4 months pregnant
The fourth month opens the second trimester - the quietest and most comfortable period of pregnancy. By this time, the manifestations of early toxicosis had almost disappeared, the woman underwent an initial examination at the antenatal clinic, the recently formed placenta reliably protects the fetus from the negative effects of the external environment. The unborn child has already formed all organs, and the baby's life support system began to function.
Content:
- Changes in the female body
- What a woman feels
- How the fetus develops
- The psychological state of a pregnant woman
- Mandatory examination
- Formation of the diet
- Problems 4 months - the threat of miscarriage and constipation
- Allocations
- Bleeding
- Intimate relationship
Changes in the female body
During the fourth month of pregnancy, the uterus grows very quickly. If by the beginning of the first week of this month it barely rises above the pubic joint, then by the end of the fourth month the bottom of the uterus approaches the level of the navel. Another significant change is the increase in blood volume by 30-40%. This increase in blood volume increases the stress on the heart muscle. A healthy heart copes with it, and with the pathology of cardiovascular activity, these changes can affect the work of the heart in a bad way.
An increase in the level of melanin in the blood affects the condition of the skin and hair - moles darken, age spots appear on the skin, the strip of skin between the navel and the pubic bone, the skin of the perineum darkens. These changes will disappear some time after giving birth. To somewhat reduce the intensity of the appearance of spots, you need to actively use sunscreen for faces.
What a woman feels
The belly at 4 months of pregnancy may be completely absent, and most pregnant women still use conventional clothing. However, an increase in waist volume is already noticeable, and in some women, a rounding of the abdomen. Since the uterus grows intensively, severe pain in the groin and lower abdomen may appear due to sprains. They pass as quickly as they appear.
Due to the increase in the total volume of fluid in the body, the woman experiences increased sweating. The volume of vaginal discharge also increases. The load on the circulatory system causes a violation of the integrity of small vessels, bruises and nosebleeds. They may appear less often if the air is intensively humidified in the dwelling.
Due to frequent constipation, prerequisites for hemorrhoids - varicose veins of the rectum may appear. Outside and inside the anus, venous nodules appear, which bleed when straining, become inflamed and swell.
A pleasant sensation for women undergoing a second and subsequent pregnancies, and for slender, thin women, is the sensation of the first movements of the unborn child.
How the fetus develops
The placenta is a universal organ - it protects the fetus from pathogenic bacteria and viruses, synthesizes the necessary proteins and hormones, removes the waste products of the unborn child with venous blood, filters out harmful substances, delivers oxygen and nutrients from the mother's body. Thanks to her, a woman manages to avoid accidents and not be afraid of abortion due to the negative effects of the external environment.
Waste products of the child are urine, which the fetus excretes every 40-45 minutes into the amniotic fluid. The amniotic fluid is renewed every 2-3 hours, it is sterile and has the same chemical composition. Amniotic fluid protects the fetus from damage, stimulates the child's metabolism, and allows him to move freely. At 4 months of gestation, the fetus mimics breathing movements by drawing water into the lungs, training the respiratory system.
The weight of the fetus by the end of 4 months, and its growth increases from 12 to 20 cm.
The unborn child has already developed a swallowing and sucking reflex - from time to time he sucks his thumb. The handles are bent at the elbows, palms and fingers can fold into a fist, the fetus can grab the umbilical cord, touch its face. Despite the fact that the baby moves a lot and willingly in the uterine cavity, these gentle movements are not yet fully felt by the woman, it is easy to mistake them for the sensation of intestinal motility.
A light and thin fluff appeared on the child's skin - lanugo. It covers the entire body of the fetus, and will disappear only after childbirth. The fluff helps to keep the original lubricant on the body, which protects the skin from the action of amniotic fluid. Eyebrows, hair, eyelashes are outlined on the head and face of the fetus. The formation of nails begins on the fingers.
The baby's genitals are in the process of formation, but its gender can already be determined. It is still very difficult to distinguish a boy from a girl during an ultrasound scan. In a male fetus, the prostate begins to develop, in future girls, the ovaries already contain eggs, and have descended into the small pelvis from the abdominal cavity.
The baby's ears gradually take their permanent place, rising from the side of the neck to where they should be. The formation of the inner ear has not yet been completed, but the baby is already reacting to loud noise. The sensitivity of the retina of the eye increased, and the fetus was able to raise and lower the eyelids.
The psychological state of a pregnant woman
Women who undergo their first pregnancy, in the fourth month, finally realize that expecting a baby can bring positive emotions. They begin to feel that they have an extremely important mission ahead of them, anxiously awaiting the first movements of the fetus. Those who already have children know that in the second trimester of pregnancy they will have the pleasure of joyful excitement during a kind of communication with an unborn child, from his first tender, and then more and more tangible movements and movements.
Mandatory examination
During the fourth month of pregnancy, if there are no deviations from the normal course, the woman visits her doctor once. The obstetrician-gynecologist will evaluate the results of previously passed tests, ultrasound data. If the results of the smear test for urogenital infections are unfavorable, antibacterial drugs should be taken within the fourth month. After a course of therapy, a control examination of a vaginal smear is prescribed.
At the end of the fourth month, your doctor may order tests related to screening for the second trimester of pregnancy. It is carried out from 15 to 20 weeks of the gestational period. This screening includes a blood test, or "triple test", and another ultrasound.
Triple test content:
- Analysis for the concentration in the blood of the hormone hCG, or chorionic gonadotorpine;
- Analysis for? -Fetoprotein (AFP);
- Analysis for unconjugated (free) estriol.
If the level of these markers deviates significantly from the norm, the risk of having a child with congenital abnormalities is high:
- Down syndrome;
- Edwards syndrome;
- Cranial hernia;
- Spinal hernia;
- Splitting of the anterior abdominal wall of the fetus.
If the level of markers in the blood of a pregnant woman is increased, it is likely that a second blood test will be performed. It is advisable to take a second test before the 20th week of pregnancy. Therefore, women at risk of having a baby with abnormalities are referred to the "triple test" as early as possible in order to have time to repeat the study.
Risk factors:
- The woman's age is over 35;
- Radiation impact;
- Harmful working conditions;
- Side effects of drugs;
- The presence of children with pathologies in the family;
- History of habitual miscarriage.
The increased content of markers indicating a high risk of anomalies in the results of screening of the first and second trimester is a reason for amniocentesis. This study is voluntary, it consists of puncture of the uterus under ultrasound control to collect amniotic fluid. This is an extremely informative analysis, which is performed only with significant indications for it. One procedure out of 200 ends in spontaneous abortion.
According to the results of the study of amniotic fluid, it is determined:
- Genotype and sex of the fetus;
- The level of? -Fetoprotein, indicating malformations of the central nervous system;
- Bilirubin level indicative of hemolytic disease;
- The content of hormones, proteins.
In the fourth month of pregnancy, it is safest to conduct this study, excluding or confirming many pathologies of fetal development.
During the fourth month, it is advisable to visit the dentist to check the condition of the oral cavity and dental treatment, if necessary. At this stage of pregnancy, pain relievers are allowed. For the correct selection of anesthetics, the doctor must be aware of the patient's pregnancy.
An infection in the oral cavity is unacceptable, its presence negatively affects the health of the fetus, so you need to regularly brush your teeth, rinse your gums with chamomile decoction to treat and prevent bleeding.
Formation of the diet
Since nausea no longer accompanies meals, the pregnant woman's appetite increases. You should not mindlessly consume various dishes, because there is a danger of weight gain in excess of the permissible norm. If you count from the initial weight to pregnancy, at this time the increase should be no more than 2-2.5 kg.
The optimal diet is to eat often, but little by little, without overeating. Most of the diet is consumed in the morning, during lunch and breakfast. In the morning they mainly eat cereals, dairy products, at lunchtime - hearty dishes, and for the evening it is better to leave easily digestible foods. For snacks, it is better to use fruits and vegetables instead of cookies and sandwiches.
The use of salty foods is limited, food is better not salted in order to avoid edema. Smoked meats, fatty and fried foods, semi-finished products are prohibited. Sweets and baked goods can lead to weight gain.
Products are very useful. containing protein - meat, fish, cottage cheese, cheese. Dairy products will not only replenish the calcium deficiency in the body, but will also help to establish digestion and bowel function. For the prevention of anemia, it is recommended to use beef, liver, apples, dried apricots. In practice, your doctor will recommend supplementing such a diet with iron supplements.
Problems 4 months - the threat of miscarriage and constipation
Despite the fact that the threat of miscarriage is no longer as great as in the first trimester, it still exists. The main reason is cervical-cervical insufficiency. It occurs due to the weakness of the muscle bundle, which normally keeps the internal os of the cervix tightly compressed. The cervical pharynx does not hold the fetal bladder for the following reasons:
- Pathological course of previous labor;
- History of abortion and miscarriage;
- Hormonal disorders
The diagnosis of "East-cervical insufficiency" threatens with infection of the membranes and fetal death. It is placed on palpation, confirmed by ultrasound. Treatment is with a surgical suture on the cervix or a ring on the cervix. A woman with such a diagnosis is strongly discouraged from exerting herself and doing housework.
Primary placental insufficiency is another risk factor for maintaining pregnancy. In this condition, the fetus does not receive the required amount of oxygen and nutrients due to endocrine disorders, the action of an infection, or due to a genetic factor that manifests its effect before the 16th week of pregnancy.
The symptoms of placental insufficiency are similar to those of a miscarriage:
- Lower abdominal pain;
- Back pain;
- Bloody vaginal discharge.
Due to the insufficient supply of nutrients to the fetus, congenital malformations can develop. Diagnostics - study of the level of placenta hormones in urine, blood and amniotic fluid.
Placental insufficiency treatment:
- Vitamin therapy;
- Antispasmodics - papaverine, but-shpa;
- Cocarboxylase;
- Actovegin;
- Trental;
- Methionine;
- Soothing herbal preparations.
Additionally, it is recommended to walk more often, get enough sleep, eat well.
Constipation is another problem of the fourth month, arising from the compression of the intestines by the uterus and the action of hormones.
Prevention of constipation:
- Drinking a sufficient amount of still water, it is especially useful to drink a glass of water before breakfast to stimulate intestinal peristalsis;
- Active movements, feasible physical education;
- Fortification of food with vegetable fiber contained in beets, prunes, bran, cereals;
- Take a safe laxative as recommended by your doctor.
Allocations
Normal discharge at 4 months of pregnancy is a transparent whitish-gray leucorrhoea with a small volume. The action of hormones can slightly increase the volume of vaginal discharge, but they do not cause discomfort, do not have a smell.
The addition of an infection affects the nature of the vaginal discharge - they acquire a yellow-green color, can be foamy or more abundant, have an unpleasant odor. It is possible that this is a sign of an inflammatory process of the reproductive organs or the development of thrush (vaginal candidiasis), colpitis, vaginitis.
Bleeding
The appearance of bloody discharge, accompanied by pain in the abdomen and in the lower back, is a very dangerous symptom, indicating that a spontaneous abortion has begun. The discharge is bright red and may contain blood clots. If these symptoms appear, you should immediately seek emergency help. If action is taken in a timely manner, miscarriage can be prevented.
Minor painless discharge that appears after an intimate relationship can be a sign of cervical erosion. This condition should be treated after childbirth.
Intimate relationship
The well-being of a pregnant woman at 4 months improves significantly, she becomes more active and energetic. If the doctor sees no contraindications for intimate relationships, you should not refrain from them.
Possible contraindications:
- Risk of miscarriage;
- Multiple pregnancy;
- Treatment for an infectious disease of the reproductive organs.
In addition, for many women, under the influence of hormones, libido only increases, and positive emotional experiences will benefit them.
Video about the rules of behavior and features of the course of the fourth month, mandatory examinations:
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.
