21 weeks pregnant
So, the milestone has been passed - the first half of pregnancy is already behind, at 21 weeks the sixth obstetric month began. For most women, it will become the calmest period, when the belly is not yet so large as to restrict freedom of action, there is a confidence that pregnancy is developing normally, there is an opportunity to establish a kind of communication with the baby.
Content:
- What happens to the expectant mother?
- Fetal development
- Sensations
- Baby wiggle
- Changes in the uterus
- Special problems - low placentation
- Belly at 21 weeks
- Allocations - norm and deviations
- Pain - their cause and prevention
- Analyzes - result of screening
- Ultrasound at 21 weeks of gestation
- Attitude towards sex
- Pregnant weight at 21 weeks
- Organization of proper nutrition
What happens to the expectant mother?
21 weeks is no exception, during this period significant changes occur in the woman's body. By this period of pregnancy, the mammary glands increase, the sensitivity of the nipples changes. The woman notices that bras are now much larger than before pregnancy. On the enlarged breast, the same stretch marks appear as on the abdomen.
Colostrum may begin to be secreted from the nipples, this is the mammary glands preparing to produce milk. It cannot be expressed, squeezed out of the chest. This tactic leads to an increase in the tone of the uterus, can provoke contractions. It is better to carry out hygienic treatment of the breast with neutral means, to put pads in the bra.
Swelling of the legs may appear at 21 weeks of gestation. Most often, this phenomenon is observed in the second half of the day, it occurs due to an excessive load on the cardiovascular system, accompanied by increased fatigue. To prevent edema, you should rest more often in the supine position, reduce the amount of liquid in dishes, and adjust the drinking regimen.
Hormonal changes in the body lead to changes in the structure of the skin, hair and nails. The epidermis has become thinner and more tender, acne and rashes have disappeared. Hair and nails began to grow more intensely. Hair growth has increased in unwanted areas as well.
Fetal development
The fatty layer under the skin of the fetus has just begun to form, so at 21 weeks of gestation, the baby is quite thin, and his skin is covered with wrinkles.
At this time, the unborn child often swallows amniotic fluid, getting glucose and other nutrients from it. Such activity serves as a training for the swallowing reflex and contributes to the development of the intestinal mucosa, its villous apparatus. Do not be afraid that unwanted substances will enter the child's body with the amniotic fluid. Amniotic fluid is sterile, its composition is renewed 3 times a day, so the fetal intestine does not yet contain a single bacteria.
The first bacteria will enter the baby's body with the first sip of breast milk or colostrum. Now the taste buds on the tongue of the fetus respond to the taste of the food the mother is eating. The only danger that threatens his digestive system is nicotine and alcohol that gets into the blood if the expectant mother uses these toxic substances.
Fetal parameters:
- Body length from heels to crown - 26-27 cm;
- Weight - 350-360 g;
- The amount of amniotic fluid you drink is 0.5 liters per day.
The child's urinary system does a serious job, processing about 450 ml of fluid per day. The respiratory system of the fetus develops, the epithelium appears, lining the inside of the alveoli. From time to time, the child performs movements that imitate breathing. This is how the body prepares itself for the first breath.
The child's endocrine system performs the functions intended for it by nature. The pituitary gland, thyroid and pancreas, spleen - all these important organs function to help the immune system create its own defenses, and produce its own hormones. Passive immunity is created using antibodies from the mother to the fetus. They create powerful immune defenses for the baby. The child's blood contains such important elements as white blood cells and platelets.
This period is a very important stage in the formation of the rudiments of molars, therefore, the expectant mother should consume a sufficient amount of calcium. The musculoskeletal system and vestibular apparatus of the child are getting stronger every day, and his movements become more confident. While the uterine cavity is large enough for him to freely turn over and move in it. If the ultrasound showed that the baby is still head up, do not worry - before giving birth, he will change his position several times.
Sensations
Some manifestations of pregnancy can make a woman uncomfortable. One of them is heartburn, when the stomach, being in an unnatural position for it, can throw gastric juice back into the esophagus. If heartburn is severe enough, you should contact a gastroenterologist and discuss the use of a safe antacid with him.
Due to the displacement of internal organs, the diaphragm rises upward, causing shortness of breath. Sometimes a woman cannot even take a deep breath in and out. A physical therapy instructor or a doctor leading a pregnancy will recommend a set of breathing exercises to normalize breathing. The learned ways of correct and rational breathing will help a woman subsequently relieve her condition during childbirth.
At 21 weeks, quite intense constipation and bloating can be felt. Most often, hormonal changes, intestinal squeezing, and dietary disturbances are the cause of such negative sensations. To alleviate the condition, it is enough to add more fruits and fresh vegetables, foods rich in fiber to the menu.
Hormonal changes can provoke small psychological changes - a woman can become insecure, lose interest in her previously loved activities. She develops unreasonable laziness or a sense of unaccountable anxiety. The best tactic is to wait a bit, because the period of instability will end without any consequences.
The activity of the baby and the load on the bladder can deprive a pregnant woman of a restful sleep. The frequent urge to urinate due to the pressure of the growing uterus can interrupt the night's sleep several times during the night. A growing belly makes it difficult to choose a comfortable sleeping position. It is best to sleep on your side using a special pregnancy pillow.
Baby wiggle
It would seem that quite recently the expectant mother was looking forward to the first movements of the fetus, and after a few weeks he became so active that one can distinguish between the periods of his sleep and wakefulness. This is due to the active development of the child's musculoskeletal system. Some women claim that they can distinguish which part of the baby's body has turned to the front wall of the uterus.
What can be said for sure - it is already possible to understand in which half of the abdomen the baby is, moving inside the uterus. At such moments, it is visually noticeable how the stomach slightly increases on one side and decreases on the other.
The movements can become too intense when a woman is in an unventilated and stuffy room for a long time. The baby feels a lack of oxygen and, while moving, stimulates the work of his heart for an active exchange of blood and the flow of oxygen into it.
Sometimes the activity of the baby increases markedly when the expectant mother needs rest, a night's sleep. Perinatal psychologists recommend in such cases to calm the child down with gentle strokes on the stomach, sing a song to him, and turn on quiet, quiet music.
Changes in the uterus
The uterus increases, rising above the navel by 1 cm, and above the level of the bosom - by 21 cm. Now it is not recommended to sleep on the back, since in this position the heavy uterus squeezes the vena cava, which significantly reduces the supply of oxygen to the fetus. During pregnancy with twins, the uterus is enlarged even more, and a woman already at this time may herself feel a lack of oxygen while lying on her back.
Now the uterus noticeably displaces the internal organs, disrupting their usual vital activity. Sometimes a woman may notice unusual sensations when the uterus suddenly becomes dense, as if "stony". These are "training" contractions that do no harm to either the woman or the child. They are usually painless and disappear after a short time. Nevertheless, it is imperative to inform your doctor about this, so as not to miss such a condition as increased uterine tone, which threatens to terminate pregnancy.
Special problems - low placentation
During a routine ultrasound, the doctor may find that a woman has a low placentation, or placenta previa. In this case, the placenta is located not at the bottom of the uterus or at the side wall, but opposite the cervical canal pharynx. This condition is considered a pathology that threatens the bearing of pregnancy. In some cases, placental abruption occurs, which leads to the death of the fetus. At this time of termination of pregnancy, the child is not yet able to survive. When diagnosing placenta previa, a woman is advised to refrain from sex, any physical activity, constant medical supervision is required.
Belly at 21 weeks
The size of the abdomen at 21 weeks is different for different women - everything is individual and depends on the weight gained during pregnancy. The child is not yet so large that its size affects the parameters of the female figure. It is recommended at this time to select and purchase a comfortable prenatal bandage, which significantly alleviates the condition of the woman.
Allocations - norm and deviations
The volume of vaginal discharge during this period of pregnancy may increase slightly. This is how the effect of the hormone progesterone on the female body is manifested. Joining the usual translucent discharge of pus, mucus, curdled inclusions, an unpleasant odor indicates the onset of vaginal candidiasis or bacterial infection of the woman's reproductive organs.
The appearance of bloody discharge on underwear may indicate the consequences of hemorrhoids, rectal cracks, as a result of constipation. Vaginal discharge mixed with blood requires immediate hospitalization, may be a symptom of termination of pregnancy
Pain - their cause and prevention
Abdominal pain during this period of pregnancy should not be felt. The main problems of 21 weeks are pain due to cramps in the legs and pain in the spine. Convulsions can be felt due to the intense leaching of calcium from the mother's body to meet the needs of the fetus. For the prevention of seizures, you need to often use fermented milk products, cheese, cottage cheese.
Pain in the spine, in the lower back occurs due to the growing load on the bones, ligaments and joints.
Preventive measures to prevent low back pain:
- Change your posture more often with prolonged sitting;
- Do not sit on backless chairs;
- Do not cross your legs when sitting;
- Rest with your legs raised on a dais;
- Does not carry heaviness;
- Refuse to wear high-heeled shoes;
- Do not stay on your feet for a long time;
- It is imperative to wear a prenatal bandage.
Maintaining correct posture, performing simple gymnastics exercises for pregnant women will help maintain good health.
Analyzes - result of screening
By this time of pregnancy, the results of the second trimester screening are likely to be assessed. The doctor, using a special program, evaluates the performance of all markers. They are analyzed collectively, not separately. Additionally, parameters such as weight, age of a woman, her history, previous pregnancies, and the number of fetuses in a given pregnancy are taken into account.
As a result, a risk value is obtained, the threshold of which is 1: 350. If the screening result is equal to or less than this number, the risk of fetal malformations is considered to be minimal. A score of 1: 250 and above implies the probability of having an unhealthy baby in one in 250 pregnancies.
These indicators show the presumptive risk of chromosomal and hereditary abnormalities of fetal development, and if screening is not performed correctly, they can be of little informative.
In the normal course of pregnancy, a woman at 21 weeks takes a standard set of tests before visiting a doctor, and if problems arise, an extended list according to indications.
Ultrasound at 21 weeks of gestation
If a woman has not had a second planned ultrasound, she can do it at 21 weeks.
Modern equipment can perform a three-dimensional examination of the state of the fetus and record the following parameters of the child:
- Body length;
- The length of the femur and humerus;
- Body mass:
- Growth;
- The state of the placenta;
- The condition of the muscular layer of the uterus;
- Amniotic fluid condition;
- Head circumference;
- The presence or absence of heart disease;
- Sex of the unborn child;
- Possible fetal malformations.
If desired, parents can see for themselves how the baby looks and moves, assess his physical activity.
Molokoa Elena Valerievna - doctor of ultrasound diagnostics, gynecologist:
Attitude towards sex
If there are no special problems with the course of pregnancy, intimate relationships are not prohibited. Possible problems - increased uterine tone, low fetal presentation, twin pregnancy. Naturally, you need to be very careful and gentle posture. But in general, sex at this stage of pregnancy can bring a woman new sensations due to the increased blood supply to the reproductive organs.
Pregnant weight at 21 weeks
At this stage of pregnancy, the fetus begins to form subcutaneous fat, therefore, a sufficient amount of resources is required for the full development of the child. A balance must be struck between the desire to give the child adequate nutrition and the ability to gain excess weight. At this stage, the optimal weight gain is no more than 300 g per week.
The maximum allowable increase from the beginning of pregnancy is no more than 6.5 kg. Since this indicator depends on the constitution of a woman, the characteristics of her physique, these parameters are purely individual. It should be remembered that being overweight significantly complicates the upcoming childbirth and recovery period.
Organization of proper nutrition
The main principle of proper nutrition at this stage of pregnancy is to ensure the quality of food without increasing its quantity. It is important to include more plant protein in your diet. Animal protein is best obtained from lean meat and fish, dairy products. A woman's body will receive valuable omega-3 fatty acids from sea fish. It is very useful to use nuts, olive oil.
Carbohydrates in a pregnant woman's diet are best provided with cereals, whole grain breads, fruits and vegetables. For heartburn prevention, it is better to eat fractional, small portions. Salt and sugar should be consumed in moderation, eat less fatty and fried foods.
For a successful pregnancy, you should wear comfortable clothes, eat properly and fully, keep track of your weight, avoid stress and physical exertion.
Video about the procedure for going on maternity leave, the condition of the fetus, and receiving an exchange card:
The author of the article: Lapikova Valentina Vladimirovna | Gynecologist, reproductologist
Education: Diploma in Obstetrics and Gynecology received at the Russian State Medical University of the Federal Agency for Healthcare and Social Development (2010). In 2013 completed postgraduate studies at N. N. N. I. Pirogova.
