estimate the fetal weight

Izzat Mubarak: Dr Shaiful, how to clinically estimate the fetal weight?
Thank you

Dr Shaiful Ehsan: Assalam izzat, overall u need to remember 3 commons SFH and mean fetal weight:

These are the golden rules:
At pog 28 weeks = 1kg
At Pog 32 weeks = 1.7kg
At 36 weeks 2.4 - 2.6kg

Then the rest is based on palpation and adjust accordingly....
Nevertheless, it depends on ur experience as well...

If u guys palpate a lot enough...u can appreciate and just +/- the golden rule estimation

In presenting estimated fetal weight...please present in estimation of 0.2kg...
Eg estimated fetal weight is 2.6 to 2.8kg...
Thanks

 Dr Shaiful Ehsan: Based on golden rules...lets say u palpate a patient's abdomen sfh is 38 weeks and its follow date...no other abnormalities u suspected on palpation...and its size appropriate....
U can tell EFW is aroun 3.0 to 3.2kg....

If u palpate it is quite small...u can roughly say 2.8 to 3.0kg...
Something like that...tq

[08/10 9:06 am]

sexual intercourse during pregnancy

Aiman Fauzi: Thank you doctor.. Doctor my patient ask me whether is it okay to have sexual intercourse during pregnancy? And she also inquire if 'pancut dalam' can cause any harmful effects on pregnancy?
Cc: faiz ros malu bertanya

Azrul Aziz: Sperm ade prostaglandin kan?

Azrul Aziz: Takut effect pada cervix

Dr Shaiful Ehsan: Waalaikumsalam for those who did ask the questions...
SI in pregnancy is indeed safe, though theoretically it may cause premature contraction due to presence of prostaglandin in semen....but it is still in grey area...
Even in placenta praevia, though painless bleeding may occur after SI....but no guidelines suggest avoidance of SI...
So, generally you can tell ur patients that there is no contraindications for performing SI during pregnancy...tq.

 Dr Shaiful Ehsan: But for those presented with prem contraction...SI should be included under your history taking..
Can refer to my 6th note for juniors....got previous script with Dr Sudesan on prem contraction....tq.

[07/10 6:06 pm]

management cor IUD of one fetus in twin pregnancies

Dr shaiful: Assalamualaikum, 5th month of pregnancy...so it would be after age of viability...which means more than 24 weeks gestations...which we called intrauterine death (IUD) or fetal demise...
For fetal demise of one fetus in twin pregnancy, mx depends on type of chorionicity, gestation and causes of fetal demise...

Dr. Shaiful: But for monochorionic twins (shared placenta) the risk of IUD of the paired twin is there...can be as high as 20%...even if survive...there is still risk of neurological damage to the surviving fetus...
I have encounter certain hospital giving MgSo4 (not for PE) but for cerebral protection in potential severe prem baby (eg htaa) which can be applied as well in this case of reducing risk of morbidity of surviving 2nd fetus...
Time of delivery is basically still grey area in monochorionic twins...and opinions from fetomaternal specialist (eg Dr Anna) is really required...
If conservative is choosed, some suggest delivery as early as 28 weeks for MCMA, and up to 34 weeks for MCDA...

Dr. Shaiful: Lets begin with DCDA twin (2 sacs 2 placentas = 2 different sets of rooms). If one fetus IUD, and the causes is not related to systemic or uteroplacental insufficieny, and most likely not gonna cause another IUD to the surviving fetus...conservative managememt can be done and wait for delivery at least till 34 weeks (most studies showed that 90% of preterm baby salvageable at 34 weeks)

Dr. Shaiful: Im forwarding my answers to ur fren in other posting asking about management cor IUD of one fetus in twin pregnancies....
Above are the answers...
Hope its useful...

Dr. Shaiful:My homework for u guys are events occur at 34 weeks...
Tq.

Faiz Roslan: Dr, one of the events occur during 34 weeks is that the amniotic fluid is at its max. Betul ke dr?

6oct2015