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Fetal testing such as a biophysical profile at this stage is not routine. It is done for a specific reason, such as to check the well-being of an overdue baby (at 41 weeks or beyond) or to assess the functionality of the placenta. Because you have gestational diabetes, your doctor wants to watch the baby extra closely during these last weeks of your pregnancy.

A biophysical profile uses ultrasound and takes from 20 to 60 minutes to complete. The baby is scored between zero and two points for each part. A total score below eight indicates a need for further testing. The least common of the three tests, a Doppler flow study, uses ultrasound to assess the rate of blood flow in the umbilical blood vein and in the baby’s arteries, brain, and heart. The procedure is much like a regular ultrasound exam, except that the test uses color to differentiate the blood vessels. Waveforms on an ultrasound screen show variations in the rate of the blood flow. Decreased flow may indicate that the baby is not receiving enough blood, nutrients, and oxygen from the placenta.

Sonograms, also called ultrasounds, refer to high frequency sound waves. When these sound waves hit a dense mass, tissue or fluid, they produce echoes, which bounce back to a receiver. The receiver then translates these into a signal that converts to either sound (fetal heartbeat) or an image.

It has been over 40 years since ultrasound was first used on pregnant women. Although some harmful effects in cells have been observed in a laboratory setting, abnormalities in embryos and the offspring of animals and humans have not been demonstrated.

Apparent ill effects such as low birth weight, speech and hearing problems, brain damage and non-right-handedness reported in small studies have not been confirmed or substantiated in larger studies from Europe. The studies were not adequately performed or large enough to show actual validity.

Of course, it remains important for scientists to continue to study the effects of this technology. Ultrasounds are considered to be a very safe method of providing valuable information during pregnancy. There is no indication that they are harmful or affect the baby in any way.

In some areas, women can even choose to see their babies in 3-D or 4-D color scans. Sometimes these sonograms are offered in non-medical settings that are set up very much like photography studios. Personally and professionally, I have mixed feelings about having an ultrasound merely for a photo or video of the baby. I think it is sensible to have one only as needed, and recommended by your care provider.

Your question concerns two topics: the rupture of the water bag (amniotic sac) before labor begins, and premature labor. Let’s address these two separately. In the movies, labor always seems to begin with the breaking of the water bag. But labor actually begins this way for only 10 to 15 percent of women. When it does, it usually happens at full term, between 37 and 41 weeks. Labor seldom begins before 37 weeks. But when it does, it often begins with rupture of the membranes. Sometimes, there has been a mild infection in the uterus and amniotic sac. This condition, called chorioamnionitis, can be difficult to diagnose and treat. In other cases, undiagnosed cervical dilation has caused the amniotic sac to break. In still others, the amniotic membrane was weak for some reason.

The fact that your water bag ruptured prematurely in your first pregnancy does not necessarily mean it will this time. Although both the premature birth of your first baby and the premature labor you have experienced in this pregnancy increase the likelihood that you’ll deliver prematurely again, the terbutaline and bed rest appear to be working well for you. Hang in there for just a few more weeks!

Rh factor, or Rh antigen, is a substance present by heredity in the blood of most people. Only 15 percent of us lack Rh factor, or have Rh-negative blood. Years ago, babies often died from what was known as Rh incompatibility, or rhesus disease. Today, we can prevent this from happening. If both you and your husband have Rh-negative blood, then the baby will also have this blood type, and no treatment is needed. If, however, your blood is Rh-negative and your husband’s is Rh-positive, the baby may have Rh-positive blood. In this case, your body could begin producing antibodies to your baby’s red blood cells. If you have never been pregnant before, your baby would be unaffected by these antibodies. They would remain dormant and harmless unless you became pregnant again. Then, if your baby were Rh-positive, the antibodies could cross the placenta and attack the baby’s red blood cells. This could cause anemia and mild to severe jaundice in the baby. To prevent this problem, an Rh-negative mother with an Rh-positive partner receives a shot of Rh immune globulin, or RhoGAM, at 28 weeks of pregnancy and again within 72 hours of giving birth. Rh immune globulin is also given to an Rh-negative woman after a miscarriage, an ectopic pregnancy, or an induced abortion, and at the time of amniocentesis, CVS, or another invasive procedure during pregnancy. A shot of RhoGAM should be considered, too, if an Rh-negative woman experiences any significant bleeding or blunt trauma, such as from a car accident or fall, while she is pregnant. This kind of injury can also cause Rh sensitization.