Pada 12 Jun (sabtu) lepas, cikgu gi buat review kat Sabah Medical Centre (SMC). Kiranya nak survey2 la keadaan di sana. Manatau best nak deliever baby. Tapi bab kos yg tak tahan tu. Ye la hospital swasta. 3 minggu lepas cikgu dah booking appointment ngan Dr. Krishnen. Punya la lama nak tggu dia punya appointmnt.
Tunggu punya tunggu sampai la giliran cikgu utk masuk ke bilik Dr. Krishnen. So, cikgu n hubby pun masukla. Dalam hati sempat berkata 'wow.. dasatnye opis dia nih'.. Jadi jakun (a.k.a sakai) sekejap. Dr.Krishen pun myapa dgn ramah skali. Agaknya Dr. ni berbangsa Singh umur dalam lingkungan 50 thn. Tapi yg bikin xtahan soalan pertama yg kluar dr mulut dia, ni suami ker boifren? Aduzz.. Cikgu gelak aje lah walaupun gurauan itu agak sedikit melampau. hehe.. Nasib baik org tua. Xla amik hati sgt.
Dr. Krishen pun cek la buku klinik cikgu. Tanya smua la pasal tahap kesihatan cikgu. Then, dia pun suruh cikgu baring kat katil utk buat ultrasound. Jadi jakun lagi kali kedua bila tgk mesin ultrasound 4D. Slama ni dah banyak kali buat ultrasound kat klinik smuanya masih mesin 3D. Kagum gila bila boleh nampak 'ttuuuuutt' baby dgn sgt jelas. So, kompom la baby girl. Yeay!! Sebelum ni gi poliklinik gambar scan dia hitam putih aje. Ye ye la doktor tu tunjuk 'ttuuuuutt' baby tu tapi cikgu xfaham langsung. So, cikgu angguk2 je la. Padahal xfaham apa pun gambar tu. Bila scan kat SMC guna 4D, haaa.. baru la puas hati. Skali tunjuk je cikgu dah nampak. Then, Dr. Krishnen pun capture gambar muka baby. Naik plak bulu roma bila 1st time nampak imej muka baby cikgu. Kagumnye.. The obvious thing is her nose.. Skali tgk je dah nampak cam hidung my hubby. Hahakz! Dr. Krishnen pun kata 'wah.. ini hidung bapa nih. Hidung pakistan. Ada keturunan pakistan ka?' Appada doktor ni.. Tapi mmg happy sgt dapat tgk muka baby. Xsabar nak tggu dia kuar ;D
Tapi bila Dr.Krishnen cek saiz baby, there was something wrong. Saiz the baby is smaller than normal. Dr. kata 'this is not good'. Dia sebut term 'IUGR' Cikgu pun cam blur2 n risau pun ada. Pasal sblm ni gi klinik xde plak doc sana kata not good. Dr. Krishnen bagitau maybe sebabnya ialah plasenta cikgu yg ada prob cuz xdapat salurkan makanan dgn efisyen kepada baby. Hmm.. So, doc menasihatkan cikgu supaya sentiasa alert dgn pergerakan baby. Kalo kurg pergerakan kena cepat2 gi hospital. And doc juga suruh cikgu bgtau doc kat klinik beaufort supaya jgn tambah tarikh due cikgu lebih dr 40 minggu. My biggest fear skrg ni, takut2 kalo kena induce kelahiran baby pasal baby xdapat makan dgn secukupnya di dalam perut. Huhu.. Kesian baby... ;'(
So, cikgu pun surf2 la pasal IUGR ni pasal cikgu masih blur about that medical term.
Intrauterine Growth RestrictionSynonyms:IUGR, intrauterine growth retardation, fetal growth restriction, FGR
Definition
Intrauterine growth restriction (IUGR) is a condition where a baby's growth slows or ceases when in it is in the uterus.
It is part of a wider group - small for gestational age (SGA) fetuses - which includes fetuses that have failed to achieve their growth potential and fetuses that are constitutionally small.
Approximately 50-70% of fetuses with a birthweight below tenth centile for gestational age are constitutionally small.1 The lower the centile for defining SGA, the greater the likelihood of IUGR. On the other hand, a fetus with growth restriction may not be SGA.2
Aetiology
If the mother is small, it may be normal for her to have a small fetus; this is constitutional SGA, not IUGR. Causes of IUGR can be maternal, placental or fetal.
Placental causes * In many cases of IUGR, the placenta is small and doesn't provide sufficient nutrition to the growing baby. In IUGR pregnancies, blood flow to the placenta decreases as pregnancy progresses, compared with normal pregnancy when blood flow to the placenta increases throughout pregnancy to meet the growing baby's demand for oxygen and nutrition.
* Cell death (apoptosis); in pregnancies complicated by IUGR, the placenta contains a relatively high proportion of cells that have a shorter life than normal. This means the placenta functions less well, thereby transferring fewer nutrients and less oxygen both to and from the baby.
* Pre-eclampsia
When to deliver?The Growth Restriction Intervention Trial (GRIT) showed there is no evidence that early delivery to pre-empt severe hypoxia and acidosis reduces any adverse outcome. However it appeared that obstetricians currently make appropriate delivery decisions to minimise mortality.18,19
* When end diastolic flow is present in the umbilical artery, delay delivery until at least 37 weeks, provided other surveillance findings are normal.
* When end diastolic flow is absent or reversed, admission, close surveillance and administration of steroids are required.20,21 Among preterm growth-restricted fetuses with absent end-diastolic blood flow in the umbilical artery, the umbilical artery/middle cerebral artery ratio is the best predictor of neonatal mortality or severe morbidity.22 If other surveillance results (biophysical profile, venous Doppler) are abnormal, delivery is indicated. If gestation is over 34 weeks, even if other results are normal, delivery may be considered.
p/s: Harap2 baby cepat membesar. Mummy harap semuanya ok saja. Ya Allah.. slamatkanlah bayi dalam kandunganku ini. Amin..