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Q. I had a level 2 sonogram yesterday and my doctor saw white spots on my placenta. Can this be harmful to the baby? What do they do to resolve this if the spots don't disappear on their own? I am very worried. Thank you.
-Dani, New York
A. White spots on the placenta are usually calcifications. These calcifications can appear at numerous places on the outside and inside of the body. They can sometimes show up as a hard, whitehead pimple on your skin. Seems benign, right? I think so.
Sonograms and other prenatal tests are becoming more and more advanced each day, revealing information we never knew about fetal development and pregnancy. Unfortunately, technology sometimes progresses a lot faster than the deciphering of the information it provides. White spots or calcifications on the placenta could be quite common, but sufficient research has not yet been done to prove otherwise.
I remember when my sister was pregnant with her first baby, the doctor noted that there were cysts on her baby's brain. The doctor did not yet know what the cysts could mean, but he had to tell her to cover his ass legally. Her son turned out to be perfectly fine but she certainly did have a scare.
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Q. I am 23 to 24 weeks pregnant and I just got the results of my anatomical sonogram from two weeks ago. My doctor told me that they want me to have it done again in seven to 10 days because the femur length was showing relatively shorter then all the other measurements (minus 1 1/2 to 2 weeks shorter). Has something like this happened to anyone else? I'm very concerned and worried as to what this might mean!
-Anonymous, New York
A. I know how every "possible abnormality" talk from your doctor can send you into a panic. Unfortunately, if happens a lot during pregnancy. Do keep in mind, though, that medical professionals do have to tell you about any and all of their possible concerns—to cover their asses legally.
It's very possible that your baby's femur was just at an angle that made it appear to be shorter than "normal." Also, sonograms and other prenatal tests are becoming more and more advanced every day, revealing information we never knew about fetal development and pregnancy. Unfortunately, technology sometimes progresses a lot faster than the deciphering of the information it provides, which isn't always accurate.
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Q. I recently had an ultrasound and the doctor said the baby's head, neck and back look swollen, possibly signifying an infection. I'm not sure what this means and I haven't been able to find any information online. Is this a serious problem? I want to be prepared when I go back to my doctor.
-Anonymous, West Virginia
A. Sonograms and other prenatal tests are becoming more and more advanced each day, revealing information we never knew about fetal development and pregnancy. Unfortunately, technology sometimes progresses a lot faster than the deciphering of the information it provides. Your baby may very well be within the realm of normality, but your doctor does have to point out any "maybe" problems. See the other "prenatal testing" questions for more details.
Q. Should I be concerned about an elevated AFP? (Note: Maternal Serum Alpha Feto Protein is a prenatal blood test.) I am 21 weeks pregnant.
-Anonymous, Washington DC
A. Low levels of MSAFP may indicate one the following: Spina Bifida, Anencephaly (missing part of the brain) or Down Syndrome. Elevated levels could mean preeclampsia, a placenta problem and/or fetal growth issues.
Your doctor will probably want to monitor your baby's condition with frequent sonograms for the duration of your pregnancy.
Try not to worry too much. This test only indicates that there "might" be a problem. You and your baby could very well sail through the rest of your pregnancy without a glitch. If you do have a problem, at least you and your doctor will be well prepared to remedy the situation. And, you get to have frequent sonograms – that's always fun!
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Q. Can an OB/GYN really estimate the size of your baby? And, is it possible for the baby to drop its weight – let's say by 2lbs – from one week to the next?
A. Estimate, guesstimate, same thing. By measuring your uterine growth and weight gain, an OB/GYN can guess at your baby's weight and size based on an average gestational chart. Of course, there's a lot of room for variation with amounts of placental fluid, thickness of the uterus, maternal weight gain, etc. Sometimes these estimates are accurate and sometimes they can be way off. My friend Suzanne delivered a 7lb 2oz baby, just like her doctor estimated. Wilma delivered an 11lb 4oz baby. That was about 4lbs off from her doctor's guess.
It's possible, but not usual, for a baby to drop its weight from one week to the next. It's more likely that your measurements were a little bigger the prior week due to water retention or other factors, making the baby appear to be bigger.
Q. I am going for my first sonogram at week 18 and a lot of people have told me that this not normal. Can you tell me when I should have gotten my first sonogram?
A. Most OB/GYNs will order one sonogram (between 18 and 20 weeks) during pregnancy, while others will want you to have three or more. I, for one, would want as many as possible. This is the one test during pregnancy that is actually fun. You get to see your tiny baby and all of his or her parts! Sometimes you might even see a thumb sucking, a kick or a wave.
There are a lot of factors that may affect the number of sonograms you have, such as: if you have any problems with the pregnancy (e.g. bleeding, placenta previa or a suspected breech birth); if your doctor has sonogram equipment available at the office; and if your health insurance covers a certain number of sonograms during pregnancy (most will cover only one).
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Q. How soon can a sonogram show multiple embryos?
A. Sometimes multiple embryos can be detected within six to eight weeks by sonogram if the yolk sacs are separate and/or the embryos are spaced apart. Sometimes, but rarely, a twin will not be detected until the usual "big sonogram" at 18 to 20 weeks.
Q. I consumed 25,000 IUs of vitamin A daily during the first two and a half months of my pregnancy. I had two periods during this time so I didn't know I was pregnant. I am 12 weeks now and have discontinued the excess vitamin A. The maternity clinic I go to didn't even know it was considered teratogenic. I was taking it to clear up acne. Can a sonogram spot the birth defects associated with excessive vitamin A intake? Will an amnio catch any A-associated defects?
A. One study showed that women taking more than 20,000 IUs of vitamin A daily were four times more likely to deliver infants with deformities of the head, heart and brain. While the risk of birth defects is increased with high vitamin A, only one baby in 57 actually develops birth defects. Although your risk factor is higher, you still have a very good chance of having a perfectly healthy baby.
An amniocentesis is used to diagnose a large number of genetic and chromosomal abnormalities in the fetus, but probably won't show birth defects associated with the teratogenic effects of vitamin A. A sonogram may be the best way to spot these types of defects. Voicing your concerns to your OB/GYN should ensure that you have frequent sonograms throughout your pregnancy to monitor your baby's development.
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Q. I am 39. Will they do a routine amniocentesis because of my age? I go to a birth clinic and I am therefore considered "poor and uneducated." I'm not sure if we "drain-on-society women” are treated to the same considerations as everyone else. Will they even run extra tests?
A. Most OB/GYNs will recommend an amniocentesis if you are over the age of 35. At 35, the risks for having a baby with genetic abnormalities such as Down syndrome can increase. Whether your doctor will prescribe these tests for you depends largely on if the birth clinic is state run or privately sponsored. The state of California may only provide the minimum in prenatal care and testing, while a privately sponsored clinic may have a much bigger budget and could provide you and your baby with more services. I think it's probably best to directly ask them at the clinic what kind of services and tests they provide.
Q. Can an internal ultrasound pick up my heartbeat?
A. Depending on the sensitivity of the ultrasound equipment and the location of the instrument, your heartbeat may be detected. I wouldn't worry about your OB/GYN mistaking your heartbeat for the baby's, though. The baby's heartbeat sounds kind of like an echo and is much faster than an adult's.
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