I begin with - Al fateha

Thursday, September 4, 2008

24 Weeks check Up...

Alhamdullilah, I just had my 24th week check up.

That means I should be around 6mths pregnant. Baby moves well and growing well.

So cute seeing Adik in the scan. Adik seems independant. Its just my instinct. Adik looks adorable and Adik must be super sweet cos Ive been told my sugar level is high ! haha....

Water bag didnt leak which was my major concern since I had a bad cough a few weeks ago, However, again DR Heng says water level still looked too much and recommends me the same advise such as more rest and less sweets.

Hubby was NOT there for me during the check up as he was caught out with work. Only Allah (swt) knows how I felt when I saw all the other couples with their hubbys next to them. I felt so alone..so alone with adik. I felt as if only I am happy with this pregnancy. I felt like protecting adik, but I dont know how I was going to do that.
Me is an Emotional Mummy. I tried to distract these thoughts by doing zikrullah.

Its the month of Ramadhan, hubby is caught up with solat Terawih. I cant blame him.
Its seems, I seldom get a chance to sit and talk to him. By the time he comes back from Terawih, I am already asleep. I dont know how to tell him. I dont know if he will understand or just tell me to tawakkal.
I wish to write him a letter, explaining my condition but Im too busy with work. Very Tired with work.

At this point, my only confidante is Ummu Mukhtaar. Last night, alone while it rained outside, I recited Surah Maryam while exchanging smsed with her.
Today, She has sent me some links on my condition. It may be called Polyhydramnios.

Its can get really serious, and the more I read, the more scared I feel !! ( maybe I should stop reading these things cos it really makes me more worried ...why didnt my gynea mention any of this to me ? All she said was sugar level, premature labour, rest.....)

My water level last checked was 20.2cm. It says hear that Polyhydramnios is around 24cm. So does that mean Im at the mild end ?

I do suffer alot of the symptoms like breathlessness and tummy that is so thight, it stretches and is shiny. Once on the way back from Masjid Alkaff, I was so breathless in the car, I thought it was time for labour !! thats how bad it was.

Meantime, Im really wondering how do I get more rest. How ???

Quitting my job is out of the question, and going on early maternity leave is a waste as I would prefer to have more time with the baby after giving birth.

I do feel guilty when I leave Little Habib at my parents house and as for asking for my hubby's help, Im the type who wont ask if not offered, abit sensitive lah..heh.

The only time I do ask for help is when Ive gone bonkers with the chores load that I really become bonkers, but I hate it when that happens and I know hubby hates it too.

I really dont know what to do. I dont think Habib Abbas accepts visitors during fasting month and how am I going to ask him for air doa ? I think I will keep on reading surah Maryam at the same time recite Ratib.

I am at a loss... I am close to tears and I do hope to get more understanding from my other half. Insya'allah. ( pls pray for me and the baby.... )


Polyhydramnios: Too Much Amniotic Fluid


When a woman has polyhydramnios, the level of amniotic fluid surrounding the baby is too high. To understand how this can affect your health and the health of your baby, it's helpful to first understand the role amniotic fluid plays in a healthy pregnancy.

What You Need to Know About Amniotic Fluid

The amniotic fluid that surrounds your baby plays an important role in your baby's growth and development. This clear-colored liquid protects the baby and provides it with fluids. Your baby breathes this fluid into its lungs and swallows it. This helps your baby's lungs and digestive system grow strong. Your amniotic fluid also allows the baby to move around, which helps it to develop its muscles and bones.

The amniotic sac that contains your baby begins to form about 12 days after conception. Amniotic fluid begins to form at that time, too. In the early weeks of pregnancy, amniotic fluid is mainly made up of water supplied by the mother. After about 12 weeks, your baby's urine makes up most of the fluid.

The amount of amniotic fluid increases until about 28-32 weeks of pregnancy. At that time you have about 1 quart of fluid. After that time, the level stays about the same until about 37-40 weeks, when your baby is considered full-term. After that, the level begins to decrease.

What You Need to Know About Polyhydramnios

Polyhydramnios (too much amniotic fluid) occurs in about 2 out of 100 of pregnancies. Most cases are mild and result from a slow buildup of excess fluid in the second half of pregnancy. But in a few cases, fluid builds up as early as the 16th week of pregnancy. This usually leads to very early delivery.

Polyhydramnios is diagnosed with ultrasound. Medical experts do not fully understand what causes this condition. In 2 out 3 cases, the cause is not known. Here are two of the best-known causes:

Birth defects in the baby that affect the ability to swallow.
Normally, when the fetus swallows, the level of amniotic fluid goes down a bit. This helps to balance out the increase in fluid caused by fetal urination.

Heart defects in the baby.
Women with
diabetes are at increased risk for polyhydramnios. But they have fewer complications from polyhydramnios than women without diabetes.
Women with mild polyhydramnios may have few symptoms. Women with more severe cases may have discomfort in the belly and breathing problems. That's because the buildup of fluids causes the uterus to crowd the lungs and the organs in the belly.

Preterm rupture of the membranes (breaks or tears in the sac that holds the amniotic fluid; also called PROM)

Umbilical cord accidents

Polyhydramnios may also raise the risk of pregnancy complications, including:
Preterm delivery
Placental abruption (the placenta peels away from the uterine wall before delivery)
Poor growth of the fetus
Stillbirth
Cesarean delivery
Severe bleeding by the mother after delivery

How can you tell if you have polyhydramnios?


Advertisement Polyhydramnios usually starts from about the 30th week of pregnancy.
You may feel that your tummy is getting too large too quickly and that your skin is stretched and shiny. You might feel so breathless that it is hard to climb a flight of stairs.

Other symptoms include abdominal pain, severe heartburn and constipation, swollen legs and varicose veins.

When your midwife or doctor carries out an examination, you will appear to be "large for dates". They may find it difficult to feel your baby or hear his heartbeat because there is so much fluid around him. Ultrasound scanning can confirm the diagnosis of polyhydramnios. The sonographer will measure the amount of fluid in four areas around your baby to work out your Amniotic Fluid Index (AFI).

If you have an AFI of more than 24 centimetres then you have polyhydramnios. The greater the AFI, the more severe the problem is.

What causes polyhydramnios?


It can be difficult to find out the cause of polyhydramnios and, sometimes, no cause can be found. Sometimes the extra fluid is due to a problem with the baby, or with the placenta or with you, the mother.

Possible causes include:
• Having diabetes, where your blood sugar levels are not well controlled. Your baby's urine output increases and this in turn increases the volume of amniotic fluid.

• Being pregnant with twins. There may be a particular problem if the babies are identical (monozygotic).

• Infections that affect your baby, such as rubella, cytomegalovirus, toxoplasmosis and syphilis, may be associated with polyhydramnios.

• A congenital problem with the baby occurs in about 20 per cent of cases of polyhydramnios. There may be a blockage in the oesophagus (swallowing tube), meaning that he cannot swallow the amniotic fluid and control the amount of it around him. It may also be a sign that the baby has a problem with his central nervous system, or with his heart or kidneys.

• Sometimes, polyhydramnios is associated with babies who have chromosomal abnormalities, such as Down's or Edward's syndrome.

• In very rare cases, the placenta may have developed a tumour or there may be a problem with the arteries in the umbilical cord resulting in polyhydramnios. However, it is important to remember that most women with polyhydramnios go on to have healthy babies, particularly if the condition is mild.

How is polyhydramnios managed?


If you are not known to have diabetes, you will be given a glucose tolerance test to check your blood sugar levels. If these are high, you may be referred to a diabetes specialist who can get your blood sugar levels down. This will reduce the amount of fluid.

There are other laboratory tests for investigating polyhydramnios if it is thought that it might be due to infection.

In the last two months of pregnancy, you will have regular appointments at the antenatal clinic to keep a check on your progress. Depending on the cause of the extra fluid, you may be prescribed a drug which reduces the amount of urine the baby produces. In severe cases, it may be possible to drain some of the amniotic fluid to reduce the volume. This can reduce the risk of you going into premature labour or the placenta starting to come away from the wall of the uterus.

However, there is a balancing act with this technique - taking too much fluid out also increases the risk of the placenta coming away and there are other risks, such as infection and bleeding as well.

Instead, in most cases your doctor and midwife will advise you to rest as much as possible.
This may mean starting your maternity leave early. Even with rest, because your uterus is so swollen, you may go into labour prematurely.

Your midwife will explain the signs of premature labour to you so you can contact the hospital immediately if your waters break or you start having contractions.

What will happen when it comes to the birth?


About one in five women with polyhydramnios go into labour and give birth early because the uterus simply cannot hold the baby and all the extra fluid any longer.

It's important to get to hospital as quickly as you can if you are in labour before 37 weeks. Ring the delivery suite and tell them what's happening. If there's no-one to take you to hospital, phone for an ambulance. If it is known that your baby has a problem, you will be booked to deliver at a Regional Referral Centre where they have the best facilities for looking after poorly babies. Even if your baby seems fine, and you don't have to go to a specialist hospital, you will be very carefully monitored during labour. This is for a number of reasons.

The extra fluid in the uterus makes it difficult for your baby to settle head down into the pelvis. So if your waters break, there is a danger that the umbilical cord will be pulled down into the vagina in front of his head. If this happens, you may need an emergency caesarean section.

There is a risk of the placenta coming away early if the uterus suddenly shrinks as the amniotic fluid is released. You're also at an increased risk of
haemorrhage after the baby is born.

If you have diabetes and your baby has grown very large, your midwife will be watching to make sure that the baby moves down steadily through your pelvis and doesn't get stuck. Occasionally the shoulder can become caught when a big baby descends. If this happens to you, an obstetrician will be called and will help you get into a position that frees the baby in most cases. Find out more about big babies.

Sometimes it might be suggested in advance that you have a planned caesarean section ("elective caesarean"). This may be the case if you are carrying twins, if your baby is lying across your uterus (transverse lie) or won't settle into any particular position (unstable lie) or if he is thought to be very large.

What are the best ways to cope with polyhydramnios?


If you are very breathless:

• get plenty of rest
• keep everything that you need for the daytime downstairs
• do household chores in small bursts and don't worry if they take you far longer than usual
• accept all offers of help

You may also find that you have heartburn because your uterus is pushing against your stomach:

• eat small amounts regularly

• don't lie down after a meal or eat just before going to bed

• avoid food and drinks that can make heartburn worse, such as fatty foods, coffee and alcohol • sleep well propped up in bed

• you can get an antacid prescription from your doctor

You're likely to feel very anxious as well as very large:

• Get as much information as you can. Go to antenatal classes as soon as possible, rather than waiting until the end of pregnancy.

• Try and distract yourself. If you don't want to be seen in public because you are self-conscious about your size, invite friends to your house. Get hold of the DVDs you've been thinking of watching for ages, and enjoy them!

• Contact an organisation such as the National Childbirth Trust and ask if they know of someone who has had polyhydramnios who you can talk to through their experiences register.
• If you have any new symptoms, or your existing symptoms become worse, telephone your midwife immediately, or go straight to the hospital.

6 comments:

Ihsan said...

Don't get overly worried eh. I will always pray for you also. Insya'Allah, all will be well. Also, sometimes it's best not to know too much. You will be psychologically affected.

Ummu Habib said...

Ihsan : Thanks my dear pal... Its good to know, but not too much..hah. My hubby lagi best, he told me to doa, tawassul and tawakkal. Hmmm......

Anonymous said...

Salaams,

I hope with the information that research has/have done will make us aware and be more careful next time.

No doubt that any that happen to us come from Allah. We do our best to understand ourselves by reading. Seeking ilmu is also usaha.

Do what you can do best, especially this Ramadhan. Insya Allah with Allah grace, things will be better for you and the foetus. Ameen.

p/s: will look around for any part time helper.

Wassalam
Ummu Mukhtaar

Ummu Habib said...

Salaams

Ummu Mukhtaar : Thanks for your help...Im looking around too... maybe I shd get a full time helper..maybe...

Anonymous said...

Assalamu Alaikkum Ummi,

Don't worry much too about a liitle more fluid in your tummy. Rest well and screen for diabetes.

Don't research too much about these conditions, it only makes you very anxious. Your gynaec is well trained and stick to her advice. You are going to be fine. The water level is not that too high.
It is just mild increase in the fluid level. You take care and leave the rest to Allah. He will do the best for you. I suggest do not research much about your pregnancy and let it be a normal pregnancy. HUGS

Ummu Habib said...

Wala'laikumsalam anonymous : Thks for the advise and do include me in your doa.

While Im going to just let the pregnancy take its course and listen to the gynea's advise, I do think it was good to know that there is such a condition. At least, tak lah katak bawah tempurung sangat. Just tat I will stop reading it cos the more I know, the scarrier it gets and I do agree that I should leave it in God's hands after putting all the effort I can.

*hugs*