Abdominal prolapse during pregnancy by expectant mothers is quite reasonably regarded as the first sign of the imminent approach of childbirth. But not all women, especially primiparous women, are sure that they can accurately recognize the moment of abdominal prolapse.
In this article, we will tell you how long before delivery you should expect abdominal prolapse and why it happens.
Lowering mechanism
The uterus is a very elastic organ; during pregnancy, it increases in size almost 500 times. It is these growth rates that are physiologically capable of providing sufficient space inside the organ, which is necessary for the growth and development of the baby.
A large uterus with a baby inside, an almost half-kilogram placenta and a fetal bladder filled with amniotic fluid, noticeably "infringes on the rights" of neighboring organs, which every day, due to the increase in the size of the baby, the uterus, has less and less available space in the abdominal cavity.
Unlike the reproductive organ, the abdominal cavity cannot increase during pregnancy, its volume is fixed. As a result, the reproductive organ compresses the intestinal loops, exerts a squeezing effect on the lower part of the stomach, which is why gastric juice is thrown into the esophagus. The bladder and ureters experience inconveniences, their reproductive female organ squeezes from above. The uterus constricts the gallbladder, the pancreas.
Having organs in cramped conditions is like surviving in difficult conditions. They adapt, but they can no longer function normally, although the dysfunctions appear compensated.
Due to pressure on the diaphragm, normal breathing is disrupted, a woman cannot take a deep full breath, suffers from shortness of breath even with little physical activity, walking on foot.
She suffers from heartburn, regardless of the diet, the outflow of bile is disturbed, the problem of constipation and increased gas formation is characteristic of almost every expectant mother, and almost 100% of women in the third trimester of pregnancy have frequent urination.
In the last month of pregnancy, the baby, obeying the inexplicable signals of the female body, begins to take the correct position in the uterus, suitable for subsequent passage through the birth canal.
Its head is pressed against the exit from the abdominal cavity into the small pelvis, while the fetus is completely placed in the uterine cavity at a level lower than during all previous months of pregnancy.
The uterus becomes more elongated, oval, its bottom, with the lowering of the baby, also drops lower. Due to this, the abdomen looks lower, it feels like the navel line is "looking down".
The abdomen usually drops either 3-4 weeks before delivery, or later. In some women, the baby is pressed against the exit to the pelvis just a week before delivery.
It depends on the degree of preparedness of the female body and a similar indicator of the fetus as it approaches the expected date of birth.
The tummy may well not go down at all with fetal positions different from the normal head position - with the pelvic position of the baby, when the presenting part is the buttocks, with the transverse position or oblique position of the crumbs relative to the exit from the uterine cavity.
Diagnostic indicators and symptoms
To understand if the abdominal prolapse has occurred, a pregnant woman needs to look at herself in the mirror more often... The mirror should be full length. Some women take pictures of their reflection on their mobile phones every week to keep track of how their belly grows. Such a "gallery" of photographs will help you quickly understand that your stomach has dropped. Wherein the tummy will visually have a slightly smaller size than a week earlier... Its shape also changes somewhat.
When omission occurs, the assumptions can be tested using a simple manual test. If a woman can easily place her own palm between the lower line of the mammary glands and the highest point of the reproductive organ - the bottom of the uterus, there should be no doubt that the prolapse has taken place.
In addition, the following changes in well-being can be observed almost immediately after omission:
- it becomes noticeably easier to breathe in and out, shortness of breath decreases or disappears completely;
- ribs do not hurt as much as before;
- movements of the crumbs become less painful, the baby is mostly "thrown" and is active in the lower abdomen, and not under the ribs, as it was before;
- the urge to urinate becomes more frequent and worse;
- symptoms of symphysitis (pain in the pubic bone, pubic articulation) are more pronounced;
- constipation becomes more frequent and stronger;
- walking becomes harder and harder.
Often, at this moment, there is an intensification of training fights, in which the muscles of the uterus tenses and relaxes completely spontaneously. Such contractions do not indicate the onset of labor. There is no need to be afraid of them.
What affects the timing?
Abdominal prolapse after 36 weeks of pregnancy is considered quite normal and timely.
If the expectant mother notices that the belly has changed its shape and began to be located lower earlier, it is imperative to report your feelings and observations to the attending physician. This is important in order to exclude the likelihood of premature birth, to reduce the corresponding risks.
The process of lowering the abdomen is very individual and depends on many reasons. The key role is given to the presentation of the fetus. But the constitution of the pregnant woman's body, and the size of her pelvis, the state of the muscle tissue of the abdomen also affect.
The main question that women and doctors ask themselves, whose belly before the indicated dates and did not think to go down, does this mean that childbirth can be postponed, that the pregnancy will become delayed?
The countdown of the weeks to the birth of the baby does not always depend on the moment the abdomen drops. When a woman bears twins or triplets, the prolapse is physiologically impossible, or it is so insignificant that it will be unrealistic to determine it by eye.
If the expectant mother is carrying a large or giant baby, the estimated weight of which before childbirth is estimated at 4 kilograms or more, there is also no need to wait for abdominal prolapse.
A woman with polyhydramnios will not notice a significant change either - her uterus is enlarged more than normal due to an excess of amniotic fluid.
In primiparous and multiparous
The preparation of the body for the upcoming birth during the second, third and each subsequent pregnancy always proceeds faster than during the first. This applies to absolutely all aspects - maturation of the cervix, the course of the latency period, as well as abdominal prolapse.
Thus, in women who are expecting their first child, the abdomen begins to sink earlier than in multiparous women.
Experienced mothers, after the manifestation of such a symptom, usually do not have to wait long in time - the symptom appears a week or two before the birth of the baby, and sometimes even several days. In obstetrics, there are cases when the stomach of a multiparous woman sank only with the onset of labor pains.
In any case, childbirth begins not only when the baby presses its head against the exit to the small pelvis. Numerous conditions must be met - the level of oxytocin must increase, and progesterone must fall, a sufficient amount of actomyosin protein must be formed in the cells of the uterus, the ligaments holding the uterus must relax as much as possible under the influence of the hormone relaxin, the cervix must become softer, smoothed, shortened. Only when all of the above conditions are met, labor pains begin.
You need to assess your condition in a comprehensive manner, to consider all accompanying symptoms - "harbingers".
These include increased back pain, aches, heaviness, discharge of a mucous plug that closed the cervical canal, insomnia, nesting syndrome, increased anxiety, causeless anxiety, mood swings, changes in the nature of vaginal discharge.
If any, post-prolapse childbirth can be expected for a multiparous woman in the next days or even hours. A pregnant woman awaiting the birth of her first child can wait longer - 2 to 4 weeks... It takes more time to soften the cervix, prepare the birth canal when carrying the first pregnancy.
You will learn how to understand the location of the baby in the tummy from the following video.
