weeks of your pregnancy, fluid passes from your circulatory system into the amniotic sac. Early in the second trimester, your baby starts to swallow the fluid, pass it through her kidneys, and excrete it as urine, which she then swallows again, recycling the full volume of amniotic fluid every few hours. (Yes, this means that most of the fluid is eventually your baby's urine!)
So your baby plays an important role in keeping just the right amount of fluid in the amniotic sac. Sometimes, though, this system breaks down, resulting in either too much or too little fluid – both of which can present problems.

How much amniotic fluid should I have?

Under normal circumstances, the amount of amniotic fluid you have increases until the beginning of your third trimester. At the peak of 34 to 36 weeks, you may carry about a quart of amniotic fluid. After that, it gradually decreases until you give birth.
When there's too little fluid at any point in your pregnancy, it's called oligohydramnios. (When there's too much, it's called hydramnios or polyhydramnios.

How will I know if I have low levels of amniotic fluid?

Your practitioner may suspect this problem if you're leaking fluid, measuring small for your stage of pregnancy, or not feeling your baby move very much. She may also be on the lookout for it if you've previously had a baby whose growth was restricted; if you have chronic high blood pressure, preeclampsia, diabetes, or lupus; or if you're past your due date.
To find out what's going on, your practitioner will send you for an ultrasound. The sonographer will measure the largest pockets of amniotic fluid in four different sections of your uterus and add them together to see where you rate on the amniotic fluid index (AFI). A normal measure for the third trimester is between 5 and 25 centimeters (cm). A total of less than 5 cm is considered low.

What could be causing this problem?

Experts don't always know what causes low levels of amniotic fluid. It's most common late in the third trimester, particularly if you're overdue. The later in pregnancy the condition develops, the better the outlook for your baby. Here are some of the most common causes:
Leaky or ruptured membranes
A small tear in your amniotic membranes can allow some fluid to leak out. This can happen at any point in your pregnancy, but it's more common as you approach delivery. You may notice the leaking fluid yourself if you find that your underwear is wet, or your practitioner may discover it during an exam. (Let your practitioner know if you suspect your amniotic fluid is leaking.)
A ruptured membrane can increase the risk of infection for both you and your baby because it provides a way for bacteria to enter the amniotic sac. Occasionally, a tear in the sac will heal on its own, the leaking will stop, and the fluid level will return to normal. (This is usually the case if the leaking happens after an amniocentesis.)
Placental problems
A problem with your placenta, such as a partial abruption, in which the placenta peels away from the inner wall of the uterus, can lead to low levels of amniotic fluid. If the placenta doesn't supply enough blood and nutrients to your baby, he will stop producing urine.
Certain medical conditions
As mentioned above, certain conditions — such as chronic high blood pressure, preeclampsia, diabetes, and lupus – can result in low amniotic fluid levels.
Carrying twins or multiples
You're at risk for low fluid levels if you're carrying twins or multiples. Oligohydramnios is likely in the case of twin-to-twin transfusion syndrome, in which one twin has too little amniotic fluid while the other has too much.
Fetal abnormalities
If you're found to have low levels of amniotic fluid in your first or second trimester, it may mean that your baby has a birth defect. If his kidneys aren't there or aren't developing properly or his urinary tract is blocked, your baby won't produce enough urine to maintain the level of amniotic fluid.

What will happen if I'm diagnosed with oligohydramnios?

If you have low levels of amniotic fluid, your caregiver will follow your pregnancy closely to be sure your baby continues to grow normally. How your pregnancy will be managed depends on how far along you are, how your baby's doing, and whether you have other complications.
If you're near term, labor will be induced. In some cases, you may need to have your baby early – if you have severe preeclampsia or your baby isn't thriving in the womb, for instance.
In any case, your baby will monitored very closely with frequent ultrasounds and nonstress tests, as well as biophysical profiles and possibly Doppler studies. You'll be asked to drink plenty of fluids, do fetal kick counts, and let your caregiver know immediately if you notice your baby becoming less active.
Low levels of amniotic fluid can make complications during labor more likely. The main concern is that the fluid level will get so low that your baby's movements or your contractions will compress the umbilical cord.
During labor, your practitioner may pass a flexible catheter through your cervix so that she can pump a steady stream of warm saline solution into the amniotic sac to reduce the risk to the cord. If your baby can't safely tolerate labor, your doctor or midwife will recommend a c-section.

Sumber : www.babycenter.com

Intrauterine Growth Restriction (IUGR)

Intrauterine growth restriction (IUGR) refers to a condition in which an unborn baby is smaller than it should be because it is not growing at a normal rate inside the womb.
Delayed growth puts the baby at risk of certain health problems during pregnancy, delivery, and after birth. They include:

• Low birth weight
• Difficulty handling the stresses of vaginal delivery
• Decreased oxygen levels
• Hypoglycemia (low blood sugar)
• Low resistance to infection
• Low Apgar scores (a test given immediately after birth to evaluate the newborn's physical condition and determine need for special medical care)
• Meconimum aspiration (inhalation of stools passed while in the uterus), which can lead to breathing problems
• Trouble maintaining body temperature
• Abnormally high red blood cell count

In the most severe cases, IUGR can lead to stillbirth. It can also cause long-term growth problems.

Causes of Intrauterine Growth Restriction

IUGR has many possible causes. A common cause is a problem with the placenta. The placenta is the tissue that joins the mother and fetus, carrying oxygen and nutrients to the baby and permitting the release of waste products from the baby.
The condition can also occur as the result of certain health problems in the mother, such as:

• Advanced diabetes
• High blood pressure or heart disease
• Infections such as rubella, cytomegalovirus, toxoplasmosis, and syphilis
• Kidney disease or lung disease
• Malnutrition or anemia
• Sickle cell anemia
• Smoking, drinking alcohol, or abusing drugs

Other possible causes include chromosomal defects in the baby or multiple gestation (twins, triplets, or more).

IUGR Symptoms

The main symptom of IUGR is a small for gestational age baby. Specifically, the baby's estimated weight is below the 10th percentile -- or less than that of 90% of babies of the same gestational age.
Depending on the cause of IUGR, the baby may be small all over or look malnourished. They may be thin and pale and have loose, dry skin. The umbilical cord is often thin and dull instead of thick and shiny.
Not all babies that are born small have IUGR.

IUGR Diagnosis

Doctors have many ways to estimate the size of babies during pregnancy. One of the simplest and most common is measuring the distance from the mother's fundus (the top of the uterus) to the pubic bone. After the 20th week of pregnancy, the measure in centimeters usually corresponds with the number of weeks of pregnancy. A lower than expected measurement may indicate the baby is not growing as it should.
Other procedures to diagnose IUGR and assess the baby's health include the following:
Ultrasound. The main test for checking a baby's growth in the uterus, ultrasound involves using sound waves to create pictures of the baby. The ultrasound exam lets the doctor see the baby in the uterus with an instrument that is moved over the mother's abdomen.


Ultrasound can be used to measure the baby's head and abdomen. The doctor can compare those measurements to growth charts to estimate the baby's weight. Ultrasound can also be used to determine how much amniotic fluid is in the uterus. A low amount of amniotic fluid could indicate IUGR.
Doppler flow. Doppler flow is a technique that uses sound waves to measure the amount and speed of blood flow through the blood vessels. Doctors may use this test to check the flow of blood in the umbilical cord and vessels in the baby's brain.
Weight checks. Doctors routinely check and record the mother's weight at every prenatal checkup. Weight gain in the mother can be used to measure the growth of her unborn baby. If a mother is not gaining weight, it could indicate a growth problem in her baby.
Fetal monitoring. This test involves placing sensitive electrodes on the mother's abdomen. The electrodes are held in place by a lightweight stretchable band and attached to a monitor. The sensors measure the rate and pattern of the baby's heartbeat and display them on a monitor or print them.
Amniocentesis. In this procedure, a needle is placed through the skin of the mother's abdomen and into her uterus to withdraw a small amount of amniotic fluid for testing. Tests may detect infection or some chromosomal abnormalities that could lead to IUGR.

IUGR Treatments

The best way to manage IUGR depends on the severity of growth restriction and how early the problem began in the pregnancy. Generally, the earlier IUGR begins and the more severe it is, the greater the risks to the unborn baby. Careful monitoring of a fetus, using tests such as ultrasound, Doppler flow, and fetal monitoring, may be helpful.
Although it is not possible to reverse IUGR, the following may help slow or minimize the effects.

• Improving nutrition. Some studies have shown that increasing the mother's nutrition may increase the baby's weight gain and growth in the uterus.
• Bed rest. Whether in the hospital or at home, bed rest may help improve circulation to the fetus.
• Delivery. If IUGR puts the baby's health at danger, the doctor may decide to deliver the baby early. If the doctor believes the baby is too weak for the stresses of labor and delivery, or if the baby has problems during labor, a cesarean section (C section) may be safer.

Preventing Intrauterine Growth Restriction

Although IUGR can occur even when a mother is perfectly healthy, there are things mothers can do to reduce the risk of IUGR and increase the odds of a healthy pregnancy and baby.

• Keep all of your prenatal appointments. Detecting potential problems early allows you treat them early.
• Be aware of your baby's movements. A baby who doesn't move often or who stops moving may have a problem. If you notice changes in your baby's movement, call your doctor.
• Check your medications. Sometimes a medication a mother is taking for another health problem can lead to problems with her unborn baby.
• Eat healthfully.  Healthy foods and ample calories help keep your baby well nourished.
• Get plenty of rest. Rest will help you feel better and it may even help your baby grow. Try to get eight hours of sleep (or more) each night. An hour or two of rest in the afternoon is also good for you.
• Practice healthy lifestyle habits. If you drink alcohol, take drugs, or smoke, stop for the health of your baby

Copy n paste from  http://www.webmd.com/

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Bismillah... nk main taip2 pn malas.. dtg keje pn setakat lepaking jer... x larat nk buat keje berat... duduk surf tenet je la... cukup time punch out blik umh... rest.. rest.. n rest.. utk entri ni aku rase malas sgt nk share kenape aku kene warded lame2 gtu but entri berikut akan menperjelas semuanya! slmt mentelaah!