Growth restriction of the baby- unusual Findings

An UNUSUAL finding in C section- Very thick cord with a Growth Restricted Baby.

Obese lady has been diagnosed with GDM (GESTATIONAL DIABETES MELLITUS) by OGTT (with 75 gram glucose) done in early pregnancy as per International Recommendation.

Sugar was controlled with oral tablet (Metformin), regular sugar check , dietary restrictions and consultation with Endocrinologist.

Serial GROWTH SCAN with COLOUR DOPPLER Was advised, every 2 weeks, which detected Inadequate Growth of the baby, FGR (FETAL GROWTH RESTRICTION).

As the growth was slow over last 3 scans , we discussed with the woman, about the need of early delivery.Steroid injection was given to promote lung maturity. As steroids increase blood sugar level, she was put on Sliding scale of Insulin. C section was done at 36 weeks at NICU set up. Healthy baby cried at birth, weighing 2.4 kg. He was kept in SCBU for 24 hours for observation, then sent to the mother.

Mother's blood sugar became normal after delivery without need of medicine. She was put on Enoxaparin Injection for prevention of thrombosis.

Usually in FGR cord is thin and small. Here it's the opposite, that's why it's unusual.

We thank the patient for keeping faith on us and giving us her KIND PERMISSION to upload the pictures.