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Anomaly Scan in Pregnancy
There are three trimesters in pregnancy and each trimester holds its importance in the birth cycle of a child. It is essential to get various scans and health check-ups performed during the nine month period to ensure that the baby’s growth is normal and on track. An anomaly test or scan is conducted in the second trimester of pregnancy predominantly to track the growth progress of the foetus.
During the scan, the sonographer (the person who performs the test) checks the overall growth of the baby’s organs and the formation of the body structure to ensure that the growth is normal. Let us understand more about anomaly scan and also answer FAQs in detail.
What is an Anomaly Scan (Ultrasound level 2)?
An anomaly scan, also known as the ultrasound level II, is a mid-pregnancy scan that takes a closer look at your baby and the uterus (womb). In this scan, the sonographer can see whether the baby is developing normally and will also check the position of your placenta, the umbilical cord, and amniotic fluid around the baby. This scan is also known as morphology scan or 20-week scan. It is important to note that the purpose of this scan is to check your baby’s health and not to determine the gender of the baby.
Why Should you go for an Anomaly Scan?
As mentioned above, an anomaly scan is performed to determine the growth and health of your child. It is not mandatory to get this scan done, but it is highly recommended to monitor your child’s growth. Getting an anomaly scan procedure done is also an opportunity for the parents to see their child in the womb and have some beautiful memories to carry home.
When is an Anomaly Scan done?
An anomaly screening is done in the second trimester of pregnancy. This is when you are around 20 weeks into pregnancy. It can be done anytime between 18th and 23rd week of pregnancy. This 18 - 23 weeks pregnant ultrasound test helps ensure that the child’s growth is normal and all critical organs are developing correctly.
How to Prepare for an Anomaly Scan?
Getting an anomaly test during pregnancy is a normal process, and this does not require any special preparation. Here are a few tips that can make the scan quick, comfortable and efficient:
It is advised to relax before the scan. Reach the diagnostic centre early and get comfortable.
For this scan, it is best to have a full bladder when you come for the test, as the scan cannot be performed on an empty bladder. You might have to wait a bit longer if your bladder is not full enough.
Like most other routine pregnancy scans, even anomaly scan requires you to expose the tummy from belly button to the pubic bone and hence it is advised to wear clothing which can be easily adjusted. Also, high heels will have to be removed before the test, so it is best to avoid such footwear.
You might be required to remove any jewellery that is on your body during the scan.
Carry all your previous tests reports and medical records so that they are readily available if needed.
How is an Anomaly Scan Done?
The anomaly scan or the ultrasound scan uses sound waves to produce images inside the body. The sonographer will apply a water-based gel on the part which needs to be scanned and will use a transducer to collect the sound waves that bounce back. These waves will be used by the computer to create an image of your child. Usually, there is no radiation exposure in this process as the examination does not use ionising radiation. The scan does not hurt.
The anomaly scan takes about 20 minutes to complete, and the sonographer will usually allow you to have a look at the scan and point out to different parts of the child’s body as well as the heart-beat. The sonographer will not disclose the gender of your baby as India’s laws on pre-natal diagnostic techniques prohibit hospitals from doing so.
What can this Scan Detect?
The primary purpose of the scan is to ensure that the baby is growing well without abnormalities. The anomaly sonographer looks for the following things during the scan:
The sonographer will check if the baby’s heart is developing and functioning correctly. All the arteries and veins which carry blood to and fro from the heart shall be examined.
The baby’s face is checked for cleft lip. However, spotting a cleft lip is difficult and might not always be picked up during the scan.
The sonographer checks if your foetus has two kidneys and whether the bladder is getting filled or not. In case the bladder is empty at the beginning of the test, it should be easy to observe it getting filled during the scan.
The shape of your baby’s head is also checked, and brain problems, if any, are identified.
The sonographer also checks whether the baby’s spine is developing properly and whether the skin on the back covers it up properly.
The sonographer will also check your baby’s arms, legs, feet and hands to ensure that they are growing properly.
The abdominal wall will be checked to ensure that it covers all the organs in the front. The sonographer will also have a look at the baby's stomach.
The sonographer will check whether there is sufficient amniotic fluid around the baby to provide protection
The position of the placenta is also checked during the scan. In case the placenta is placed low in your uterus, your doctor will inform you of the same. This situation is known as placenta praevia, and another ultrasound is recommended in the third trimester to see whether the placenta has moved away from the cervix. A low lying placenta even in the third trimester might cause excessive bleeding during delivery, but a low lying placenta during 18-20 weeks of pregnancy is not a cause for concern.
The sonographer will also measure your baby’s body parts during the scan and compare this with the standard growth during that stage of pregnancy.
The sonographer will usually take anomaly scan measurements of the following:
Head circumference
Abdominal circumference
Thigh bone
What does an Anomaly Scan Reveal about the Baby?
The scan will show a black and white image of your baby. The scan performed is usually a 2D scan, and you can see only one side of your baby, but if you go for a 3D or a 4D scan, you can see a right image of your baby’s body and from different angles.
The scan will show a general situation of your child’s body. The sonographer will look into the growth of the baby and identify abnormalities (if any). The scan will help you determine if you have one or more babies and the sonographer will also take measurements of your baby’s body parts to ensure normal growth.
Can the Anomaly Scan Harm the Mother or the Baby?
Unlike X-rays, the ultrasound anomaly scan does not use ionizing radiation and hence is not harmful to the mother or the baby. Also, the sonographer takes precautions to ensure that the mother is comfortable during the scan.
The application of gel and usage of the transducer could make the scanning process a little uncomfortable, but it is not harmful or painful to get the scan done.
What is the Purpose of an Anomaly Scan?
The principal purpose of anomaly scan is to allow the sonographer to monitor the growth of the baby and determine the health of vital organs of the body and the structure of different body parts. The scan is used to identify and assess any significant abnormalities that the child may have in any of the body parts. Getting a mid-pregnancy ultrasound scan is recommended to monitor the well-being of the child.
The focus is usually on organs such as the brain, heart, kidneys, spinal cord and placenta placement in the womb.
What do the Anomaly Scan Results mean?
Anomaly scan results indicate the progress of the child in the womb and help in determining the growth graph of the child. The results will either show that the child is developing normally and as per the usual pace or it will throw up abnormalities if any. In case of defects, your doctor will discuss the corrective action that can be taken to solve any deviations of the child from regular growth graph.
Which Abnormalities are Detected in an Anomaly Scan?
There is a list of observations that the sonographer makes while doing the scan and covers the baby from tip to toe. The foetal abnormalities detected might be normal ones that can be treated after your child is born. If they are severe, they will require immediate action.
Here are some of the abnormalities that can be detected in anomaly scan:
Cleft lip
Spina bifida (defect of the spinal cord)
Heart problems
Kidney problems
Anencephaly, or missing the top of the head
Problems in the limbs (for example – too short limbs)
While the scan is done with the purpose of finding abnormalities, it is not easy to spot one in the baby. For example, if there is a problem with the abdominal wall, kidneys, limbs or spinal cord, there are good chances that the scan will detect them. But the likelihood of spotting defects in the heart, assessing if there is a hole in the muscle which separates the chest and abdomen, or detecting excess fluid build-up in the brain is comparatively less.
In case an abnormality is spotted, the sonographer might refer the report to another person to confirm the observation made and then discuss the plan of action to be followed.
Is an Anomaly Scan Accurate?
A mid-pregnancy ultrasound scan is very important as it will help determine the growth of the child and aid in early detection of abnormalities that the child might be developing. The anomaly scans are usually accurate and present a clear picture. However, it is not always necessary that scan is 100% accurate and shows correct results at all times.
This is because it is difficult to determine abnormalities in the baby, especially in the vital organs, and an anomaly scan may or may not show up the same. A sonographer may also need to scan the abdomen multiple times to get a clear picture of the baby. Usually, the parents are also asked to give consent of their understanding that results of the scan being performed might not be 100% accurate.
What if the Scan indicates a Problem?
Once again, it is essential to understand that an anomaly scan report is not always 100% accurate and the observations might not always be correct. Also, note that the chances of identifying a severe problem at this stage are rare. However, in case a problem is spotted, you will be given advice on how to deal with it and the steps you must take. In case any problem is identified, you can expect the following next steps:
There might be situations where the sonographer has not been able to see everything since your baby was not in a good position while the scan was being performed. Also, the scan might not be consistent if you are overweight as body fat can interfere with the sonography. In such situations, you might have to get the scan redone at the 23rd week
In case the sonographer finds or thinks that there is a problem, you will be informed immediately and it is recommended that you see a foetal medicine specialist within 72 hours of the scan result.
You might be asked to get a foetal echo scan done in case there is a suspicion of your baby having a heart problem. This scan will take a detailed look at your baby’s heart
Your doctor will recommend the suitable solution for the detected problem. This will depend on the severity of the problem and whether or not it requires intervention at this stage. The solution usually involves surgery to the child after birth. In case of severe problems, certain surgeries might also be performed while the child is in the womb.
Seeing your baby taking shape inside your womb is a unique experience for parents. In most cases, you are allowed to take your partner along with you to witness this moment. The diagnostic centres performing these scans usually offer pictures and video copies of the scan for you to carry back as memories.
Getting an anomaly scan is always advised as it plays a very important role in ensuring that the child’s growth is normal.
Also Read:
Transvaginal Ultrasound Scan
3D & 4D Pregnancy Scans Read more
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Eating Pista (Pistachios) During Pregnancy
You will be given a long list of do’s and don’ts during pregnancy, of which eating habits often form a large part. Pistachios offer health benefits to people in various ways. Delicious and crunchy when eaten raw, these nuts can also be used for cooking. Also commonly known as pista, they grow on small trees and shrubs found in the subtropical and tropical regions of Asia, Africa, and the USA. They are considered one of the oldest nuts known to mankind and are believed to have existed as far back as 6,000 B.C.
Is it Safe to Eat Pistachios During Pregnancy?
It is considered safe to eat pistachios in moderation during pregnancy. Eating too many of them during pregnancy might result in certain side-effects. This is why it should be consumed in moderation. There are plenty of nutritious benefits that this nut offers, and knowing about it will help you include it in your pregnancy diet the right way.
The Nutritional Value of Pistachios
Despite being a rich source of energy, pistachios are low in calories and pack a punch with other nutrients. Their high nutritional value can be seen in the fact that approximately 30 gm of these nuts has 6 gm of proteins, 2.8 gm of fibre, and 12.7 gm of total fat. The amount of calories is about 500 per 100 gm.
Benefits of Eating Pista When Pregnant
One serving of pistachios can fulfil almost all your daily requirements of iron, calcium, folate, and potassium when pregnant. These are all essential for the growth and development of your baby, while in the womb. The benefits of pistachios are:
Pistachios are a rich source of protein, which is essential for the development of the baby’s muscles and tissues.
The monounsaturated fatty acids they contain can help increase good cholesterol levels and lower bad cholesterol, thus, balancing lipid levels.
The presence of antioxidants like Vitamin E, Vitamin A, carotenes, and polyphenolic compounds increases your immunity.
The copper content in pistachios helps maintain red blood count during pregnancy.
Their anti-inflammatory properties help combat joint pain and swelling during pregnancy.
The fibre content of the nuts helps fight constipation that pregnant women are prone to.
Omega-3 fatty acids in pistachios facilitate the baby’s brain development.
They contain quite a few B-complex vitamins like riboflavin, niacin, thiamin, Vitamin B6, and folate, which are important for foetal development.
Besides this, pistachios are helpful in preventing liver disease, jaundice, and anaemia.
Harmful Effects of Eating Pistachios
There are certain side-effects of pista and it is advisable to talk to your gynaecologist before including these in your pregnancy diet.
Pistachios are also categorised as nuts and contain anacardic acid, which is the allergy-causing chemical compound present in nuts. Thus, the possibility of an allergic reaction cannot be ruled out, especially if you are allergic to some other types of nuts.
The presence of fructans in pistachios can lead to digestive issues such as diarrhoea, constipation, bloating, pain in the abdomen, and flatulence.
These crunchy nuts are best eaten raw, as roasted ones contain more sodium, which can increase blood pressure and are not recommended during pregnancy.
The nuts are also believed to have heat-inducing properties, which can have an adverse effect on the health of a pregnant woman.
How to Include Pista in Your Diet
There are plenty of ways in which you can include pistachios in your daily diet during pregnancy. Here are some useful tips:
You can eat them raw as a snack or choose to include them in dishes you cook.
Try adding pista to fruit salad for some crunch and variation.
You can also try making a rough powder of pista nuts to dip chicken breasts coated in beaten eggs in, before grilling or frying.
Top frozen yoghurt, oatmeal, or cereals with pista for a nutritious breakfast or dessert after meals.
Try making a milkshake with pista, saffron, cardamom, and almonds for those times when you are hungry and need something filling.
Kesar pista kulfi is something you can make in a jiffy when you feel like eating something cool during the hot summer months.
Pistachio Frozen Yoghurt Recipe
This is a healthy dessert that you can enjoy during the summer months, without having to worry about you or the baby’s health being compromised.
Ingredients:
1 cup frozen yoghurt
1/2 cup crushed pistachios
2 mashed bananas
1/2 cup honey
1 tsp vanilla extract
How to Make
Add all the ingredients, except the pistachios, into a bowl and whisk until smooth. You can also use a blender, but whisking the mixture will make the frozen yoghurt airy.
Add 3/4 of the crushed pistachios and mix well, in a ‘figure 8’ motion, to not let much air escape from the mixture.
Pour the mixture into a pan and sprinkle the remaining crushed pistachios on top.
Cover the pan tightly with a plastic wrap or cling film to avoid any icicles forming.
Freeze for three to four hours or until ready to serve.
Remove from the freezer, scoop, and serve. If the mixture seems too hard, keep the pan out of the fridge for five to 10 minutes. and then scoop.
As with most things in life, too much of pista can be detrimental, especially to pregnant women. By consuming them in moderation, you can reap the maximum benefits of this nutritive nut and avoid any side-effects. So, unless you have been specifically told to steer clear of pistachios by your doctor, go ahead and relish your daily serving of them.
References and Resources: Livestrong
Also Read: Eating Cashew Nuts during Pregnancy Read more
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Feeding a 15 Months Old Who Refuses Solid Food
A 15-month-old toddler refusing solid food can be frustrating for parents. In fact, it's a struggle many moms face. Yet, while getting your baby used to table food does take some doing, its not impossible and with persistence you can get it done.
Transitioning a toddler from baby food to solid food is not something that happens overnight. Sometimes it can take many, many attempts of introducing solid food before your child takes to it. If you’re one of those moms whose patience is being stretched to the limit, a few tricks may help.
5 Tips on How to Get Toddlers to Start Eating Solids
1. Begin by thickening baby food
When trying to introduce solid food to your toddler, it helps to begin by increasing the thickness of her baby food. The consistency will require her to use more of her tongue and muscles in the mouth. This is good practice for getting children used to thicker textures of food as well as enabling them to move about more solid pieces of food in their mouths when the time comes.
2. Keep offering the food
When introducing your baby to solid food, keep offering the item to her rather than trying to force-feed it. Bear in mind that she doesn’t have to eat it right then and there. If she wants to pick it up in her hands and play with it, let her. It’s perfectly natural for toddlers to examine and explore a food item. The idea is to keep offering the food till they get used to it.
3. Introduce foods one at a time
Offer one type of food at every meal. Giving a variety of foods at one go will only confuse your child and make it that much more difficult for you to get her to eat it. Let her become used to the taste and texture of one type of food before you offer another.
4. Feed small amounts of the family meal
If your toddler shows an interest in eating when you sit down for your family meal, offer her small portions of it. Cut meat or vegetables into small pieces and try feeding it to her. A baby might feel more inclined to place the food into her mouth when it’s in pieces.
5. Offer food when she’s hungry
One of the best ways of feeding solids to 15-month-old toddlers is to offer it when they’re hungry. They’re more likely to accept and chew solid food rather than when they have a full stomach. Chopped bananas, macaroni, boiled carrots and potatoes, diced and mixed with fine grains like rice, are good examples of soft food that a baby can easily warm to when hungry.
Don’t be discouraged if your child refuses to eat solid food. Like everything else, getting a toddler used to it is a gradual process and takes time. As a parent who’s trying to help her baby with this food transition, you need to have patience. Otherwise, your child will pick up on your frustration. Read more
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BMI (Body Mass Index) During Pregnancy
Pregnancy is not an easy journey. As the pregnancy progresses, there is always a risk of certain complications but not all women will face problems. However, if you are obese or are on the heavier side, you might face certain complications during pregnancy or while giving birth to your baby. Understanding the normal BMI for pregnancy is absolutely necessary since the onset of obesity directly increases the chances of having an unhealthy heavy baby, or leading to choose a caesarean delivery over a normal one.
What Is Body Mass Index (BMI)?
The concept of BMI has existed in the space of healthcare and medical sciences for many years. Recently, it has found recognition in the mainstream and is being hailed as a great standard to understand your position in health. BMI is a simple mathematical formula that makes use of various parameters to get to a medical understanding of your weight, demarcated either as underweight, normal, or overweight. As the name 'body mass index' suggests, the BMI score is used to figure out if you have the right proportion of body fat based on your height and weight. A simple formula to calculate the score is to divide your weight in kgs by the square of your height in cms.
Is BMI an Accurate Indicator of Good Health
Even though BMI is used pretty widely nowadays, it doesn't exactly indicate your health condition. As per a recent study, the BMI score of certain people was compared with the actual values of various other health markers such as blood pressure, cholesterol, sugar levels etc. and it was observed that many people who were healthy on those lines were termed as overweight as per the BMI score. On the other hand, others with good BMI scores were detected to have various health issues in other areas.
The body shapes of people across the world differ in the physical structure and in muscle composition, making it difficult to differentiate simple fat from muscle using a mathematical formula. The technologies of today have made it possible to get over that gap and reach a conclusion of higher accuracy. Taking into account the waist to height ratio instead gives a better idea of the health of the person since a lot of excess fat tends to get deposited in the region of the waist, around the important organs such as kidneys, liver, and heart.
BMI and Weight Gain Range in Pregnancy
To get a better understanding of what might be your current health status based on your BMI score, as well as to get a better hang of the weight gain during your pregnancy that can be considered as healthy, we have put together a BMI pregnancy weight gain chart that can assist you with the same.
Description
BMI Score
Healthy Weight Gain Range
Obese
Higher than 29 – 30
Not higher than 7 kg
Overweight
Between 25 – 30
Between 7 – 11 kg
Normal
Between 18.5 – 26
Between 11 – 16 kg
Underweight
Less than 18.5
Between 13 – 18 kg
The suggestions of your doctor might vary based on the scale used for calculating your BMI score.
How to Calculate BMI While Pregnant
Calculating your BMI when you are pregnant isn’t difficult. You need to get an approximation of the weight of your pregnancy from your doctor. Once you have that, you can deduct it from your total weight to get your true weight. This should be used to calculate your BMI. Based on this, there is a weight gain that is presumed to be healthy over the trimesters. The initial phase should show a weight gain of around half kilograms every month. As you enter the second trimester, it will be twice as before, which further increases to four times as that of the first when you are in the third trimester.
Does BMI Change from Normal to Obese during Pregnancy?
BMI is a score that is calculated on the basis of your body weight as well as your height. During pregnancy, your weight increases, while your height stays the same. This results in your BMI score shifting to the higher side gradually, which could put you into the zone of overweight or obese as you proceed ahead in pregnancy. That isn’t a cause of worry as such, as long as your weight gain has been within the healthy limits as specified at the beginning of the pregnancy.
Obese BMI and Pregnancy Complications
With a high BMI during the third trimester of your pregnancy or at any stage for that matter, the chances of complications increase quite a lot, especially if the score is higher than 30. These can vary across a lot of possibilities such as:
Increased chances of delivering a stillborn.
A propensity to go for caesarean delivery instead of a normal vaginal one.
Infections.
Urinary tract infections or kidney issues.
Formation of blood clot anomalies.
A possibility of extreme bleeding following the delivery.
Increased risk of complications due to anaesthetics.
Foetus having various birth-related defects.
Obesity making it difficult to view the baby via ultrasound.
A higher chance of contracting pregnancy-induced diabetes.
Tips to Manage Your Weight during Pregnancy If Your BMI Is High
Pregnancy and excess weight is not a healthy combination. However, the presence of a high BMI score should not make you deter from proceeding ahead with your pregnancy. There are a bunch of tips you can adhere to, which will help you manage your weight better.
Opt for cereals or grains since those are extremely healthy and barely affect your weight gain at all.
Combining various vegetables and fruits, along with different legumes can provide you with the necessary energy throughout pregnancy.
Keep a track of your meat consumption, do not overdo it.
Exercise daily, starting with around 20 minutes daily, and ramping it up slowly.
Go for simple exercises such as walking or swimming, and try your hand at yoga to calm yourself and stay stress-free.
Precautions/Guidelines for Women with High BMI during Pregnancy
In case you have a high BMI during pregnancy, guidelines and precautions for you are extremely essential to make sure your pregnancy does not hit any roadblocks and proceeds ahead with minimal complications.
As a preventive measure, take suggestions from your weight loss expert before you try to conceive.
Calculate BMI as early as possible once you find out that you are pregnant.
Stay within the healthy parameters of weight gain for your BMI score.
Talk to your doctor or nutritionist to chalk out a proper diet that can help you balance the necessary nutrients as well as keep your weight under control.
Consult an instructor to create an exercise programme that is suitable for pregnancy.
Follow up with your cardiologist to check for any possible heart-related issues as well as your general doctor to check for the chances of having pregnancy-induced diabetes.
Motherhood is an experience you should not miss. If your weight does not fall within the realm of normalcy, you shouldn't make it a reason for not getting pregnant. Yes, there are chances of higher risks and complications during delivery, but those can be handled by taking the right decisions well in advance.
Also Read: Weight Gain in Pregnancy: How much is Good? Read more
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Magic Sensory Bottle
Ready to tickle your toddlers senses with this sparkling magical bottle?
Children are always amused by shiny and sparkly objects. These magical sensory bottles will be fun to create and admire afterwards too. They are really easy to create and sharpen your toddler's sensory skills too.
You Will Need
Glass or plastic bottle
Water
Glycerin of baby oil
Glitter
Step-by-step Instructions
1.Add water to the water bottle
2. Pour about 20 drops of baby oil or glycerin into the bottle.
3. Add the glitter to the bottle and shut the bottle tight.
4. Shake the bottle and observe the magic!
Messiness Score
6
Parental Involvement
Medium
Level Of Difficulty
Medium
Skills Enhanced
Sensory Skills
You Will Observe Your Child Doing
Shaking the bottle vigourously to observe the bubbles forming.
So, go on make the magic happen with this sparkling sensory bottle! Read more
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Dr Ghouse has added a new answer
Expecting Mom due in 4 months
19 hours ago
Q. Eaten ajinomoto food by mistake 2 time
Dr Ghouse
Paediatrician
18 hours ago
A. okay already had it it's ok. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Sameer awadhiya has added a new answer
Mom of a Newborn child
18 hours ago
Q. My 2month old baby is doing green poop from last 10-15 days. Baby is formula fed
Dr Sameer awadhiya
Paediatrician
17 hours ago
A. Green colour Motion is normally seen in babies and mostly it may be dvue to less feeding or formula milk feeding babies.
If it is associated with mucous and foul smell inf motion than there could be some infection.
Dr Ghouse has added a new answer
Mom of a Newborn child
18 hours ago
Q. My 2 month old baby has started breastfeeding now earlier baby was on formula Now i dont know when is baby full. How to schedule breastfeeding and formula both?
Dr Ghouse
Paediatrician
18 hours ago
A. if the baby is sleeping after breastfeeding and passing urine adequately nothing to worry. if there is no relief it is better you see your doctor for proper examination particularly physical examination if there is need for doing investigations to find out the problem and treatment ok
Dr Disha Patel has added a new answer
Expecting Mom due in 2 months
18 hours ago
Q. I'm 8 months old pregnant,can I eat Jack fruit?
Dr Disha Patel
Ayurvedic Physician
18 hours ago
A. you can eat it in moderate amount.
do eat protien rich food during last trimister.
dtink lots of fluids.
tajlk e care n all the very best.
Nidhi pant has added a new answer
Expecting Mom due in 2 months
16 hours ago
Q. I'm in my 28th week of pregnancy and from past 2 days I felt movement of Baby a little low is it normal??
Nidhi pant
Guardian of 2 children
16 hours ago
A. eat sweet things and plz consult your gynae
Rashmi has added a new answer
Expecting Father due in 2 months
3 hours ago
Q. #AskExpert Pl explain :
Fundal Anterior wall, Grade II. Well away from the internal OS. The placenta echotexture is homogenous and there is no evidence of Retro placenta clots. Placenta maturity normal.
Rashmi
Mom of a 9 yr 8 m old girl
3 hours ago
A. Only Dr would be able to give you better guidance on that so whatever doubt you have associated with your query kindly take it up with your doctor as the doctor has to see entire situation as all that basis for health can be provided
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