So the middle of pregnancy has come. Week 20 ends the first half of a difficult and interesting journey, at the end of which a long-awaited meeting with the baby will take place. The woman is now at the peak of well-being, she looks impressive and is full of enthusiasm.
Several days between 19 and 20 weeks are a time of amazing experience of the first fetal movements, the first "contact" between mother and baby. Let's talk about this in more detail.
How many months is it?
The beginning of 20 weeks of gestation is 19 full obstetric weeks. They are called obstetric because they are counted from the first day of the last menstruation. In fact, the baby exists in the mother's womb for about 2 weeks less - 18 weeks have gone from the day of conception. About 16 weeks ago, the woman learned of the delay and probably did a pregnancy test for the first time.
In the usual calendar terms, 4.5 months have passed. By obstetric standards, the fifth month of pregnancy ends. There is still the same amount of time before childbirth, but now the woman will face a paradox - time will begin to flow more slowly, since the third trimester is perceived and experienced by expectant mothers a little harder than the second.
In the meantime, the second trimester is in progress - the most favorable and calm period... 19-20 weeks is an impressive period during which the fact of pregnancy can no longer be hidden, and there is no need for this. The mother-to-be has already gotten used to the fact that big changes await her soon. In the meantime, life flows fairly smoothly. A pregnant woman is registered at the antenatal clinic, she takes the necessary tests, and the period from 19 to 20 weeks is no exception.
Feelings of a future mother
It may seem to others that at this time little has changed, because a woman continues to lead her usual way of life - to work, study, and do everyday household chores. However, only the pregnant woman herself now knows what deep and interesting processes are taking place in her body. A woman feels a surge of strength and vigor, she wants to have time for everything, to do everything, because very soon another family member will be born, who will definitely become the main one.
At week 20, the sensations are constantly renewed, let's see what they can be.
General well-being
In general, a woman who is 20 obstetric week of pregnancy is doing well. The severity that will accompany the last trimester is not yet, but the painful toxicosis is gone. The tummy, although it grows by leaps and bounds, does not yet cause great inconvenience.
However, this week a woman may notice something new in her condition: from time to time, especially at night, she is thrown into a fever, then a chill. These "hot flashes" are caused by hormonal changes that occur from the first days of pregnancy.
Stirring
The vast majority of pregnant women at this time clearly feel the movements of their baby. This is definitely one of the most exciting and touching moments of pregnancy. If the woman has not yet felt the movements of the baby, now she is in tense anticipation: she is looking for an answer to the question why she still does not feel them.
The movements are very individual. Much depends on what kind of pregnancy a woman has. If the second or third, then the walls of the uterus stretch faster, movements become apparent earlier. If the birth of the first child is expected, then the woman will feel the first slight tremors much later. Pregnant women with twins or triplets begin to feel the activity of their children before anyone else.
If the placenta is located on the back wall of the uterus, then there is a high probability of feeling the fetal movement earlier. If the "baby seat" is located on the front wall, the sensitivity is reduced.
Women who do not sit still, constantly move, work, lead an active lifestyle, later begin to feel their baby, because they simply do not have time to focus on themselves and their feelings.
At 19-20 weeks, almost 90% of pregnant women say that they already clearly feel how the baby is moving in the tummy. But there are those who still live only in anticipation of this miracle. In primiparous women, the baby can manifest itself only in the next or 22 weeks. This is not considered unusual or abnormal, you just need to be patient.
Those who already have perturbations note that babies are more active in the evening and at night. This does not mean that the baby is an avid night owl. It's just that in the evening and at night a woman relaxes, rests, all the subtle touches of the crumbs from the inside in this state are perceived more vividly and clearly.
Mood and emotional state
Week 20 somewhat "knocks" the woman out of the measured blissful state in which she was in the previous weeks. This is due to worries about getting a second prenatal screening.
But right now the image of the child is being visualized. If earlier my mother imagined him only in general terms, now she knows exactly what a belly-resident looks like, what gender he is. If you hang an ultrasound image in a prominent place, then it becomes even easier to communicate with the baby.
Some pregnant women have long noticed that they began to forget everything quickly, they are absent-minded and cannot concentrate in any way. This is completely normal, because it is through the processes of inhibition, which cause forgetfulness and absent-mindedness, that the body tries to protect the baby, save him from mother's emotions, which are not always positive.
Often, at 20 weeks, a woman has difficulties in communicating with household members, because not all family members are ready for the fact that the need for attention from a pregnant woman increases sharply. Now the expectant mother needs not so much physical help (to lift, move, rearrange), as a sincere conversation, warm support and participation, a feeling of complete safety.
If the spouse and the rest of the family cannot, for some reason, create such a stop, the woman becomes capricious, whiny, which clearly does not contribute to strong and friendly relations in the family.
The nature of the discharge
Between 19 and 20 weeks, a woman may notice that vaginal discharge has become more abundant and lighter. The so-called leucorrhea (leucorrhoea) is often encountered by expectant mothers. Now the increase in the amount of discharge is associated with the natural need of the female body to maintain normal vaginal microflora. To maintain it in such a crucial period, the secretion increases, which can cause many questions for expectant mothers.
Do not be afraid of leucorrhea. By themselves, leucorrhoea, when they are light or yellowish, are not accompanied by itching and do not have a pungent bad smell, do not carry any danger. The inconveniences associated with discharge are of an exclusively hygienic nature: a woman must constantly wear thin panty liners (tampons are strictly forbidden to use during the period of bearing a baby!).
Unpleasant sensations should alert the pregnant woman. If a painful burning sensation and itching appeared in the perineum, and the discharge changed its consistency and began to resemble granular cottage cheese, then with a high degree of probability we can say that thrush has begun.
Abundant leucorrhoea is an excellent environment for the development of a wide variety of disease-causing organisms. Therefore, the addition of infection is not excluded. If the discharge has become greenish, this indicates a bacterial purulent inflammation. Pink and brown discharge are blood impurities, and white plaque on the walls of the vagina and external genitals is a sign of a fungal infection.
In all cases, if the normal discharge has changed color, smell, consistency, a woman should consult a doctor. The sooner the pathogen is found, the faster the treatment will be carried out, the sanitation of the genital tract. The risks of fetal infection will also be reduced.
Pain
If earlier the absence of pain was considered a sign of a normal healthy pregnancy, then from the 20th week (from this conditional "equator") some types of pain are considered quite acceptable and physiologically conditioned. These include, first of all, pain in the lower back and knees.
The load on the legs increases every day, because a woman's body weight changes upward, and the center of gravity also shifts, which causes complaints that the lower back and back hurt.
The stretching of the ligamentous apparatus, which holds the uterus in a fixed position, is also quite noticeable. This organ grows, the ligaments have to "adjust", they thicken and stretch, this can cause tingling in the lower abdomen, in the right and left sides, as well as sudden episodic "shocks" that resemble electric shocks.
If the lower back does not constantly pull, and the pains themselves do not resemble seizures, contractions, then there is nothing to worry about. If there is severe pain radiating to the anus, abnormal discharge, a woman should immediately consult a doctor, and it is better to call an "ambulance".
From 20 weeks, some women experience unpleasant breaking pains in the pubic bone. These sensations are associated with the onset of softening of the pelvic bones, with the help of which the pregnant woman's body begins to prepare for childbirth.
A slight discrepancy of the pubic symphysis can cause severe discomfort, especially when changing body position, when walking. If it hurts so much that it is difficult for a woman to move, be sure to consult a doctor to rule out the onset of symphysitis.
Due to calcium deficiency, a woman can now experience quite severe pains with cramps in the calf muscles. Reduces legs most often at night. Due to physiological hypocalcemia (the growing fetus takes most of this mineral from the mother), dental problems can also begin. Now, if a tooth hurts, it can be treated even with anesthesia. This should be used, even if the teeth are not sick, preventive examination and sanitation of the oral cavity will not interfere.
Headaches at 20 weeks of gestation are usually not permanent or even regular. If the head hurts severely and often, this cannot be considered the norm, a woman must definitely control blood pressure: most likely, the pains are associated precisely with its increase.
Changes in the body
It is impossible not to notice the changes in the female body at week 20. The waist has not only increased in girth, its lines have almost smoothed out. Many currently pregnant women joke that they no longer have a waist. But for many, the navel begins to stick out funny, and this somewhat raises the mood of the future mother.
How does the uterus grow?
The main reproductive organ of a woman grows intensively, adding about 1-2 centimeters in height per week. The height of the fundus of the uterus at 20 weeks may be different for different women. Normally, it is within 18-24 centimeters. Most often, this size, which is determined with the help of a measuring tape from a point in the center of the pubic bone border to the height of the upper part of the uterus, is equal to the number of weeks, therefore, most pregnant women at the current period are “measured out” 19-20 centimeters.
The uterus is located in the abdominal cavity, its upper wide part, called the bottom, is now close to the same level as the navel. The belly grows actively. If a woman visits the doctor several times a week, she will notice that the height of the fundus at 19 weeks and 3 days will be about a centimeter less than at 19 weeks and 5-6 days. Now the uterus is comparable in size to a decent ball.
The length of the cervix this week is for the first time determined as an indicator of its viability. In total, four routine examinations of the cervix are carried out during pregnancy, with the obligatory measurement of its length using ultrasound. The first such examination is carried out precisely at week 20. The average neck length is now 40.3 mm. If a woman is expecting her first child, a greater value is possible - up to 48 mm, if the pregnancy is not the first, the neck is slightly shorter - 40.1 mm. A pathological condition is the shortening of the cervix at this time to 30 mm or more.
A short neck is a threat of premature birth, and the baby cannot survive on its own. Therefore, when a pathology is detected, a woman is hospitalized and a decision is made - to suture the neck, use a pessary or apply medication.
At week 20, all of the above methods are still technically possible; after 21 weeks, suturing is usually not performed.
A woman at 20 weeks usually feels her uterus well, she can determine its upper border herself if she lies on her back. Also, almost all expectant mothers at this time are able to independently determine the tone of the uterus and even imagine the location of the fetus in it: the tummy is already asymmetrical, the baby can be located in its left or right lobe, and also regularly change its location.
Weight gain
A woman will now be reminded of the need to control weight gain at every scheduled appointment with a doctor. Now an uncontrolled increase in body weight may be the only symptom of a condition that is dangerous for a woman and her baby - gestosis. Weight at week 20 arrives quite intensively, because the baby is growing, and the amount of amniotic fluid also increases.
From what complexion the woman had before pregnancy, the rate of increase by week 20 will depend:
- thin girls and women are now "allowed" to add up to 6 kilograms to their initial weight;
- expectant mothers with normal weight and slightly overweight should not gain more than 5.8 kilograms;
- obese women, women with varying degrees of obesity can afford to add no more than 3 kilograms to their original weight by week 20.
Arterial pressure
Now the woman's body circulates about 40% more blood than before. All this puts a significant strain on the blood vessels and the heart. Right now, a woman may begin to complain of dizziness attacks.
The head is usually dizzy due to changes in blood pressure. It most often decreases at 20 weeks: systolic pressure decreases by 4-5 millimeters of mercury and diastolic pressure by 15 mm of mercury. Due to the need to pump more blood, the heart rate of the pregnant woman accelerates: the pulse becomes more frequent by about 8-15 beats per minute.
Such drops do not require medical intervention. However, if a woman begins to faint, suffers from nausea and severe dizziness, she must definitely inform her doctor about this.
Blurred vision
Often, at the 20th week of pregnancy, women begin to complain of a slight deterioration in vision. If before there were no problems with the organs of vision, then there is no reason for worry: visual acuity will soon return. A slight decrease in visual function is associated with an increase in the amount of blood in the body of a pregnant woman. Due to pressure drops, the retinal vessels are slightly narrowed, due to which visual acuity decreases.
For some, this process goes unnoticed. Women who now drive a car or work in positions that require good vision and accuracy of work should be extremely careful.
Stretch marks
Unpleasant traces of stretching on the skin in medicine have a certain name - "striae".With the increased growth of the abdomen, buttocks, mammary glands, which occur in the middle of pregnancy, the skin "does not keep up" with the growth rate, micro-ruptures of elastin and collagen fibers occur, and coarse connective tissue forms at the site of these breaks. It is she who gives an unsightly cosmetic effect in the form of stripes of different colors - from pink to purple.
After childbirth, stretch marks are difficult to correct, striae for the most part do not tan, since they do not contain malatonin. In order not to put up with such a cosmetic defect later, you need to take all measures to slow down the growth of stretch marks. To do this, a pregnant woman needs to monitor her weight: in women who have gained 20 kilograms during pregnancy, the likelihood of extensive stretch marks is much higher.
You can already use baby cream or other hypoallergenic gels and creams. The main thing is to prevent an allergic reaction, because the skin of a pregnant woman at 19-20 weeks is very sensitive.
Nosebleeds
About 15% of expectant mothers complain about such a phenomenon as spontaneous nosebleeds. In the middle of the gestation period, due to changes in blood pressure, as well as increased fragility of the vessels of the mucous membrane of the nasal passages, their integrity is disrupted from time to time. As a result, the woman may experience sudden bleeding.
Doctors urge expectant mothers to distinguish physiological nosebleeds from pathological ones. Natural ones occur most often with a sharp change in body position, with careless blowing of your nose. Pathological nosebleeds are repeated with enviable regularity and have no apparent reason. In fact, they can accompany hypertension, impaired blood coagulation, lack of calcium in the body.
For such bleeding, you should consult a physician and an ENT doctor.
Chest
The mammary glands of a pregnant woman at 20 weeks look very impressive: they have become noticeably larger, the nipples have become stronger, their sensitivity has increased several times. If colostrum begins to be secreted at the current time, you do not need to be frightened, nothing terrible happens. This is a completely natural phenomenon.
Colostrum is a highly nutritious substance rich in proteins, fats, carbohydrates and minerals. While it has a thick consistency and a yellowish tint. In the third trimester, colostrum becomes more transparent, and after childbirth, a few days later it turns into full-fledged breast milk.
Most often, colostrum in the middle of pregnancy appears in women who have already given birth and breastfeed: their ducts are dilated compared to those who have not given birth.
If colostrum is now bothering you enough, leaks and stains your clothes, you should use a bra designed specifically for nursing mothers. Its cups on the inside have special "pockets" for liners that will absorb colostrum and prevent stains on clothes.
Now you need to properly care for your breasts: wear supportive bras, wash your nipples with warm water twice a day, use stretch marks.
Fetal development
Sometimes you can find information that at 20 weeks the fetus has a soul. Some peoples really believe this, while Orthodoxy tends to believe that a child has a soul from the moment of conception. This is a controversial issue, and the expectant mother, if interested in it, will be able to devote this week to studying a variety of points of view.
One thing is certain: a baby is already a feeling and even thinking creature who very subtly senses his mother and is now beginning to comprehend the world around him.
In half the term, the baby has gone a long way from a fertilized egg to an embryo, and then to a fetus. Now there is a fetal period of its development, which means that the baby is fully formed, now it only has to grow. At 18 embryonic weeks (this is 20 obstetric), the baby has reached the size of a papaya fruit. His height is about 24-26 centimeters, and his weight is close to 350 grams. We will tell you more about how the baby is doing.
Appearance
The kid is getting prettier every day. He is no longer as thin as the expectant mother could have seen him at the first ultrasound; he is developing subcutaneous fat. Due to this, the baby's body gradually takes on more rounded shapes, the cheeks and tummy are the first to "recover". The arms and legs are still thin and therefore look somewhat awkward. The skin ceases to be bright red, because the subcutaneous fat layer gradually begins to separate the network of blood vessels from the thin skin layer. The skin itself from this week becomes four-layer, thicker and stronger.
From head to toe, the baby is covered with cheese-like grease. Its purpose is to protect the skin from constant exposure to amniotic fluid. The lubricant is reliably retained on the skin thanks to thin vellus hairs - lanugo, which now cover the entire body.
Gradually, as the baby grows, it will get rid of both lanugo and original lubricant. Closer to childbirth, his skin will become smooth, and lubrication will remain only where it is really needed - in places of physiological friction (in the folds of the skin, in the groin area, in the bend of the elbow and in the fold on the legs under the knees).
The baby looks more proportional at 20 weeks than before. His legs have noticeably grown, which were initially shorter than the arms, the head has almost acquired the correct shape, its dimensions are gradually coming in line with other parts of the body. Therefore, the baby no longer looks like a tadpole - now it is a man in everything, down to the smallest... So, he has eyelashes and eyebrows, fingernails and even his own unique fingerprints.
The baby's face will no longer undergo significant metamorphosis. The ears, which were originally on the neck, have long stood in their proper place, at 20 weeks nature adds the final "touch": the auricles acquire their final formed shape. The baby's eyes are still closed, but the eyelids are getting denser, at the current time, the baby begins to try to open them. This process is long, it will take several weeks, but the blinking reflex is being formed right now.
If a woman at 20 weeks decides to go not to a regular two-dimensional ultrasound, but to an ultrasound in 3D, then she will be able to see all the facial features of the crumbs on the monitor without any particular difficulty: they are already unique, they have everything that the baby inherited genetically. He has his own special shapes of nose, forehead, chin. He already looks like one of his parents, and, possibly, his grandmother or grandfather.
Sense organs
From the 20th week of pregnancy, the baby begins to better navigate in his environment. Now he clearly distinguishes between the time of day - night and day, morning and evening. His daily routine may not coincide with his mother's, for example, the period of wakefulness of the crumbs may fall just on the night's rest of the mother, but so far this will not bother the woman much, because the baby, even while actively moving, does not cause her pain and discomfort. Night somersaults of the offspring may remain completely unnoticed for the sleeping mother.
The world will never be the same for your child, because from 19-20 weeks his hearing organs begin to work in full... Until that time, the baby also heard, but mostly only the vibrations that created various sound waves and voices.
Now he enthusiastically begins to listen to the world as it is. His most beloved sounds, no doubt, are the beat of his mother's heart, her voice.
Right now, according to perinatal psychologists, his attitude to the world is being formed - optimistic or pessimistic. And here a lot depends on what kind of fairy tales and songs he will hear from his mother, how her relationship with his father will be built, what sounds will more often reach the tiny ears inside the mother's womb.
The fetus cannot yet see, although all the receptors of the organs of vision are fully formed. Bright light and night darkness are two light effects that the fetus can perceive through closed eyes. But he has achieved real perfection in the definition of tastes.
Since the receptors-papillae on the tongue were formed earlier than other senses, now their work is already debugged: the baby is well "versed" in what the mother ate, prefers sweet, is not too happy with sour or salty. He swallows amniotic water, it is they that can have different flavors, which depend on what the woman eats.
Tactile sensations are well developed, the baby, in the absence of the ability to see, perceives everything around him by touch, and this process of cognition gives him great pleasure. The baby's sense of smell will appear after birth, when he begins to breathe through his nose.
Immunity
From the 20th week of pregnancy, the baby's own immunity begins to work almost in full force. Now he is more protected against various external threats. By this point, the baby walked for a very long time. The first cells of the immune system began to form after about 4-5 weeks. The baby receives a sufficient amount of immunoglobulins from the mother's blood, they are passed by the placental barrier. In addition, the number of leukocytes in the blood of the fetus is approximately 2 times higher.
These cells are immature forms, they are unable to fully participate in the production of interferon and immunoglobulin, but so far this is not required: the baby's immunity protects the baby now and during the first months after birth. but all components of the fetal immune system are formed at this time.
Nervous system
This week, the formation of gray matter in the baby's body continues - the cerebral cortex with its convolutions and grooves. New nerve cells develop dynamically. The largest number of neurons originate around the ventricles of the brain, as well as in the inner cortex of the temporal regions of both hemispheres. This process will continue before and after childbirth. Young neurons are found even in adults, and it is believed that they partially provide the brain's ability to compensate for lost or impaired functions.
New neurons migrate to the cortex and deeper layers of the brain. This process is going on most intensively now and will remain the same dynamic until the 29th week of pregnancy.
Since the baby is becoming "smarter" with every second, this cannot but affect his behavior. The movements of the arms, legs and head are almost under the control of the central nervous system. Reflexes continue to develop. The baby already swallows perfectly, sucks, grabs what falls within the reach of his palms, knows how to push off with his legs from the walls of the uterus. It is improving every day.
Science does not know much about how the psyche of the fetus develops. Some experts say that already at week 20, the puzzler sees dreams, others are sure that this is impossible. However, there are several facts that have been proven by doctors. So, more than 70% of babies in the middle of their mother's pregnancy suck their right finger, and only a third - the left. In 99% of cases, those children who sucked the right toe in the womb are right-handed, while the left one already prefers left-handers.
If the belly of the expectant mother is now affected by a loud sound transmitted through the headphones, then in most children the temporal lobes of the brain are activated, and in rare cases, the frontal. These are precisely those parts of the cortex that will subsequently process speech information.
Thus, the baby's nervous system is already developing "with an eye" on the future habitat of the new man.
Internal organs, skeletal system
Understanding how a small organism works now will help the expectant mother to approach nutrition issues more competently, because her task at this stage is to provide her son or daughter with everything she needs.
At week 20, the most intense process is bone growth. Now the child really needs calcium and magnesium, as well as iron for the heart. If there is not enough calcium, the baby will begin to "take" the mineral from the mother's bones, as a result of which their fragility will increase, problems with the musculoskeletal system, teeth, and hematopoiesis may begin.
The baby's heart has all departments, 4 chambers. The fetal heartbeat is not like the mother's: the heart of the baby beats more often. Heart rate at week 20 is normally 150 to 170 beats per minute. The kidneys of the crumbs are involved in the production of urine, and the bladder and urethra contribute to its excretion from the child's body.
The intestine begins to accumulate the original feces - meconium. All glands work, including the thyroid and pancreas. All organs can already be examined by ultrasound.
Sex determination
The sexual characteristics that distinguish boys from girls even before they are born are fully developed. On an ultrasound scan, the doctor, if the baby allows him to examine his intimate places, will confidently inform who exactly to expect in the near future - a son or a daughter.
In boys, the testicles are now beginning to move into the pelvic area, and from there into the scrotum. This is a rather long process and will last until the end of pregnancy.
In girls, all the components of the reproductive system are already in place, and there are more than five million eggs in the ovaries - this supply will still increase. It should be enough for a woman's entire life.
Sex hormones are synthesized in boys, and girls will begin to provide themselves with hormones a little later, while their hormonal background is akin to that of the mother, the girls receive hormones from the mother's blood.
Your child is on ultrasound
When undergoing an ultrasound scan at 19-20 weeks, not only the growth of the fetus is assessed, but also the features of the formation of all its organs, so as not to "miss" cases of genetic and chromosomal genetic pathologies. Even now, the doctor can see abnormalities in the development of the kidneys or heart of the child, if any.
The gestational age and the size of the baby are no longer determined by the CTE, there is a whole table of various parameters. This week is characterized by the following values.
Fetometric norms at 19-20 weeks
Fetal presentation, although it is determined, is not yet of great value. It is pelvic or transverse - information that is more important for the last weeks.
So far, neither one nor the other should instill sacred horror in a pregnant woman, since the baby is not yet big enough to take a fixed position. He moves and many times changes his posture relative to the exit from the uterus.
Dangers and risks
There are not many dangers at week 20, but they cannot be ignored. The threat of miscarriage is now minimal, even if it was previously, the end of the fifth obstetric month is a fairly calm period during which spontaneous abortion is unlikely. However, other complications may develop, and the woman needs to be prepared for this.
The most common complication of the second half of pregnancy is gestosis. Its main symptoms are edema. They can be external and internal. The external woman will notice herself: first, the rings will no longer be easily removed from the fingers, and then the usual worn-out shoes can become cramped.
Internal edema is much more difficult to suspect. That is why it is now strongly recommended to weigh yourself (with edema of internal organs, the weight grows at a pathological rate), at 20 weeks, a woman is recommended for tests that will make it possible to judge the likelihood of developing preeclampsia.
Reduced immunity can now cause colds and infectious diseases. Immunodeficiency in a woman is now physiological in nature, the body's natural defense mechanisms are suppressed by hormones so that there is no threat to the development of the child. But it is he who becomes a fertile ground for ARVI, flu, cystitis and other ailments.
Medicines, including some antibiotics, for example "Flemoxin", can now be prescribed to a woman, since they will not harm a child with a proper scheme and dosage. A much more formidable consequence of a cold can be a violation of the uteroplacental blood flow, which sometimes develops due to a high temperature.
Problems with the functioning of the digestive system are common enough. In a woman, due to the fact that the uterus has begun to press the abdominal organs, constipation, diarrhea, and heartburn may begin.
Frequent constipation, in turn, increases the likelihood of developing hemorrhoids. According to medical statistics, about 70% of expectant mothers suffer from them in the second half of pregnancy.
Often, against the background of an increased load on all organs during pregnancy, old illnesses again "declare" about themselves, which a woman could already have forgotten: colitis, gastritis, peptic ulcer disease.
Polyhydramnios and low water, established at this time, are not a definitive diagnosis, they describe only tendencies towards an increase or decrease in the amount of amniotic fluid. Such a pregnant woman will be more closely monitored, she will have to take tests more often and visit her obstetrician-gynecologist.
The danger at week 20 lies in hypocalcemia - calcium deficiency, and in anemia: an insufficient level of hemoglobin at the current time is diagnosed in approximately 20% of expectant mothers.
Analyzes and examinations
From this week on, a woman will have to visit a gynecologist not once a month, as it was before, but twice. But this will be after the second screening. Usually it is planned to be carried out in the period from 18 to 21 weeks, this week about half of the women who are registered will have to be diagnosed.
A comprehensive study includes an ultrasound scan of the fetus and a biochemical blood test. "Triple test" - determination of levels of hCG, free estriol and alpha-fetoprotein. These three substances and their concentration are important indicators of a baby's health.
The results from the laboratory will be supplemented with an ultrasound protocol. The purpose of this comprehensive universal diagnosis is to determine the risk group for chromosomal abnormalities. This screening differs from the first in that the range of diagnostic possibilities is expanding: now the doctor can draw conclusions about how the baby's brain and spinal cord are developed, whether he has neural tube pathologies.
General tests - blood and urine tests are considered mandatory at week 20. If an increased sugar content is found in them, the doctor will suspect gestational diabetes, and if protein is found in the urine, the woman will be at risk for the development of gestosis.
Tips and tricks for expectant mothers
Recommendations for mothers remain the same - fresh air, quality food, gentle work schedule. However, now some adjustments are being made to it: long walks are now undesirable, evening promenades in a park or public garden should be limited in time to 10-15 minutes. Other tips that will be helpful in the middle of pregnancy include the following.
- Get a pillow for pregnant women: its special shape will make it easier for a woman to take a night rest on her left or right side, sleep better, and wake up less.
- To prevent stretch marks and relieve discomfort in your lower back and back, start wearing a prenatal orthopedic brace.
- Do not hesitate to openly tell colleagues and friends so that they do not touch your belly that this is unpleasant for you: there are more than enough people who want to touch a woman's rounded belly.
- It's time to learn how to get out of bed correctly: first you need to turn on your side, then lower your legs, sit down and only after a short pause take an upright position. This will prevent dizziness, fainting, nosebleeds.
- Sex is not forbidden, especially since a woman's sexual desire begins to grow this week. The couple needs to make sure that there are no contraindications (check with the doctor), and then be careful not to put pressure on the stomach, avoid positions with deep penetration.
- If any alarming symptoms and "malfunctions" appear, a woman must inform her doctor about it, be it a runny nose, frequent urination or headache.
- Now it is very important to regulate your diet - to avoid foods, the use of which is undesirable, and "lean" on healthy and necessary foods. You need to eat fractionally, at least six times a day. Fresh vegetables and fruits are an excellent prevention of constipation and a source of vitamins. Fatty meat, carbonated drinks, flour, sweet, salty and smoked, as well as pickled foods and canned food are not recommended.
Reviews
The main topic of reviews that pregnant women left on the Internet are movements and issues of ultrasound diagnostics. New sensations that have appeared (or have not yet appeared) in connection with the sensation of the baby's movements raise many questions. There are even more doubts and worries about the screening results. If they turned out to be doubtful or unsatisfactory, women are offered invasive diagnostics - cordocentesis or amniocentesis.
Since these methods, although they are accurate, can pose a danger to the health and life of the baby, women are looking for alternative ways to find out if the baby is healthy. There are such methods now - these are non-invasive prenatal DNA tests, for which only the usual venous blood of the woman herself is needed. They find fetal blood cells in it, and from them get DNA that can answer all questions - about the health and sex of the fetus.
About what happens to a woman and a fetus in the 20th week of pregnancy, see the next video.
