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21 Weeks Pregnant: What to Expect
You are slowly getting closer to the day you meet your little bundle of joy. At the 21st week, you will be able to feel your baby more than usual. You will also begin to experience a few more symptoms for which you need some relief. Here is a list of suggestions and answers to any questions you might be having about your 21st week.
Your Baby's Growth During Pregnancy - Week 21
At week 21, your little one will begin to taste his or her food, as the taste buds start to form. Even though the baby obtains nutrition by swallowing amniotic fluid, what you eat will flavour the fluid itself. Some studies have shown the babies prefer the same foods that their mothers ate during the pregnancy. In addition to taste, your baby now has its limbs proportionately developed, allowing for coordinated control over movements that you will start to experience as kicking or pushing. As the foetus is still rather small, you will be unable to tell which part of its body is pushing against your belly. Developing senses like sight and sound make your baby aware of your daily habits, and might even recognize your voice. Eyebrows, eyelashes, and eyelids have formed, although the irises have not got their colour in yet.
What is the Baby’s Size?
At 21 weeks pregnant the baby’s size is around 24-25 cm in length from head to toe, the same size as a large carrot. Its weight is approximately 450-500 grams, and it is slowly pushing against your organs.
Common Body Changes
During the 21st week, there are some body changes during pregnancy that you will come to expect:
Varicose Veins:
With your baby getting bigger, the veins in your legs experience more and more pressure. This is worsened by progesterone levels in your blood, leading to varicose veins.
Stretch Marks:
Your tummy, thighs, hips, and buttocks will begin to bear the brunt of your expanding pregnancy bump. These stretch marks appear as dark streaks caused due to the tearing of the supportive tissue below the skin. The lighter skinned you are, the higher your chance of getting them. They usually don’t go away after birth, but do become a lot less visible.
Spider Veins:
Small veins with a radial pattern like tree branches might appear on feet, hands or face. Luckily, they usually go away after you give birth.
Worse Acne:
The hormonal flux surging through your body will wreak havoc with the oil levels in your skin, leading to acne breakouts. However, do not use oral or topical acne medication as they may cause complications in your pregnancy.
Symptoms of Pregnancy at Week 21
The symptoms you will experience during your 21st week might indicate how you will feel for the final trimester. Some of them are:
Braxton Hicks Contractions: These are contractions experienced by your body even before labour, as a form of practice for the real event. If they begin to cause discomfort, contact your doctor immediately.
Discharge from Breasts: Milk or the yellowish colostrum will leak from your breasts as the milk ducts are fully functional at this point. This is not painful, however, it might cause embarrassment so carry around some tissues or wet wipes with you.
Irritated Skin: Your stretched belly skin will tend to become drier than usual, and might even get chapped. The generous use of moisturizer should solve your problem.
Cramps in Legs: This is a very common symptom most likely caused due to your legs now carrying more weight than they are used to. Do stretching exercises or get leg massages for relief.
Inflamed Gums: Your gums will be a lot more sensitive than usual, so take care to brush your teeth gently.
Belly at 21 Weeks of Pregnancy
21 weeks of carrying your baby around will put a strain on your entire body. As the belly continues to grow you may find that the belly button turns flat or pop out in certain cases.
You will be around 5-6 kg heavier than usual. This includes the weight of the baby, amniotic fluid, placenta, uterus, increased blood and other fluids, fat and protein storage in the breasts, and so on. You could keep your uterine and pelvic muscles in tiptop shape by doing Kegel exercises.
21 Weeks Ultrasound
If you get your mid-pregnancy ultrasound scan this week you will be able to see the intricate details of your baby’s body such as its heart chambers and brain hemispheres. Details of your little one’s limbs, sense organs and hair will also be visible. You may also find out the sex of your foetus at this stage; however, doing so is illegal in India to combat the rates of female foeticide.
What to Eat
Your need for iron has never been higher than it is at this point, as you are producing a lot more red blood cells to supply your baby with whatever it needs. If your iron reserves fall low, you might become anaemic, which could lead to fatigue, shortness of breath and even loss of consciousness. The best 21st week pregnancy foods those which are rich in iron such as spinach, red meat, leguminous veggies, and fish are recommended. Iron supplements are also often prescribed to deal with the situation.
Avoiding caffeine will enhance the absorption of iron, so cut down on those twice daily espresso shots.
Consume foods with a lot of vitamin C like lemons, grapes, watermelons, and chillies. If being overweight or obese is your problem changing your diet to include whole grain foods, fruit, vegetables and avoiding processed food and refined sugar should do the trick.
Above all else, remember to stay hydrated with at least 2-3 litres of water a day.
Tips & Care
You may need to learn how to deal with the most common issues such as heartburn, haemorrhoids, back-pain and so on. Visit your doctor regularly to learn more about what you could do to protect yourself and your baby.
Do's
Keep your leg muscles stretched and relaxed to avoid them getting cramped. If necessary visit a physiotherapist for help with the same.
Talk or sing to your baby for at least a couple of hours every day. The baby will learn to recognize and grow attached to your voice. Playing the baby music will also help it rest better.
Don’ts
Don’t forget your regular exercise, sleeping on the left side of your body and keeping your lower limbs propped up.
Pregnant women are strongly recommended to take vaccinations for Whooping Cough at this point, so don’t forget to ask your doctor for further advice.
What You Need to Shop for
The most important thing for you to spend some money on is some maternity clothing. These clothes are comfortable, yet supportive for someone in the middle of their pregnancy. There are several online stores to choose from. It might be a good idea to invest in some pregnancy books, maternity bras, and accessories for your baby’s room.
Early preparation for an effortless pregnancy and delivery is the key to reducing a lot of stress that comes with it.
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DVT (Deep Vein Thrombosis) in Pregnancy
Along with many physiological changes in the body during pregnancy, an increase in the susceptibility to Deep Vein Thrombosis(DVT) is also found in many women. Veins are tubes that transport blood in the body, and blockage in these veins is termed as venous thrombosis. During pregnancy, a woman has a six times higher chance of developing such a clot in the vein, compared to a non-pregnant woman. Learn about the various aspects of DVT, its causes, symptoms, treatment and prevention.
What is Deep Vein Thrombosis (DVT)?
In deep vein thrombosis, clotting of blood occurs in the veins found in the leg and pelvic region. Clotting of blood is a normal physiological process in the body and occurs when there are any cuts or openings in the blood vessel. In the case of DVT, this occurs inside the vein, constricting the flow of blood resulting in serious implications, if left unidentified. Thrombosis in pregnancy is caused by an increase in the blood clotting capacity of the body during pregnancy, as a means of preventing excessive blood loss during delivery. This can sometimes result in a blood clot in the leg during pregnancy.
How Common is DVT During Pregnancy?
DVT during pregnancy is not very common and occurs in only one in thousand pregnant women. The risk of developing DVT is six times more in a pregnant woman, with an increased chance of occurrence in the first trimester of pregnancy and six weeks post-partum.
Why is It More Common When Pregnant?
The body experiences numerous physiological changes during pregnancy. These changes are mostly driven by variations in the hormonal levels. One reason is one of the safety precautions that a woman's body takes during pregnancy, which is an increase in the clotting proteins and a decrease in the anti-clotting proteins, to minimize blood loss during delivery. Another factor that can contribute to this condition is pressure exerted by the enlarged uterus on the veins which carry blood to the heart from the lower body.
Causes of DVT
DVT during pregnancy is primarily caused by the hormonal changes the body undergoes during this period.
1. Oestrogen
During pregnancy, the circulating levels of oestrogen hormone are high in the blood, which in turn increases the chances of a blood clot.
2. Uterine Growth
The expansion of uterus that occurs with the development of the foetus, puts a lot of strain on the veins carrying blood back from the lower body to the heart. This also results in clotting of blood inside the veins returning from the extremities.
3. Increase in Body Weight
Excessive weight gain puts a lot of pressure on the veins of the legs and pelvis, leading to increasing the chances of having a DVT.
4. Multiple Pregnancy
Mothers carrying more than one foetus in their womb have a higher risk of developing DVT.
5. Age and Genetics
Women who have a family history of DVT or are expecting a baby at 35 years of age or more are at risk of experiencing venous thrombosis during pregnancy.
DVT Sign and Symptoms
Women who develop DVT during their pregnancy have one or more of the following symptoms:
Pain in one leg accompanied by swelling
Visibly enlarged veins
Pain while walking
The feeling of tenderness in the thighs and calf muscle
Diagnosis
Based on the symptoms and previous family history of DVT, the medical practitioner usually performs a Doppler ultrasound examination to check for any venous blocks. The Doppler ultrasound estimates the speed of blood flow in the veins and flags the areas that have reduced flow. The diagnosis of DVT can be very tricky, and in some cases, the doctor may prescribe a D-dimer test. This test works by identifying the presence of any blood clots in the blood vessels.
To quantify and characterize the block, doctors also carry out a venogram, in which a dye is injected into the veins to help in clearly visualizing the blockages.
Who is Most At the Risk of Getting DVT?
Pregnant women who have one of the following risk factors have an increased susceptibility to developing DVT.
A family history of DVT
Previous history of DVT
Age above 35 years
Obesity or weight gain
Women who travel long distances during pregnancy
Smoking
Inactive lifestyle
Multiple pregnancies
C-section delivery
Clotting or inflammation due to infection in pregnancy
Treatment of DVT in Pregnancy
Once a diagnosis of DVT during pregnancy is made, the doctor usually prescribes medications to thin the blood. This medication is continued after delivery up to at least six weeks post-partum, as there are chances of block formation even after the birth of the baby.
Does Deep Vein Thrombosis Affect the Baby?
Typically, DVT causes discomfort to the mother but does not affect the baby's growth and development. Rare situations where the block moves up till the lungs, affecting its function, it can hamper the oxygen supply to the foetus. Also, during delivery, when the mother loses excessive blood because of the blood thinners, it can affect the baby.
Management
Management of DVT during pregnancy is possible with heparin injections. Heparin is an anticoagulant that inhibits the clotting of blood. Apart from the medication, some lifestyle changes like adopting an active routine, reducing body weight and quitting smoking can also largely prevent the further clotting of blood.
A special kind of compression stockings can be worn to improve the blood circulation in the leg. Apart from that, drinking lot of water and exercising also helps in managing DVT.
How to Reduce the Risk of DVT While Travelling?
The chances of the symptoms of DVT flaring up is high during travel. To reduce the risk while travelling, take precautions like increasing your water intake, ensuring constant movement of the lower body either in the sitting position itself or by walking within the vehicle, and completely avoiding the intake of alcohol.
Can Deep Vein Thrombosis Affect Labour?
If you have been identified to have a tendency to develop DVT, then the doctor would advise you to take some precautions before the delivery. To reduce the risk of developing thrombosis during labour, you can wear the compression stockings while constantly moving around and drink lots of fluids before going to deliver the baby.
If you have already been diagnosed and are on heparin medications, the doctor may ask you to discontinue it as it can interfere with the clotting of blood after delivery.
Can Caesarean Delivery Increase Risk of Getting Blood Clots?
Yes, a C-Section delivery is shown to increase the risk of post-partum blood clots, as compared to a vaginal birth. This is because the body takes necessary precautions and mobilizes its healing mechanisms for an invasive procedure, one of which is an increase in the propensity of the blood to clot.
Prevention
Some of the ways by which you can prevent the occurrence of DVT during pregnancy are,
1. Drinking Lots of Water
Fluid intake is very important in the prevention of DVT as dilutes the blood and prevents it from becoming very thick. This has to be followed throughout pregnancy and even after the delivery to prevent the formation of blood clots.
2. Exercising
If you are at the risk of developing thrombosis during pregnancy, then practising light and safe exercises regularly can immensely help in improving the blood circulation to the body. Exercises that particularly benefit the circulation of the lower body can be helpful in preventing DVT.
3. Move on the Go
If you are having DVT and have to travel long distances on a regular basis, then try to move around inside the bus, flight or train every few minutes to break the resting period. This keeps the circulation alive. If getting up and moving around is not a possibility, then try to do simple twisting and moving exercises in sitting position itself.
4. Wear Stockings
Compression stockings that activate the blood circulation in the leg can be worn during pregnancy and even during labour to avoid clot formation.
DVT is a common condition in pregnancy that many women lack awareness about. It is easily treatable with medications and identifying it at the right time is the key to have a safe and healthy pregnancy.
Also Read: High & Low Haemoglobin Levels in Pregnancy Read more
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Methi Paranthas
Kids are often very fussy about eating the nutritious green leafy veggies. So, as a mother you are left with the option of incorporating them in their diet through disguise. Paranthas are very popular among kids and adults alike. So, we thought it is a great idea to add the not-so-popular-greens into this dish. If your kid turns his nose at the sight of methi/ fenugreek greens, serve him these ‘Methi Paranthas’ and watch him finish it no time.
Serves
Preparation Time
Cooking Time
4 People
20-30 Minutes
20-25 Minutes
Ingredients
1½ cup wheat flour (atta)
1 cup fenugreek leaves, tightly packed, washed and chopped
1 green chilli, minced
½ fennel seeds
2 tsp white sesame seeds
1 tsp red chilli power
¼ tsp turmeric powder
2 tbsp oil
1½ tsp salt
¼ tsp asafetida
About ½ cup to ¾ cup water to make the dough
About 30 ml oil for pan frying the paranthas
½ cup wheat flour for rolling
Method
Step 1
To make the dough, add all the ingredients (except water) for the dough in a deep bowl. Combine with hands and keep adding water little by little.
Step 2
Knead well so that all the ingredients come together evenly in the dough. The dough should be smooth and pliable.
Step 3
Once the dough is ready, set it aside for about 15-20 minutes.
Step 4
Now, make 12 large lemon sized smooth balls of the dough. Keep them covered.
Step 5
Heat a tawa or pan. Once it is heated, turn the flame on medium.
Step 6
Roll each dough ball into a circle – just like you roll a chapati. Use the dry flour as needed.
Step 7
Cook the rolled dough circle on the heated pan/tawa. When one side is cooked, apply a little oil over it and flip over. Apply some more oil and press it slightly with a spatula. When it is cooked you can see some light brown spots on each side.
Step 8
Remove it from heat and keep it on a plate.
Step 9
Continue the process with the rest of the dough balls. Pile the cooked paranthas one over the other. It helps in keeping them soft.
Step 10
Serve warm with a dollop of butter if you like. Pair it with pickle and raita for a satisfying and filling brunch.
Nutritional Information
Calories
372 K cal
Proteins
6.1 g,
Total Fat
21.8 g
Total Carbohydrates
37.6 g
Cholesterol
50 mg
Sodium
582 mg,
Potassium
50 mg
Tip: You can replace the fenugreek leaves with chopped spinach leaves for ‘Spinach Paranthas’. Read more
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Is It Safe to Get a Vaccination for Whooping Cough During Pregnancy?
Whooping cough, which is also known as pertussis, is a respiratory infection caused by a bacteria. When a woman is pregnant, her body goes through a lot of changes. The hormonal changes in the body can weaken the immune system and put her at the risk of contracting infections. Whooping cough is one such infection, which is why now pregnant women are offered vaccines for it.
What Is Whooping Cough?
As mentioned above, whooping cough is a serious respiratory infection caused by bacteria. It can affect people at any age - whether they are young or adults. This infection is not dangerous for adults; however, it can be fatal for infants and children under the age of 5. The symptoms of this infection start showing after 7-10 days of being exposed to it.
Is Whooping Cough Dangerous During Pregnancy?
Whooping cough during pregnancy may not be harmful for a mother-to-be, but it can be extremely dangerous for the unborn baby. Sometimes, this infection may lead to urinary incontinence or even fracture in ribs in the pregnant woman, but it does not harm her in any significantly dangerous way. However, it can affect the health of the baby. This condition may pass on to the baby. In rare cases, this condition can also prove fatal, especially for babies less than 2 months old.
Symptoms of Whooping Cough
Mentioned below are some of the common signs and symptoms of whooping cough during pregnancy.
Sudden violent coughing spells
Forceful coughing
Rapid breathing
Deep “whoop” like inhalations after a coughing fit
Clogged and runny nose
Dry throat or stuffed throat
What Are Its Complications?
Whooping cough can lead to numerous complications during pregnancy. The extreme coughing fit can lead to premature labour. A baby may can be susceptible to pneumonia or brain damage. Fetal complications could lead to stillbirth delivery. The biggest problem with whooping cough is that it weakens the immune system of a mother. Although there is no direct link between whooping cough and fetal complications or premature labour, doctors believe that a weakened immune system can affect the health of a woman and make her susceptible to other problems.
How to Prevent Pertussis During Pregnancy
The most effective way to protect you and your child from the condition is by getting an immunization vaccine for whooping cough. This vaccine is known as Tdap and it requires a booster every 10 years or so. The effectiveness of vaccines decreases over time, this is why boosters are required to ensure you don’t develop this condition.
Can You Get a Vaccination for Whooping Cough While Pregnant?
Yes, whooping cough usually affects young children with weakened and developing immune systems. Pregnant women are also at a risk of developing this condition more than any other adults. The rapid hormonal changes during pregnancy weaken the immune system greatly, hence a women may get this condition.
When and How to Get a Whooping Cough Vaccination While Pregnant?
Women who have not been vaccinated against whooping cough prior to their pregnancy should wait until the late second or third trimester to get a vaccination. Women who have just delivered a child and have not had a vaccination for whooping cough during or before the pregnancy should be vaccinated soon after the pregnancy to avoid complications. The whooping cough vaccine does not provide lifelong immunity from the condition and may require boosters every 10 years. Immunization vaccines are the most effective way of curbing this condition
Can a Vaccine for Pertussis During Pregnancy Lead to Whooping Cough?
While there is a possibility that the whooping cough vaccine can cause whooping cough in pregnant women, the chances are extremely low. There has nearly never been a case where this vaccine has caused the condition to pregnant women or adults and children.
Will a Baby Need to Be Vaccinated at 2 Months If the Woman Had Been Vaccinated Against Pertussis During Pregnancy?
Yes, regardless of whether a woman had the vaccine during pregnancy or not, the baby will need to be vaccinated for this condition. The vaccines for a mother may not provide enough antibodies to the child. Doctors recommend that you follow the NHS vaccination schedule for your child.
Can You Get Pertussis Vaccine and Flu Vaccine at the Same Time During Pregnancy?
Yes, there has been no evidence that pertussis and flu vaccines counteract each other in any way. So, you can have both vaccines at the same time. It is important that you stick to the vaccination schedules and do not delay one shot for another.
If a Woman Had Received a Vaccination for Pertussis in Her Childhood, Does She Need to Get Vaccinated Again During Her Pregnancy?
Yes, the pertussis vaccine is not a lifelong immunity shot. It requires boosters every 10 years or so. Doctors recommend that you stay on an active NHS vaccine schedule for whooping cough for your child and you get a booster when you require it. For more accurate information about vaccine boosters for whooping cough, talk to your medical professional.
If You Were Vaccinated Against Whooping Cough in Your Previous Pregnancy, Do You Need to Be Vaccinated Again?
Yes, to protect your baby from this condition at birth, doctors recommend that a mother must get vaccinated in the late second or third trimester for whooping cough. This will ensure your baby does not contract the condition.
Are There Any Risks or Side Effects of Pertussis Vaccination?
Yes, there are numerous side effects of this vaccine, which are mentioned below:
Mild swelling
Redness at the injection point
Tenderness at the injection point
Loss of appetite
Mild fever
Skin irritation at the injection site
Who Should Not Get a Vaccination for Pertussis?
Vaccination for whooping cough during pregnancy is recommended for nearly everyone who is not allergic to the shot itself. The chances of you being allergic to this shot are close to zero. Everyone regardless of the age should have a whooping cough vaccine and its subsequent booster shots on time. It isn’t just the mother, everyone who comes close to interacting with the baby should get a shot, as whooping cough can be very dangerous. The condition is also very contagious and can be contracted through the air or by smear contact. So, you must ensure that your baby’s caregivers also receive a vaccination for pertussis.
Whooping cough is characterized by the “Whoop” sound after a cough, this symptom may not exist in adults but is very prominent in young children. A woman may also be affected by this condition during pregnancy, which is why, you must look out for its symptoms and seek medical assistance immediately.
Also Read:
Benefits and Side Effects of Prednisone during Pregnancy
Consecutive Test during Pregnancy
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My preganancy ups and down journey with my first baby
To begin with we were newly married and before we got the news about my pregnancy I was not well I had tumor in my ovary which we got to know just a month before I came to know about my pregnancy as per doctors I could never get pregnant after the removal of ovaries but this sudden news of pregnancy just shocked everyone this unplanned pregnancy was the best thing ever happend but the tumor was getting increased each passing day which needed to be operated as soon as possible I had my first checkup in my 6th week of pregnancy we found that there was no heartbeat of the baby doc said we must abort the child if the condition were same after 8 weeks on my 8th week test finally we heard our baby heartbeat which was the world's best feeling ever due to complications I was on bed rest and worst part was contionous vomitings due to which I didn't eat properly for 5 months I had to go for regular sonography test every month to have a watch on my baby growth and every month I fell more in love With the little angel growing inside me her first picture on the usg report made our heart melt in the 5th month I was said if everything doesn't goes well we must operate u but God was with us everytime we went for checkup we were given dates for the operation but all thanks to my doctor she never lost the hope and my pregnancy continued for 39 weeks my edd was 31july and pains started on 31st night and we went to hospital at 3:00am on 1st August as I was to operated for tumor I had to go for C-section which was decided on the very first day of my pregnancy on 1st August morning 6:47am my little angel was born I could hear her cry and Hear doctors saying she is such a cute girl who is looking all around the operation therate I was not given my because I was getting operated for next 1 hour I could not see my baby for 2days I just saw her pic after 2days I saw my little angel but the worst part is I could not breastfeed my baby due to heavy medications I feel very sorry for my baby as She in on formula feed but this doesn't mean I don't love my baby this what society thinks the breastfeed mother loves their baby but that's not true love is not defined on basis of bottle feed or breastfeed and today my angel is 4 months old Read more
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Dr Ghouse has added a new answer
Guardian of 0 children
8 hours ago
Q. #asktheexpert
what is the pain killer than can be taken by a breastfeeding mother to deal with pain of stitches after delivery?
Dr Ghouse
Paediatrician
5 hours ago
A. dolo 650 safe analgesic. 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
Anu Sharma has added a new answer
Expecting Father due in 3 months
2 hours ago
Q. My wife taking tablets for UTI it caused fever last week she took paracetamol and Pan D in IV and now for the past 5 days taking Nitrofurantoin tablet IP I have two questio
1) Will this tablets and IV affect my baby in any way and it's growth inside
2) She says still feeling some pain groin and abdomen area comparatively lesser than previous days
3) Any diets to avoid this UTI in future
Read moreAnu Sharma
Mom of a 1 yr old boy
2 hours ago
A. UTI infection is common in pregnecy. Better to consult gyne
Dr Ghouse has added a new answer
Guardian of 0 children
2 hours ago
Q. ma lmp 28.9.2023 edd date 5.7.2024 ma age 25.7.1999 ma beby boy or girl plsss tell me mam
Dr Ghouse
Paediatrician
2 hours ago
A. be not possible to tell. 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. Minal Acharya has added a new answer
Expecting Mom due in 5 months
1 hour ago
Q. Hii...., Is it safe to eat jackfruit in 4th month of pregnancy, daily 2 ...
Dr. Minal Acharya
Nutritionist
1 hour ago
A. dear mam, you can eat jackfruit during the 4th month of pregnancy. there is no problem in having it. you can eat all types of seasonal vegetables and fruits even green leafy vegetables.
Dr Sameer awadhiya has added a new answer
Expecting Mom due in 2 months
58 mins ago
Q. is that positive result??? my Due date is tommoro I am having vomitting and nausea and back pain etc please reply asap
Dr Sameer awadhiya
Paediatrician
55 mins ago
A. Regarding the mentioned concern your local doctor will guide you in a proper way and the doubts can be cleared accordijtngly .so you can discuss and get the solution for query.
Also online consultation can be taken on the platform and it will also be helpful in getting the proper guidance as there could be a detailed discussion which would be benifecial helpful in the correct manner .
Dr Laxmi Chavan-Sawant has added a new answer
Guardian of 0 children
4 mins ago
Q. Hi I'm in 23weeks pregnancy
my afi is 26 I have no diabetes or any other issues
is that risky ? what to do for making normal delivery possible
Dr Laxmi Chavan-Sawant
Ayurvedic Gynaecologist
New Answer
A. yes AFI level is very high and yes you need to be very careful to have regular follow up with your doctor take the precautions advised by your doctor and regularly keep a watch on baby movements
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