Third trimester of pregnancy
This period begins at the 29th week of the gestational period and ends with childbirth, which for most women with full-term pregnancies occurs at 38-40 weeks. A child born as a result of premature birth at any stage of the third trimester has every chance of a successful development outside the mother's body. By the end of the second trimester, he comes, weighing more than 1000 g, growth over 35 cm, almost completely formed organs and systems. Nevertheless, full-term pregnancy and timely delivery are what every woman and the leading antenatal clinic specialists strive for.
Content:
- What a woman feels in the third trimester
- Fetal development in the 3rd trimester
- Third trimester screening
- Preparation for delivery - important little things
- Bleeding
- Lack of movement
- Premature birth
- How to treat a cold in the 3rd trimester
- How to treat thrush
- Formation of the diet
- Intimate relationships in the 3rd trimester
What a woman feels in the third trimester
During this period, the uterus significantly increases in size, the fetus grows. His movements occur more and more often, become more intense. The pregnant woman increasingly feels myometrium spasms, or Braxton Hicks contractions. "Training" contractions are irregular, painless, lasting from several tens of seconds to two minutes. If a woman changes her body position, they usually stop. Frequent contractions occurring more than 4 times per hour require medical supervision.
The bladder, as in the first trimester, functions much more frequently than usual due to the drooping pelvis and the enlarged uterus. A woman has frequent urination in small portions of urine.
Shortness of breath is a common symptom of the third trimester. Rapid breathing is caused by the uterus lifting the diaphragm upward. There is much less opportunity to expand the lungs with a deep breath. Frequent shallow breathing helps the woman to saturate the blood with oxygen, which should also be enough to supply the placenta. Walking in the fresh air and airing the room will help ease the breathing process. A month before giving birth, the uterus with the fetus will descend into the small pelvis, and there will be no shortness of breath.
Insomnia is more common in the third trimester than before. Uncomfortable and unusual sleeping positions, the activity of the baby, most often during rest, do not provide an opportunity to fully rest and sleep. There are several simple remedies for the prevention of insomnia: a glass of warm milk before bed, listening to calm music, walking in the fresh air.
A rapid increase in weight in the third trimester leads to a disruption in the coordination of movements in a woman, inactivity, annoying clumsiness, awkwardness, and limited mobility. Lower back pain appears, caused by the fact that the spine has to cope with an increased load. The increased mobility of the articular joints is caused by the action of progesterone, aimed at softening the ligaments and bones of the small pelvis to facilitate the process of giving birth.
Problems that appeared earlier can go into the third trimester - varicose veins, swelling of the extremities due to squeezing of large blood vessels of the abdominal cavity by the uterus.
What to do to alleviate the condition:
- Change your posture more often, do not stand for a long time and do not sit in one position;
- Do not wear high-heeled and flat shoes;
- Do not sit with your legs crossed;
- Use a small bench as a footrest;
- Perform a complex of gymnastics for pregnant women;
- Do not use an overly soft mattress for sleeping.
At 37-38 weeks of gestation, the hormonal background of a pregnant woman's body changes - the synthesis of estrogen increases. The signal for this is the maturation of the fetus and its readiness for extrauterine existence. Under the influence of estrogen, the tone of the uterus increases, its neck changes. The cervical canal opens slightly, the neck becomes shorter and softer, the mucous plug comes off - mucus mixed with blood.
Peak estrogen levels stimulate prostaglandin synthesis, triggering labor.
Fetal development in the 3rd trimester
An increase in fetal mass leads to the fact that it no longer has such freedom of movement, cannot move freely in the uterine cavity. His movements stimulate short-term contractions of the myometrium - so the uterus stimulates the baby to sit head down for easier overcoming of the birth canal. The fetus takes its final position at 34-35 weeks of gestation. Later, he will no longer be able to roll over.
Seventh month (29-32 weeks of pregnancy)
By this time, the central nervous system of the fetus was practically formed - the nerve endings were covered with a myelin sheath, all the convolutions appeared in the cerebral cortex with which a person will live his life. The sense organs have also matured, since the child reacts to harsh sounds and taste sensations, distinguishes the mother's voice, touches himself, closes his eyelids, if a source of bright light is brought to the stomach.
Fetal parameters by 32 weeks of gestation:
- Weight - 1700 g;
- Height - 40-42 cm.
The general proportions of the fetus are more and more approaching the proportions of a newborn baby, he already has a sufficient supply of fatty tissue, the skin has become smooth, wrinkles have smoothed out on it. The respiratory system is already close to full maturation - a surfactant accumulates inside the lungs, preventing the lungs from collapsing after exhalation.
The liver and kidneys are fully prepared to perform their functions; the fetal blood glucose level is regulated by the pancreas.
Eighth month (33-36 weeks of pregnancy)
The period of intensive weight gain of the child begins, every day it increases by 1% of the total body weight. The fetus swallows amniotic fluid, sucks its fingers, imitates respiratory movements, that is, it has developed basic reflexes: respiratory, swallowing, sucking.
The kidneys of the fetus daily excrete up to half a liter of urine into the amniotic fluid. The boys' testicles descended into the scrotum. There are marigolds on the fingers and toes, on the hands they reach the tips of the last phalanx, on the legs they have not yet reached the end of the fingers.
Fetal parameters by 36 weeks:
- Weight - 2300-2500 g;
- Height - 44-48 cm.
The ears and nose of the unborn child have acquired the necessary elasticity, his body is covered with a thick layer of cheese-like lubricant, which will remain on the skin until the moment of birth and will facilitate the passage through the birth canal.
Ninth month (37-40 weeks of pregnancy)
The size of the fetus at the end of the gestational period in different women can differ significantly, this difference is due to hereditary characteristics, features of the course of pregnancy, the state of the placenta, full or insufficient nutrition of a woman during pregnancy.
Fetal parameters at the time of delivery:
- Weight - 2500-4400 g;
- Height - 45-56 cm.
The motor activity of the fetus is significantly reduced, turning over and turns disappear. He has the ability to move his limbs, bend and unbend his arms and legs. Sleep and wakefulness, combined with a decrease in movement, can alert a woman. However, most often there is no cause for concern, and in the evening the baby increases his activity.
Closer to the time of childbirth, only a minimal amount of cheese-like lubricant remains on the skin of the fetus, and vellus hairs remain only on the shoulders. Depending on the type of presentation, the head or pelvis of the child is lowered and pressed more tightly against the entrance to the woman's small pelvis, preparing for the delivery process.
Signs of fetal maturity:
- The tips of the nails reach the fingertips;
- The cartilage of the nose and ears gain elasticity;
- The boy's testicles are in the scrotum;
- The large labia of the girl overlap the small ones;
- Fatty tissue is developed;
- The rib cage is convex;
- The umbilical ring is located in the middle between the bosom and the navel.
Third trimester screening
In the period from 32 to 35 weeks of pregnancy, the third stage of assessing the condition of the fetus, placenta and uterus is carried out. It includes ultrasound, carditocography and tests to assess the placental complex.
To diagnose the condition of the placenta, a woman takes the following tests:
- To determine the level. HCG;
- To determine the level of placental lactogen;
- To determine the level of free estriol;
- To determine the level of progesterone.
Since the state of the placenta is assessed over time, these tests will have to be passed repeatedly during the screening period.
Cardiotocography (CTG) helps to determine the functional state of the child, especially his cardiac activity. Such an event will significantly reduce the risk of having a baby with cardiopathology, and timely identify fetal hypoxia.
Ultrasound is performed at 32-34 weeks of pregnancy, this is a mandatory screening item for the third trimester.
What evaluates ultrasound examination:
- Fetal presentation;
- The functioning of the organs of the unborn child;
- Child parameters;
- Estimated due date;
- Fetal malformation.
According to the indications, dopplerometry is performed to study blood flow in the placenta and the circulatory system of the mother and child.
Video about joint childbirth, about child development, about the prevention of Rh-conflict, about choosing a maternity hospital:
Preparation for delivery - important little things
Since labor can begin at 38 weeks gestation, it is best to prepare in advance for your visit to the hospital. So that hospitalization does not come as a surprise, you need to prepare in advance a bag with things for yourself and for discharge for the baby.
It is equally important to collect documents:
- Pregnant exchange card;
- Medical policy;
- The passport;
- Generic certificate.
All necessary analyzes must be recorded in the exchange card. If a pregnant woman is not fully examined, she may not get to the hospital she planned to go to for childbirth.
Bleeding
With a low placentation or placenta previa, its proximity to the pharynx of the uterus, a woman may start bleeding.
Signs of placental abruption:
- Sudden onset after coughing, intimate relationships, physical exertion;
- Bright red blood with clots;
- Painlessness.
Such symptoms require immediate medical attention. Subject to bed rest, timely measures taken, the placenta can return to its place. The doctor prescribes a blood transfusion, taking vitamins. So it is possible to keep the pregnancy up to 38-39 weeks and carry out a cesarean section for delivery. If the bleeding continues, it is necessary to induce labor at an earlier date.
If bleeding during placental abruption is internal, it manifests itself as follows:
- Weakness, pallor of the skin;
- Rapid pulse;
- Decrease in hell;
- Abdominal pain due to tension in the myometrium;
- Cold sweat appears.
With such symptoms, a strict bed rest is recommended for a woman; if it is impossible to stop internal bleeding, a cesarean section is performed.
Lack of movement
If abnormalities such as the weakening of the baby's movements or their absence appear, you should immediately consult a doctor to listen to the fetal heartbeat. Such a rare complication of pregnancy, as intrauterine fetal death, is caused by blocking the supply of oxygen to it.
The death of a child from suffocation can occur in the following cases:
- Umbilical cord entanglement;
- Leakage of amniotic fluid;
- Postponing pregnancy;
- Placental insufficiency;
- Toxemia, etc.
If the baby is still alive, the woman is urgently called into premature labor and the baby is connected to an oxygen unit for resuscitation.
Premature birth
Spontaneous termination of pregnancy in the 3rd trimester is considered a miscarriage, and premature birth. In this case, the child is born much earlier than the term intended by nature. He is not yet ripe for independent existence, he needs nursing in a specialized neonatal department.
Causes of premature birth:
- Intrauterine infections;
- Hypertension;
- Bad habits of the mother (smoking, alcoholism, drugs);
- Pathology of the development of the uterus, anomalies of the cervix;
- Injury.
In most cases, modern medical technologies can save a child's life.
How to treat a cold in the 3rd trimester
Therapy for colds at this stage of pregnancy is carried out according to the recommendations of a general practitioner. Most likely, he will suggest using hot, abundant drinks, drops from a cold prepared with medicinal herbs, gargling with saline or soda solution, bed rest. If a cold is accompanied by a high fever, several Paracetamol tablets may be taken in consultation with your doctor.
A temperature not associated with colds indicates the onset of an infectious process and requires urgent diagnosis.
How to treat thrush
Vaginal candidiasis often becomes an unpleasant pregnancy companion. Due to the reduced local and general immunity, the fungus is activated and develops rapidly in the vagina. Its manifestations are accompanied by itching, yellow-green cheesy discharge. Thrush must be treated, since a child passing through the birth canal can become infected with candidiasis. This will lead to the formation of oral thrush in the newborn - a disease accompanied by pain when sucking and refusal to eat.
On the recommendation of a doctor, a pregnant woman can use vaginal suppositories (Livarol, Epigen-intim).
Formation of the diet
The basic principles of nutrition in the 3rd trimester are a varied, balanced menu, rich in easily digestible food. For the formation of the diet, foods rich in fiber are used - vegetables and fruits, iron - buckwheat, apples, beef liver, pomegranate juice.
Excessive consumption of carbohydrates (sweets, pastries) is not recommended to prevent excessive weight gain. When edema appears, you need to drink rosehip broth, green tea. It is better to eat often and little by little, so as not to overeat and not overload the stomach. In order not to provoke edema, you can not eat pickles, add salt to food, eat fatty foods.
Intimate relationships in the 3rd trimester
There are many contraindications for sexual relations in this period of pregnancy. It must be remembered that intercourse can provoke premature birth, and with low placentation, placental abruption and bleeding. Therefore, in each specific case, it is worth carefully weighing all the arguments "for" and "against" intimate contacts.
An attentive attitude to one's health throughout the entire period of pregnancy, timely examination, rational nutrition, physical education for pregnant women, will perfectly prepare a woman for the birth of a healthy child. To increase the elasticity of the pelvic floor and prevent tears, you need to regularly perform Kegel exercises, which will help you master in the classroom for pregnant women.
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.
