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Dr. Lawrence
Dr. Lawrence, OB/GYN
Category: OB GYN
Satisfied Customers: 853
Experience:  Board Certified OB/GYN and accomplished educator
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Hi, I am 34 weeks pregnant. This is my 5th pregnancy. My 3rd

Resolved Question:

Hi, I am 34 weeks pregnant. This is my 5th pregnancy. My 3rd pregnancy ended at 32 weeks when the babys heartbeat stopped for no known reason. The other 3 children are well and healthy. I am an expat in saudi. I am under a high risk specialist. The foetal heart tracing is being done twice a week and was fine. I am also seeing the consultant twice a week and she does a doppler scan. She told me that the cord is short and so not always easy to find. The SD ratio was 4.9 and 3.9 consistently, then last week it was 4.4, not sure on other reading. My blood glucose was a little high. Fasting 84, after 1 hr 193, after 2 hrs 196, after 3 hrs 164. The doctors didnt say anything about it but i am self monitoring and have changed my diet. Otherwise blood pressure is fine (110/70). The doctors here, are saying they will not let me go full term but induce me at 36-37 weeks. They follow an american system, and have high rate of c-sections. I dont know how much i can trust their opinion, as in my fourth pregnancy they wanted to induce me at 37-38 weeks without cause.
Submitted: 3 years ago.
Category: OB GYN
Expert:  Dr. Lawrence replied 3 years ago.
Dr. Lawrence :

Hello, and thank you for your question. I will be happy to assist you. Answers are for educational purposes only.

Dr. Lawrence :

Let me read your question carefully/

Dr. Lawrence :

Your 3 hour sugar test is high.

Dr. Lawrence :

Check your sugars 4 times a day.

Dr. Lawrence :

Fasting - keep less than 100

Dr. Lawrence :

2 hours after each meal....shoot for less than 120.

Dr. Lawrence :

If higher, then you may need stricter diet and therapy.

Dr. Lawrence :

In regard to timing of delivery....if anything with the testing changes, then it is reasonable to move forward with delivery.

Dr. Lawrence :

If everything is good, then inducing early is not a problem...however, you should have an amnio to test for lung maturity.

Dr. Lawrence :

Most likely everything will be fine after 36 weeks, but if the testing is good, then checking for lung maturity before delivery would be ideal.

Dr. Lawrence :

Testing for lung maturity is easy to do with an amniocentesis. The risk is very low.

Dr. Lawrence :

The upside is high.

Dr. Lawrence :

Please let me know if you have any questions and I will be happy to answer them.

Dr. Lawrence :

Best of luck.

Dr. Lawrence :

Please click on excellent service.

Dr. Lawrence :

Thank you.

Customer: replied 3 years ago.

If there is no change then I would prefer to go full term, is that ok?

Also, I would have expected the baby's movements to be reduced if the cord was short, but movements are regular and good.

What is the highest SD ratio before an absence of flow is seen? An induction would be neeeded if the SD ratio is absent or reversed?

Expert:  Dr. Lawrence replied 3 years ago.
The baby should still have mobility. You could go to term as long as you continue the testing and know that it is not foolproof. Changes can occur in the intervals between testing. The testing just provides reassurance moving forward, but does not predict or prevent events like what you experienced in the past. Absent end-diastolic velocity (AEDV) is an ominous finding and reversed end-diastolic velocity (REDV) should be interpreted as a preterminal finding
Customer: replied 3 years ago.

Thank you Dr Lawrence , this information is very helpful.

What is the highest SD ratio before?could you give me a range of values for normal, high etc and how it should change in the next few weeks

The dr wants to induce me at 37weeks even without any change in testing, I want to resist. IF there is no change then I'd like to go full term. If I resist is there any risk, as long as there is no change in sd and foetal heart rate.

Expert:  Dr. Lawrence replied 3 years ago.
Truth be told, an S/D ratio >3.0 or RI >0.6 at ≥28 weeks of gestation is the best threshold for identifying pregnancies at high risk of adverse outcome.
I understand where both of you are coming from. I think that there is probably common ground there, especially if you consider fetal lung maturity testing.
The potential risk of waiting until term is another demise. Just be aware of that if you decide to proceed in that manner.
I am sure that it won't happen, but that is the potential risk of waiting too long.
Dr. Lawrence and other OB GYN Specialists are ready to help you
Customer: replied 3 years ago.

Thank you, ***** ***** helped. I would like to walk, say 20 minutes a day, is that ok or will it reduce the flow to the baby further? How much walking can I do per day?

Thanks for all your time.

Expert:  Dr. Lawrence replied 3 years ago.
Exercise is good for you and the baby. No specific limit as long as you feel good