From the 13-14th week of gestation of the baby, the uterus is located above the pubic symphysis. Because of this, the figure of the woman is rounded and the pregnancy becomes noticeable even to outsiders. It is important not to miss visits to the doctor: up to 24 weeks this should be done once a month, from the 24th one – once every two weeks.
Clinical blood and urine tests should be taken at each gynecologist visit.
If the expectant mother is Rh-negative, and her husband is Rh-positive, the woman gives a blood test every month to determine the titer of rhesus antibodies. If she did not have time to pass prenatal screening in the first trimester, you can do it from the 16th to the 20th week.
In addition, before giving birth, a woman must complete the following studies:
At 19–20 weeks – an ultrasound scan to make sure the baby is developing according to plan.
At 24–26 weeks, a glucose tolerance test to assess the body’s ability to absorb glucose and the risk of developing diabetes mellitus during pregnancy.
At 30–32 weeks, the blood flow in the uterine artery, umbilical cord and mid-cerebral artery of the future baby is assessed using Doppler, to reveal signs of possible hypoxia. It is also necessary to pass a biochemical blood test, a coagulogram (a blood clotting test), her test for HIV, syphilis, hepatitis B and C. Ultrasonography is done at the same time to find out if the child has any abnormalities that require intervention immediately after birth.
After 30 weeks – cardiotocography (CTG). To understand how a baby feels and monitor its state over time, the child’s activity and uterine contractile activity are recorded approximately every 7–10 days.
36 weeks – smear from the genital tract for research on microflora and urine culture for sterility. With the inflammatory process there is time to heal before delivery.
After 37 weeks – an ultrasound scan to assess the weight of the baby, the degree of maturity of the placenta, the amount of amniotic fluid, determine the timing of labor and the tactics of their management.
By the 16th week of pregnancy, the laying of the internal organs of the unborn child and the formation of the placenta ends. Now it is she who will be responsible for the supply of oxygen and nutrients to the baby and remove metabolic products.
In addition, the placenta will begin to produce hormones, necessary for the normal course of pregnancy, and will become a barrier to harmful substances coming from the external environment.
From the 18th week, the expectant mother can feel the movement of her baby. In those bearing the first-born, this, however, occurs a little later – at 20 weeks.
Remember the number when the movement becomes noticeable, and tell it to your doctor.
Since during this period the future baby has teeth laid, the woman needs calcium and vitamin D. The doctor will recommend vitamin-mineral complexes.
Starting from the 20th week, doctors advise expectant mothers to wear a bandage that supports an enlarged belly. This way you can prevent stretch marks.
By the way, with stretch marks on the abdomen and chest can be fought by making massage with light, superficial plucking of the skin.
By the middle of pregnancy, the breast under the action of hormones increases by 1-2 sizes, the skin of the areola darkens, a colostrum can be gradually released from the nipple. Freckles and moles also darken.
With the increase in gestational age, problems with the gastrointestinal tract increase. During this period, it is necessary to monitor the work of the intestine. As the uterus grows with the baby, the stomach presses against the diaphragm, and the intestines move apart.
To cope with the problems of digestion will help a balanced diet with high fiber content.
Pressure on the abdominal organs can lead to hemorrhoids: this is due to the varicose veins of the rectum.
Another problem is heartburn (burning sensation in the chest). The fact is that the esophagus is separated from the stomach by a circular muscle. During pregnancy, due to increased levels of progesterone, smooth muscles, including the intramuscular sphincter, relax.
Because of this, the acidic contents of the stomach is thrown back into the esophagus, which contributes to increased intra-abdominal pressure.
Do not forget that heartburn can be a symptom of some diseases. If this condition causes serious inconvenience, report it to your doctor.
Alkaline non-carbonated mineral water can help reduce heartburn symptoms. If necessary, the doctor may recommend antacids.
To take them without consulting a doctor is absolutely impossible!
During pregnancy, the level of sex hormones increases, so there are excretions from the genital tract with a lactic smell. Changes in test results due to weakened immunity are also possible. If a future mother is offered a course of antibiotics for the treatment of opportunistic flora, it is better to consult another doctor.
Most likely, antibiotics will not be needed.
An elevated level of another hormone, estrogen, is needed to keep the body fluid for feeding the placenta. But this circumstance may be the cause of edema.
Limit the amount of salt, try not to drink at night, give up coffee, strong tea, sweet carbonated drinks.
The third trimester of pregnancy, which lasts from the 28th to the 40th week, for many women becomes a time of fatigue, because the load on the organs and systems increases many times over. The uterus is greatly increased in size and puts pressure on the neighboring organs – the bladder and rectum, due to which one has to leave the toilet more often.
The diaphragm rises, and breathing becomes shallow, vigorous movements can cause shortness of breath.
Over a period of 28–29 weeks, inferior vena cava syndrome may develop. When the expectant mother is lying on her back, the pregnant uterus is pressing on the vessels, the blood flow is disturbed, which can lead to a faint and dizzy state, a sharp drop in blood pressure and tachycardia.
To prevent this from happening, a woman is recommended to rest on her side by placing special pillows under her side.
By the 30th week, the expectant mother manages to gain the bulk of the kilograms. After this period, it remains to add only 3–3.5 kg.
Approximately at this time from time to time (up to 10 times a day) a woman can feel a slight tension of the uterus – training contractions. If they do not last long and are painless, there is no need to worry – this is how the body prepares for childbirth.
Such sensations are associated with an increase in the level of the hormone relaxin, thanks to which the vaginal tissues gradually relax and become more elastic than the muscles of the pelvic floor, cervix, cartilage of the pelvis and ligament.
An increase in the level of estrogen hormones makes the muscle layer of the uterus more sensitive, and the woman perceives the movements of the baby more acutely. By the 36th week, the uterus rises to the maximum height: its bottom (the uppermost part) is located at the rib arches.
After the 37th week, when the baby’s head starts to fall into the pelvic region, the expectant mother will feel that it has become easier to breathe. If the intensity of training bouts increases, and the interval between them decreases, there is a chance that the birth has begun.
In any case, when such symptoms appear, it is necessary to see a doctor so that he, after doing a vaginal examination, assesses the readiness of the birth canal and the condition of the baby.
A woman needs to walk more, relax, follow the recommendations of doctors on the regimen and caloric intake, measure blood pressure on both hands 2-3 times a day, and monitor well-being. If you have any doubts and alarming symptoms, you should consult a doctor.
For a period of 38–40 weeks, labor is considered timely and can start at any time. If at the 41st week the baby is not in a hurry to “get out”, you should consult a doctor in order not to miss possible complications of a post-term pregnancy.
One of the main problems that obstetricians fear in the last trimester of pregnancy is preeclampsia, or preeclampsia. Unlike early toxemia, which rarely affects a child, in late pregnancy it can be a serious danger to a future baby.
After all, this complication is associated with disorders of the vascular system, which affect the functioning of internal organs.
Starting with seemingly innocuous symptoms, preeclampsia gradually causes an increase in blood pressure, the appearance of protein in the urine, which is fraught with disturbances in the kidneys, liver, brain, premature detachment of the placenta. Therefore, it is necessary to treat edemas “anxiously” and not to disregard them.
At first, a pregnant woman has problems with her legs – by the evening they swell so that, taking off her shoes, it is impossible to put them on again. If urgent measures are not taken, the problem may worsen: the hands, the stomach (when the doctor listens to the child’s heartbeat, a trace of the tube remains on the stomach) and the face begin to swell.
So preventive measures include:
- Weight control. It is necessary to get on the scales every day at the same time, better in the morning. On average, after the 32nd week of pregnancy, a woman should gain about 50 g per day and 350–400 g per week. If the readings are greater, this may indicate swelling.
- Control of the volume of fluid consumed and the volume of urine. The amount of fluid consumed (not more than 1.5 liters) should be less than that removed from the body.
- Diet. Prefer boiled meat and fish, dairy products, vegetables, fruits.
- Moderate exercise. It is necessary to move as much as possible, to walk at a moderate pace.
Nowadays, edema is not treated with diuretics – they are unsafe for the future mother and baby. Allowed to use only light plant decoctions – bearberry, lingonberry leaf, St. John’s wort.
But, before you do something, be sure to consult your doctor about the frequency of intake and dose.
If at the beginning of carrying a child is disturbed by sleepiness, then in the later periods the problem becomes insomnia. A large stomach makes it difficult to sit comfortably in bed, the enlarged uterus crowns the adjacent organs, causing unpleasant sensations. Insomnia at night is replaced by daytime sleepiness, and many expectant mothers feel overwhelmed.
Sleep disorders are often psychological in nature, so it is important to tune yourself in a positive way.
In the afternoon, do not get involved in coffee and tea. Dinner should be light and take place at least 3 hours before bedtime.
In the evening, walk, and before you go to bed, be sure to ventilate the bedroom.
1–1.5 hours before bedtime, take a bath. 10–15 minutes spent in warm, but not hot water (temperature 35–36 ° C) will help to relax.
Only first get the approval of the doctor and discuss with him what can be added to water (coniferous concentrate, oil of lemon, rosemary, lavender, mint).
A glass of warm milk with 1–2 teaspoons of honey will also be useful. It is recommended to drink it half an hour before going to bed.
On the 30th week, the doctor prepares for a pregnant exchange card, which is always best to carry with you.
This document has 3 parts. At 30–32 weeks, the first one is filled in with the results of studies and analyzes conducted during pregnancy. She will be needed at admission to the hospital.
The second and third parts are filled by an obstetrician and a neonatologist after childbirth. They indicate how the childbirth proceeded, what were the complications, weight, growth of the baby at birth, Apgar score and vaccinations given in the maternity hospital.
These parts should be transferred by the mother to the antenatal clinic and to the pediatrician who will patronize the newborn.