A. Probably not that good, given the parameters you describe. That said, however, if you can get past 28 weeks the chances for an acceptable outcome are reasonably good, given the fantastic strides that have been made in neonatal care in the past couple of decades. It sounds like you are getting excellent care at this point. Just continue to have a low threshold for going into the hospital if you begin to detect contractions and/or a decrease in your baby’s kicking activity. This will give your doctors a better chance of preventing premature birth.
A. Certainly, it’s not a sign that anything’s wrong with the pregnancy or with you. The most likely explanation is that what you’re seeing is a reduction in the size of your stomach as a result of digestion which has occurred in the 10 or 12 hours since you last had anything to eat. During the day, your uterus presses your full stomach upwards, but by the next morning, most of that fullness is gone.
A. If you remain at rest, there’s a good chance that this will resolve on its own. However, placental abruption, as this is called, is potentially dangerous, so you need to watch closely for increasing bleeding or abdominal pain.
A. It is almost unheard of for this sort of event to cause any problems with the baby as it is extremely well protected by amniotic fluid. In the unlikely event that something dangerous has happened, it is essentially certain that your water would have broken or bleeding would have happened. If you’re still worried about this (and it is, after all, a mother’s job to worry about her children), you can have your doctor’s office listen for the heartbeat.
A. What your doctor likely meant was that your cervix is reddened. What this means is simply that the hormonal changes of pregnancy have caused the part of the cervix that is normally confined within the cervical canal, to grow out onto the visible part of the cervix, a process we call eversion. It is normal and harmless and would not cause pain. A tipped uterus is not unusual, but, in most cases, it should be starting to straighten out by now. Your doctor will want to be sure that happens in the next three to four weeks, as there are some rare but serious implications of an advancing pregnancy with the uterus “trapped” in that position.
A. Fetal position does have a big impact on the ability to see small items like heart chambers. Another sonogram in a week or two should be able to resolve this fairly common issue.
A. This could be an urgent situation. When the cervix dilates painlessly in the second trimester, that is a condition called an “incompetent cervix.” If it is detected in time, a suture can be placed around the cervix so as to hold the pregnancy until term, at which time it is removed to permit labor and birth. If the information you are providing is correct, this matter needs to be discussed ASAP with your OB.
A. This sounds quite suspicious for a digestive condition called acid reflux, which is fairly common in pregnancy. It is usually quite easy to treat nowadays. It is a nuisance, but not dangerous. Bring it to your doctor’s attention at your next OB visit.
A. There is nothing any more abnormal about a baby tilting its head back than for you to do so. Remember that a sonogram is just a momentary view during which a fetus can assume any position.
A. Yes, it is. This just means that your baby’s head measurements are in the 60th percentile; in other words, very slightly larger than average, but certainly not reflecting anything abnormal.
A. Yes, you should. Fluid leaking from the vagina means that the membranes have ruptured until proven otherwise. This raises a number of serious dangers, including infection and premature birth. Be sure your doctor is notified immediately about these symptoms.
A. At 22 weeks a visible bag of waters is a clear indication of what we call an incompetent cervix, the only treatment for which is cerclage. A pessary will perhaps make you feel more comfortable, but will not reduce the risk of an extremely premature birth. So, my advice is to have the cerclage. In qualified hands the risk of rupture of membranes should not be more than around 5%.
A. I’m concerned as well. Prenatal appointments are never supposed to be less than every four weeks. In this situation, I’d want to get another ultrasound by 24 weeks at the latest. By the way, I don’t know if anyone has advised you to have an amniocentesis, but if they do, you really needn’t worry much about miscarriage. It’s extremely rare following that procedure and a lot of important information can be gained by it.
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