What does a 4 month pregnant woman look like? The psychological state of the pregnant woman. month of pregnancy: sensations

13.04.2019

The 4th month of pregnancy is usually a fertile time, which is characterized by good health, many pleasant discoveries and the first contact with the baby. In rare cases, this period is accompanied by unpleasant complications, but with constant monitoring by a specialist, they are easily eliminated.

Feelings at 4 months pregnant

At 4 months of pregnancy, the general condition stabilizes. It is more like the usual state of health until the moment of conception. The unpleasant symptoms characteristic of toxicosis disappear, the expectant mother feels a noticeable surge of strength. True, during this period, unwanted pregnancy companions often appear:

heartburn. To reduce its manifestation, it is recommended to eat small portions and mostly healthy foods;
bleeding gums or gingivitis. You should change hygiene products to more gentle ones, increase the daily dose of vitamin C and calcium taken;
dizziness and even fainting. You need to eat a balanced diet, get enough rest, breathe fresh air to minimize the impact of stressful situations.

Allocations: what should be normal?

Belly at 4 months pregnant

Many expectant mothers are interested in whether the stomach is visible on this stage? The fourth month during pregnancy is characterized by the absence of a protruding tummy, but due to the active growth of the child, it begins to increase. At the beginning of the second trimester, it is dense, elastic, and during the entire subsequent time it grows quite rapidly. For this reason, already from the fourth month, it is necessary to use stretch mark creams that can preserve attractive appearance skin on the abdomen.

In addition, already at the beginning of this period, the mother can feel the baby's tremors. Usually those who have a second and subsequent pregnancies feel them on, at the first experience - to. Much depends on the sensitivity of the mother and the size of the baby.

Pain in the fourth month of pregnancy

Pain in the lower abdomen is characteristic of this period, as the uterus is actively growing. They have a pulling, aching character, mild and not permanent. Pain in the abdomen of a cramping type is a bad harbinger, with which it is necessary to contact an observing specialist.

Since the beginning of the second trimester, many women complain of pain in the legs caused by sharp and severe cramps. This happens when there is a lack of calcium and phosphorus. Also at this time, soreness in the gums can be observed, and even their bleeding, from time to time a headache.

Period

Menstruation at this time and other spotting is extremely rare, and is always considered a serious problem. With her, you must immediately consult a doctor to save the pregnancy. Often the cause is an accident or a fall. There are frequent cases of the appearance of menstruation due to an attempt to terminate a pregnancy. It is extremely dangerous to do this, since abortions are allowed only until after this time the baby is already formed. In some cases, the vesicles detach from the uterine wall, which causes spotting. This is fraught with anemia, so appropriate measures must be taken.

Miscarriage

4 month normal pregnancy is not characterized by a high risk of miscarriage, this time is stable and no longer dangerous. The reason for this may be the rejection of the blood of the mother and child, which happens infrequently. Inflammatory processes and infectious diseases also lead to undesirable consequences. For the continuation of pregnancy, serious violations of hormone production can be very dangerous.

Below you can watch a video about the development of the fetus in the fourth month of pregnancy.

The fourth month opens the second trimester - the most calm and comfortable period of pregnancy. By this time, the manifestations had almost disappeared, the woman underwent an initial examination at the antenatal clinic, the recently formed placenta reliably protects the fetus from negative impact external environment. The unborn child has already formed all the organs, and the baby's life support system has begun to function.

During the fourth month of pregnancy, the uterus grows very rapidly in size. 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. One more significant change– increase in blood volume by 30-40%. This increase in circulating blood volume puts more stress on the heart muscle. Healthy heart copes with it, and in case of pathology of cardiovascular activity, these changes may not affect the work of the heart in the best 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 pubic bone, perineal skin. These changes will disappear some time after childbirth. To somewhat reduce the intensity of the appearance of spots, you need to actively use sunscreen for persons

The stomach at 4 months of pregnancy may be completely absent, and most pregnant women still use the usual clothing models. However, an increase in waist volume is already noticeable, and in some women, a rounding of the abdomen. Since the uterus is growing intensively, pronounced pain in the groin and lower abdomen. They pass as quickly as they appear.

Due to the increase in the total volume of fluid in the body, a woman feels. Volume vaginal discharge also increases. Stress on circulatory system causes a breach of integrity small vessels, bruises and nosebleeds. They may appear less frequently if the air is intensively humidified in the dwelling.

Due to frequent constipation, prerequisites for - 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 feeling of the first movements of the unborn child.

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 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 impact of the external environment.

The waste products of the child are urine, which the fetus excretes every 40-45 minutes in amniotic fluid. The amniotic fluid is renewed every 2-3 hours, it is sterile, has an unchanged chemical composition. Amniotic fluid protects the fetus from damage, stimulates the baby's metabolism, and allows him to move freely. At the 4th month of pregnancy, the fetus imitates respiratory movements, drawing water into the lungs, training the respiratory system.

The weight of the fetus by the end of 4 months, and its height increases from 12 to 20 cm.

The unborn child has already formed a swallowing and sucking reflex He sucks his thumb from time to time. The arms are bent at the elbows, the 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, they can easily be mistaken for sensations from intestinal motility.

A light and thin fluff appeared on the skin of the child - 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. On the fingers, the formation of nails begins.

The genitals of the child are in the process of formation, but its gender can already be determined. When conducting an ultrasound, it is still very difficult to distinguish a boy from a girl. In the 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. Formation inner ear not yet completed, but the baby is already reacting to loud noise. The sensitivity of the retina increased, and the fetus was able to raise and lower the eyelids.

The psychological state of the pregnant woman

Women undergoing their first pregnancy, at the fourth month, finally realize that expecting a baby can bring positive emotions. They begin to feel that they have an extremely important mission to perform, and they anxiously await the first movements of the fetus. Those who already have children know that in the second trimester of pregnancy they will enjoy the joyful excitement during a kind of communication with an unborn child, from his first gentle, and then more and more perceptible movements and movements.

During the fourth month of pregnancy, if there are no deviations from normal course, a woman visits her doctor once. The obstetrician-gynecologist will evaluate the results of previously passed tests, ultrasound data. If the results of a smear test for urogenital infections are unfavorable, a course of treatment with antibacterial drugs should be taken within the fourth month. After a course of therapy, a control examination of a smear from the vagina is prescribed.

At the end of the fourth month, the 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.

Blood concentration test hCG hormone, or chorionic gonadotorpin;

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 pathologies:

craniocerebral hernia;

Splitting anterior abdominal wall fetus.

Risk factors:

The woman's age is over 35;

Radiation impact;

Harmful working conditions;

Side effects drugs;

The presence in the family of children with pathologies;

habitual miscarriage in history.

Increased content of markers indicating high risk the appearance of anomalies in the results of screening of the first and second trimester - a reason for amniocentesis. This study is voluntary, it consists of a puncture of the uterus under ultrasound control for sampling amniotic fluid. This is an extremely informative analysis, which is performed only with significant indications for it. One procedure out of 200 ends with spontaneous abortion.

According to the results of the study of amniotic fluid determine:

Genotype and sex of the fetus;

The level of ?-fetoprotein, indicating malformations of the central nervous system;

Since nausea no longer accompanies meals, a pregnant woman's appetite increases. Don't mindlessly use various dishes, because there is a danger of weight gain in excess of the allowable rate. If you count from the initial weight before pregnancy, at this time the increase should be no more than 2-2.5 kg.

Optimal mode nutrition - 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 lunch - hearty meals, and in the evening it is better to leave easily digestible foods. For snacks, it is better to use not cookies and sandwiches, but fruits and vegetables.

The use of salty foods is limited, it is better not to salt food in order to avoid edema. Under the ban are smoked meats, fatty and fried foods, semi-finished products. Sweets, rich pastries can lead to an increase in excess weight.

Very helpful products. containing protein - meat, fish, cottage cheese, cheese. Dairy products will not only make up for the lack of calcium in the body, but also help to improve digestion and bowel function. Recommended for the use of beef, liver, apples, dried apricots. In practice, the 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 insufficiency. It occurs due to the weakness of the muscle bundle, which normally holds the internal os of the cervix tightly compressed. The cervical os does not hold the amniotic sac the following reasons:
The diagnosis of "istvico-cervical insufficiency" threatens with infection of the membranes and death of the fetus. It is put on palpation, confirmed by ultrasound. Treatment is a surgical suture on the cervix or a ring on the cervix. A woman with such a diagnosis is categorically not recommended to strain, do housework.

Primary placental insufficiency is another risk factor for maintaining pregnancy. In this condition, the fetus does not receive the right 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.

Symptoms placental insufficiency similar to the symptoms of a miscarriage:
Due to insufficient supply of nutrients to the fetus, congenital malformations may occur. Diagnosis - a study of the level of placental hormones in the urine, blood and amniotic fluid.

Treatment of placental insufficiency:
- Methionine;
  
  Soothing herbal preparations.
Bleeding

Appearance spotting accompanied by pain in the abdomen and lower back - this is very dangerous symptom talking about what has begun spontaneous interruption pregnancy. Allocations have bright red color may contain blood clots. If these symptoms occur, seek immediate medical attention emergency care. If timely measures are taken, miscarriage can be prevented.

Minor painless discharge that appeared after an intimate relationship may 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:
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 conduct and features of the course of the fourth month, mandatory examinations:

Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and social development(2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.

How mother and baby feel, what changes occur in the body of a woman and fetus, what tests need to be taken in this period, you can read in our article a little lower. The second trimester of pregnancy has come, a calm and stable month, when the tummy begins to grow, but does not yet cause significant discomfort. This is a time of well-being and stable positive emotions, enjoying the state of pregnancy and the first movements of the fetus. Gradually, manifestations of toxicosis disappear, appetite arises and the woman gradually begins to gain weight, flourishing internally and externally. The fetus grows very actively, and by the end of the month you will have a neat, rounded tummy. It's important to get everything now necessary substances for the growth and development of the fetus, so that the baby does not need anything.

What happens to the body in the 4th month

The fourth month of pregnancy is the beginning of the second trimester, the most peaceful and enjoyable period of pregnancy. The period when everything passes discomfort the first months, toxicosis disappears, appetite is gradually restored and weight gains, stabilizes emotional background, this leads to the fact that the expectant mother begins to enjoy her new condition, carefully caring for her growing tummy and baby.

Instead of nausea with vomiting, there is a good appetite, as the baby in the stomach requires nutrients, grows and develops actively. During this period, vitamin deficiency may occur, and therefore, you need to monitor nutrition and, if necessary, take multivitamins. This month there is a surge of strength and you want to look good, you can enthusiastically go about your work and daily activities, and if there are no contraindications and diseases, physical activity in this period of pregnancy will only benefit. You can work in the usual rhythm, and almost not change your lifestyle. It will be very useful to walk, periodically sitting down to rest, walks should take at least two hours a day, it is especially good to take a walk before going to bed, but it is worth laying your route away from busy roads and noisy streets. It is important that the fetus breathes the cleanest air saturated with oxygen. At the end of this month, you will be able to feel the first movements of the fetus, they can occur in a period of about 16 to 20 weeks, usually in lean women this occurs earlier. The first movements are barely perceptible and may resemble a seething in the stomach, rolling or splashing water. Gradually, the movements will become more distinct. The uterus gradually rises from the cavity of the small pelvis and your tummy looms, still very small and rounded. Gradually there will be a change in gait due to the deviation of the center of gravity forward, and therefore, women instinctively reject upper part body back, arching the back in the lower back. It is now necessary to monitor the weight and blood pressure, although in general the state of health this month is very good.

Fetal development: weight, size and sex

At 4 months, the fetus will actively grow and it will be noticeable to you, as your tummy will grow significantly. In this period, the formation of all organs and systems of the fetus is almost completed, and now they will actively develop and grow, gradually improving and being included in active work. The kidneys of the baby are already actively forming urine and excreting it into amniotic fluid. There is an active development immune system, the adrenal glands produce the first hormones, and the endocrine and nervous systems begin to actively control the work of the entire body of the crumbs. The growth of the fetus and the accumulation of weight by it does not stop for a minute; in this period, active formation main organ - the cerebral cortex of the crumbs. The placenta actively took on all the functions of providing the child with oxygen and nutrients, due to it the metabolism between the mother and the fetus is carried out. It actively removes the products of its vital activity, while the blood of the fetus and mother does not mix with each other. Also, the placenta now actively protects the fetus from viruses, microbes and toxins, acting as a kind of biological filter.

The fetus has developed to such an extent that it can actively bend its arms and legs, clenches its palms into fists, sucking and grasping reflexes develop. During this month, the child's hair grows on the head, cilia and eyebrows grow, nails form on the fingers. A special fluff, lanugo, is formed throughout the body of the child, which retains the original lubricant, skin secretions of the fetus, protecting it from the effects of amniotic fluid and negative factors. At the end of the month, the child will be able to close his eyes and open his eyes, by the end of the month he reaches a weight of 200 g and a height of about 16 cm. The child swims freely in the amniotic fluid, starting from the walls of the uterus and actively moving, he has enough space in the uterus and he changes his position somewhat once a day.

Feelings of the expectant mother

General feelings in this month quite positive, unpleasant sensations of the first trimester pass, they are replaced by good health and mood. Both the mother's appetite and her activity increase, the figure gradually changes - the uterus grows rapidly, and the tummy is rounded and the waist area is smoothed, the breasts increase more and more, however, her swelling and soreness disappear. There may be age spots on the skin, freckles appear or darken, a dark line from the pubis to the navel may appear on the abdomen, the areolas and nipples darken. By increasing the metabolic rate and fluid retention in the body, there may be an increase in sweating, sensations of heat, and some increase in vaginal discharge. Can gradually change the gait and bend the back due to a change in the center of gravity, which will require changing shoes to a more comfortable one.

by the most important sensations this period will, of course, be the first movements that occur at the end of the month and are not felt by all women. Usually, re-pregnant or thin mothers feel movements earlier, but gradually all mothers catch these sensations.

Possible problems of the fourth month

One of the most serious problems this period may be the formation of isthmic-cervical insufficiency. This is insufficient closure of the cervical region during pregnancy, which occurs due to its underdevelopment, injury or ruptures in previous births. At the same time, muscle fibers are not able to completely close and completely block access to membranes and fetus. In this case, the cervix changes with its shortening, softening, the impossibility of retaining the mucous plug in it. Due to this, the fetal bladder and the growing baby put pressure on the cervix from the inside, slightly opening it, the risk of penetration of pathogenic flora from the vagina and opening increases. amniotic sac with a miscarriage. During the examination, the doctor can determine the condition of the cervix and prescribe a correction for this condition. Pathology can be corrected both surgically, by suturing the neck or by conservative measures, wearing pessaries or bed rest. Such a pregnancy will require caution and strict supervision.

Also in this period, headaches and dizziness are possible, when brushing your teeth, there may be bleeding of the gums, nasal congestion or nosebleeds due to swelling of the mucous membrane may be noted. An unpleasant symptom can be constipation due to the growing uterus and hormonal effects on the intestines, constipation should be avoided, as they can be complicated by hemorrhoids.

The growing uterus can also give pulling sensations on the sides of the abdomen due to sprains, but these pains are not strong, they disappear after rest and change of position. If the pains intensify, have a cramping character and the stomach stiffens, immediately call ambulance- this may be a sign of a threatened abortion.

It is important to pay attention to vaginal discharge - they may increase slightly, but should have normal color and consistency. If the color changes from transparent or slightly whitish to yellow, white, greenish or brown, you should immediately consult a doctor. It is also worth doing when crumbly or curdled secretions, in the presence of burning, itching or discomfort, redness in the genital area.

Call an ambulance immediately if you have spotting or spotting. At this time, they may indicate an abortion or placental problems, which must be ruled out immediately.

Analyzes and examinations

During this period, a woman expecting a baby will have to undergo certain examinations and tests. In a normal pregnancy visit to women's consultation this month will be this one, with scheduled inspection the doctor will measure the pregnant weight and determine the increase, and also measure blood pressure, listen to the fetal heartbeat, feel the size and height of the uterine fundus, and measure the circumference of the abdomen. In addition, a woman will need to pass a general urine test that has already become familiar with the detection of protein and glucose levels. Also in this period, a woman will need to undergo a special “triple” test - this is a screening study that helps in identifying genetic abnormalities and fetal malformations. In this test, blood is donated to determine the concentration of three main substances - AFP (alpha-fetoprotein), hCG ( chorionic gonadotropin) and estriol. Optimal time to pass this test - 15-17 weeks of pregnancy. When passing this screening, women with poor test results are sent for detailed diagnostics in order to exclude or confirm defects in the nervous system, chromosomal pathologies, etc.

Mother's diet and weight

At this stage of pregnancy, the woman's appetite becomes good, releases toxicosis and the body compensates for the deficiency of nutrients and weight through active weight gain and replenishment of vitamin and mineral components. A woman constantly wants to eat, something to chew or have a snack. But you should not strongly and sharply pounce on food and eat "for two", it is important to monitor your diet and weight in order to prevent excessive raises in weight and avoid due to this different kind complications of pregnancy, more or less pronounced, and associated with metabolism and weight gain. These complications include stretch marks on the skin, swelling or development diabetes pregnant.

That is why nutrition issues during the fourth month of pregnancy should be given special attention, you need to properly organize the diet itself and choose for dishes such types of products that can fully cover all the needs for nutrients and energy, both of the future mother herself, and of the fetus growing inside her and its needs for nutrition and energy. When compiling a complete diet, it is worth remembering that during this month a woman, on average, should add no more than 2-2.5 kg, and thus, experts recommend catering in such a way that a woman does not have a feeling of hunger, and food is consumed as useful as possible for organism.

It is worth taking food as often as possible, while portions should be small, and most of the food should be consumed in the morning. The first meals - breakfast and the second tomorrow should be as nutritious and high-calorie as possible, lunch should be the densest of meals, afternoon tea and dinner should be less high-calorie and lighter. In the evening, you should eat only easily digestible foods. However, with all this, in unlimited quantities, as much as you want, you can consume fresh and thermally processed vegetables and fruits throughout the day, with the exception of citrus fruits, as well as fresh cabbage, which can cause bloating, and potatoes, which are rich in starch and calories. Try to choose the most natural food for your diet - you should refuse fast food, smoked dishes, salty and spicy foods, semi-finished products industrial production and marinades. In addition, it is worth limiting salt in the diet, as it will provoke edema with fluid retention in the woman's body. Also, in a very limited amount, you need to consume foods such as sweets and confectionery, since fast carbohydrates in their composition lead to weight gain and do not give any useful substances for the developing fetus.

In the diet of a pregnant woman, there must be lean meat and fish, as the main sources of complete protein, and milk with cottage cheese will also replenish calcium for the body of the mother and the growing fetus, sour-milk drinks will help regulate bowel function. Mandatory elements of the diet of pregnant women should also be cereals and cereals, whole grain bread and vegetable and butter, nuts. To avoid anemia in the diet should be foods rich in iron, these are dried apricots, pomegranates, liver, beef. For better absorption of iron, it is necessary to replenish vitamin C and take vitamin-mineral complexes for pregnant women. Also, the fetus in this period actively needs such minerals as calcium, phosphorus, magnesium, iodine and B vitamins. You may be additionally prescribed a complex for pregnant women.

Sex

Sex during the fourth month of pregnancy is completely allowed, since the condition and well-being of the woman is very good. Orgasm and intimacy will not harm the child in any way, but only on condition that the doctor has not imposed a ban on intimate relationship for any medical indications. If there are no contraindications, within this period intimate life for partners it can sparkle with new colors and deliver a lot of new pleasant sensations. The woman's body has adapted to a new position for itself, and now the blood supply to the pelvic organs is increased, which gives increased sensitivity and new vivid sensations from intimacy. Many women celebrate the flowering of their sexuality during this period, their libido increases, and the sensations of sex become completely new and vivid.

The fourth month of pregnancy is the end of the first trimester and the beginning of the second. This period lasts from 12 to 16 weeks. By now, the condition of the expectant mother is stabilizing. The embryo is firmly established. Toxicosis replaces a good appetite. A more pronounced belly appears, the figure of a woman is rounded. It's time to think about changing your wardrobe.

Child development

The placenta is fully formed. It provides nutrition to the embryo, protects it from infections, removes waste products.

By this time, the laying of all the main internal organs had taken place. Some of them immediately take on the final form. And some, for example, the brain are formed gradually, in several stages.

Significant changes are observed in the embryo. For example, with regard to the nervous system, then:

The developing retina of the eye is already able to detect changes in light.
The auditory ossicles are formed. The fetus responds to your voice or loud sounds. During this period, it is recommended to start talking with the child.
There is a sucking reflex. On ultrasound, you can clearly see how the baby holds a finger or toe in his mouth.
Mimicry develops. He can squint, frown.
Swallows amniotic fluid and feels a change in their taste.
Continues active production neutrons, up to 5000 nerve cells are formed in one second.
Grasping reflex. The kid catches his legs with his hands, pulls the umbilical cord.

At this time, you can already determine the sex of the child:

In boys, the testicles are sent to the scrotum, by the end of the 14th week the prostate is formed.
In girls, a uterus appears, a follicle is laid in the ovaries.

From the side musculoskeletal system the following can be observed:

The ossification of the skeleton begins. During this period it is very important to use enough calcium.
Milk teeth are laid and the dates when they will erupt.
Increases joint mobility.
Muscles are formed and strengthened. The child can already hold his head.

Endocrine system:

The adrenal glands are active.
The thyroid gland begins to produce thyroxine (it ensures the development and growth of cells, activates metabolism).
The pancreas secretes insulin, which controls the amount of sugar in the blood.
The pituitary gland produces a hormone (ACTH) responsible for the development of muscle tissue, skin pigmentation.
The work of the kidneys, which excrete urine into the amniotic fluid, is normalized.

As a result of the development of the muscles of the chest, a respiratory reflex is formed.
The lungs are not yet divided into alveoli, but the baby performs actions similar to inhalation / exhalation, absorbing and expelling amniotic fluid.

The immune system:

The thymus produces lymphocytes and teaches them to recognize and destroy viruses.
The bone marrow produces red blood cells and white blood cells.
Almost all the main components are present in the blood, and its group and Rh factor can be determined.

Digestive system.

The spleen is active.
Bile is produced by the liver.

Eyebrows, eyelashes, hair begin to grow, the body is covered with guns. Nails were formed, a pattern of fingerprints was outlined.

Depending on whether the child is blonde or brunette, the follicles produce the appropriate pigment.

Physical activity

The fetus begins to move at the age of 7-8 weeks. But a woman can feel the first signs of this only at the 4th month of pregnancy, sometimes later. But it should be noted that the absence of tremors after the 20th week is not a sign of deviations. Especially if this is your first pregnancy. In women who gave birth before these women, the abdominal muscles are more stretched and sensitive.

It feels like flatulence. But some compare, as if small bubbles burst in the stomach or butterflies flutter.

The activity of the child in the womb depends primarily on his mood and movements of the expectant mother. If a woman walks a lot, it is lulling. During rest, the child, on the contrary, is energetic. But it must be borne in mind that when a person is busy or passionate, he listens less to his feelings.

Woman's well-being

The fourth month of pregnancy is considered the most easy period. The body began to adapt to the new state:

Toxicosis is significantly reduced or disappears without a trace. Appetite increases.
The irritability goes away and fatigue, there is a surge of strength, self-confidence, complacency. Anxiety about the unborn child does not go anywhere, but it becomes less than in the first trimester. As a rule, it is now that most people understand that pregnancy can be pleasurable.
The expectant mother continues to gain weight. On average, since the last menstruation, this is plus 5-6 kg. But a lot depends on height and physique. If the indicator is significantly different from the norm, a consultation with a gynecologist is necessary.
After four months of pregnancy, the woman notices that her hair has become unusually dense, and her nails have become stronger and grow faster. As a result of hormonal changes, progesterone produced by the body reduces natural hair loss and prevents delamination of the nail plate.
The temperature returns to normal, due to which the state of health improves.
Quantity whitish discharge increases from the vagina.

Many women experience a surge creativity. They feel an unexpected craving for knitting booties, sewing cute toys, creating culinary masterpieces in the kitchen. New hobbies emerge. Some begin to write stories, draw. Information is easy to digest. There may be an idea to learn a foreign language or get a second education. Truth, given period lasts several weeks, so it is better not to build long-term plans.

Stomach

The size of the uterus is actively increasing, and by the end of the 4th month of pregnancy, it rises from the small pelvis, where there is no longer room for it. Its bottom reaches the navel, as a result, the stomach is noticeably rounded. But if desired interesting position You can still hide skillfully selected clothes. The main thing is not to wear tight clothes and tight belts.

If you stand in front of a mirror and look closely, you will see a dark, vertical line running down the center of the abdomen and down to the pubis. It appears due to the deposition of melanin pigment. During pregnancy, the strip may darken, but after childbirth will be lost without a trace.

Sex

Intimacy has a beneficial effect on the baby and future mother. But only on condition that the child develops normally, and there is no threat of miscarriage.

There are no significant restrictions in postures. The belly at 4 months of pregnancy is still small and will not interfere. Only need to avoid increased stress or pressure on the uterus.

The doctor may restrict sexual life if you have:

Bleeding from the vagina.
Tone.
Low location of the placenta.
Sexual infection.

In other cases, you should not deprive yourself and your spouse of pleasure. But abuse is not recommended. You can make love 2-3 times a week.

A woman is unlikely to be comfortable when her husband lies on top of her. The optimal position is the wife on the left side, the husband is attached behind.

Surveys

In addition to passing a general blood and urine test, it is necessary to undergo an examination by a gynecologist. The doctor will check:

Woman's weight.
Pressure.
The size of the uterus, with the help of palpation and a centimeter tape.
Fetal heartbeat.
Status of the cervix during vaginal examination.

In addition, the following examinations are required:

First ultrasound. If you haven't already, hurry up. According to the norms, it must be carried out up to 14 weeks.
A triple test is preferably carried out at 15-16 weeks. It detects blood levels AFP hormones, HCG, E3. As a result, it is possible to determine the risk of developing a child chromosomal diseases: Down syndrome, defects neural tube, Edwards syndrome.

But this study defines only increased risk. And at bad result analyzes are carried out additional examination amniotic fluid.

Possible problems

Although the second trimester is considered one of the easiest periods, a woman may face certain difficulties:

Areolas of nipples, freckles become darker. Possible appearance age spots, moles, including on the face. To avoid this, try to be less in the sun.
Heartburn. It occurs as a result of the fact that the uterus presses on the internal organs and gastric juice partially enters the esophagus. Raw carrots and potato juice work well for her.
Bleeding gums, caries. Maintain good oral hygiene and rinse your teeth with clean water after eating. It is advisable to visit a dentist.
Slight nasal congestion, possibly nose bleed. As a result of an increase in blood volume, thin vessels can be damaged.
The formation of spider veins (varicose veins), exacerbation of hemorrhoids. Under the influence of hormones, vascular tone decreases. To prevent the occurrence unpleasant diseases it is recommended to walk more and add fiber-containing foods to the diet.
Falling iron levels in the blood.
Oily or brittle hair.
Increased sweating.
Dizziness.
Constipation.

Appear drawing pains in the lower abdomen as a result of the growth of the uterus and sprains. This condition is considered normal and does not require treatment. But it is necessary to consult a gynecologist to exclude the possibility of a miscarriage.

Nutrition

After toxicosis, the appetite of the pregnant woman increases. To avoid problems with excessive weight gain, meet the body's nutritional needs and prevent constipation, it is necessary to balance the diet. It must contain the required amount of fats, carbohydrates and proteins.

Some tips for proper nutrition:

You need to eat fractionally, avoiding the feeling of hunger.
Breakfast should be nutritious. It would be nice to cook porridge with a side dish.
For dinner, leave easily digestible foods.
Between main meals, snack on fruits and vegetables.
It is useful to eat lean fish and meat.
Dairy products and cottage cheese must be included in the daily diet. They will help to fill the lack of calcium, and improve intestinal motility.
Pomegranate, beef liver, green apples, dried apricots will reduce the manifestation of anemia, which is usually detected in the 4th month of pregnancy.
Drink plenty of fluids. Drink the main amount of water, juice, tea or compote before 5 pm.
Avoid potatoes, fresh cabbage, grapes.
If you are prone to edema, reduce your salt intake.
Limit sweets, cakes, chocolate. It is better to replace them with marshmallows, marshmallows, honey, jam. And it is desirable to eat in the morning, little by little.

Smoked, overcooked, fast food, sweet soda, alcohol and other harmful products should not be consumed. Coffee is allowed, but not strong and in limited quantities.

It is necessary to monitor the quality of food - it should be as natural and healthy as possible.

In the second trimester, the well-being of the expectant mother improves. And the risk of complications in the fetus is minimal. Now is the time to do what you've been putting off:

If you were planning to move, then the 4th month or a little later is the best time. Pregnant women are even allowed to fly.
Surveys by narrow specialists. In case you need additional treatment or taking medication, a developed placenta will be able to protect the baby from most drugs.
Repair in the apartment. It is necessary to make a plan so that all work is completed before the start of the 3rd trimester, when the woman can no longer cope with her usual workload.

In case of doubt, whether it is possible to perform certain actions, it would be useful to consult a gynecologist. You should also seek help if you feel unwell.

To fourth month the baby's pregnancy has developed facial muscles, so he can make movements with mimic muscles and “grimace”.

There is a complete displacement of the intestine in abdominal cavity; the production of bile by the liver continues, and insulin by the pancreas. In addition, during this period, the salivary glands begin to work.

The skin of the baby, along with its derivatives (lanugo - vellus hair, eyebrows, nails and sweat glands) is also formed. However, it is still very thin, so you can easily see the blood vessels. Under the skin, brown fat is already being deposited, which is responsible for the heat-saving process. Due to the development of the receptor apparatus, the baby's skin acquires sensitivity, especially in the buttocks and abdomen.

The eyeballs of the fetus are also formed by the fourth month, moreover, it can make movements with them. However, on the face they are still quite low, not taking their usual position. Rods are formed from the elements of the eye retina, so now the fetus perceives changes in the brightness of light. Moreover, in the fourth month, the blinking reflex is developed.

The development of the musculoskeletal continues locomotive system: the child makes many active movements of the head, arms, legs. Therefore, starting from the fourth month of pregnancy, the mother begins to feel the first movements. The fetus already in the fourth month is active according to biorhythms: it can not only actively move, but also sleep. But the duration of sleep is longer than rest. However, the baby's skeleton is still soft. The baby's heart at this time works in an active mode and pumps approximately 600 ml of blood per day.

The placenta at this time is fully formed: it contains great amount blood vessels that carry out the relationship of the mother and the growing child.

By this time, the immune system is fully developed.

Also, by the end of the fourth month, not only the auditory ossicles were formed, but also the temporal lobe, which is responsible for the perception of sound. The ears are located on the sides of the head. So in the fourth month, the fetus can not only perceive sound, but also analyze its volume and timbre.

As regards the development of teeth, milk teeth in the fourth month are covered with dentin; under them, the rudiments of permanent teeth are laid.

The uterus in girls by this time has already been formed.

By the end of the fourth month, the baby is about 14 cm tall and weighs about 190 g.

Physiological changes in the mother's body

Already in the fourth month of pregnancy, a woman can feel fetal movements (feeling of the movement of gas bubbles). During this period, there is a noticeable increase in the mammary glands by one or two sizes.

Also under the influence advanced level of female sex hormones (estrogens), pregnancy hormone (progesterone) and melanin-stimulating hormone in the skin, the accumulation of a special substance - melanin, which is responsible for color enhancement - hyperpigmentation, continues.

The areas of hyperpigmentation include not only the areola of the nipples of the mammary glands, but also the area of the skin around the navel, the midline of the abdomen and the skin of the perineum.

In some cases, a pregnant woman develops hyperpigmentation of the skin of the face - the so-called "pregnant mask".

The uterus at this time reaches the size of a melon: the load on the lungs and gastrointestinal tract increases. intestinal tract. The lungs begin to function in an enhanced mode, also due to the displacement of the diaphragm upward in pregnant women, chest type breathing. This may be manifested by slight shortness of breath when walking. Rib cage expanding, light respiratory tract also - due to the placental hormone progesterone.

There may be changes in the PNS - the peripheral nervous system - in the form of neuralgia, pain in the sacrum and lower back, convulsions in the area calf muscles, feelings of numbness of the fingers.

There is a more pronounced increase in circulating blood volume, as well as heart rate. Starting from the 4th month of pregnancy, disorders may appear in the form of varicose veins of the lower extremities.

Changes in appearance

As for the appearance of a pregnant woman, in the fourth month there is a noticeable increase in the breast. This happens under the influence of estrogens, receptors for which are present in its glandular tissue - the structural basis. Intensively grows not only the tissue of the mammary glands, but also the network of blood vessels that feed it. In addition to breast enlargement by 1 - 2 sizes, protruding veins can be seen under the skin of the glands.

The uterus reaches the distance of the middle between the navel and the pubic joint. The weight gain of a pregnant woman is insignificant - from 1 to 2 kg. This is due to the fact that there is no pronounced active growth of the fetus as such, it begins at the 5th month of pregnancy.

Increased hyperpigmentation of the skin of the neck and face, as well as the perineum and the white line of the abdomen (the presence brown spots on the skin due to increased production of melanin, the main function of which is protection from UV radiation).

The areolas of the nipples increase in size, the papillae become more pronounced.

Also, by the end of the fourth month, a woman may show signs of varicose veins (vascular "asterisks" and noticeable tortuous veins) on the skin of the lower leg - most often. In women who have previously suffered from varicose veins, the course of the disease simply becomes more severe. This happens due to the fact that under the action of the hormone progesterone, the structure of the wall of the veins of the lower extremities changes, they expand. The volume of circulating blood also increases, along with this, its outflow from the lower extremities is disturbed due to compression of the veins by the growing uterus.

Emotional background

The emotional state of a woman in the fourth month is usually stable and favorable. Future mom adapted to hormonal changes; symptoms such as increased fatigue and irritability, nausea and vomiting, headache, disappear. During this period, a woman in most cases begins to feel more confident and calm.

If in the first trimester of pregnancy there was mainly the laying of internal organs, then during the second trimester the main growth and development of the child occurs. Therefore, starting from the 4th month, the energy value of the pregnant woman's nutrition should be increased.

It is not necessary to talk about the benefits of calcium, phosphorus, vitamins A and D - they are necessary for the normal formation of the skin, bones, mucous membranes and retina.

The list of foods that need to be emphasized in nutrition includes: vegetables, fruits and berries (they can be consumed in unlimited quantities), meat and fish, liver (very useful product due to the high content of B vitamins) and poultry, all dairy products (yogurt, kefir, cottage cheese, cheese), bread and cereals, nuts.

It is better to limit the amount of sugar in your diet that comes from confectionery and white bread. Sausage, sausages, smoked meats and canned food should be replaced with complete sources of protein - meat products. Of course, alcohol is absolutely forbidden for a pregnant woman.

It is best to set the diet so that meals are 5-6 times a day; the intervals between them are 2-3 hours. The main goal is not to overload the gastrointestinal tract (for comparison: in the first trimester, the main goal of fractional and frequent meals is to prevent or alleviate the symptoms of early toxicosis).

It is better to limit the liquid: up to 1.5 liters per day, the salt content in the diet is 3-4 g / day. The liquid consumed includes not only water, but also milk, soups and compotes.

Recommended limit physical activity, starting from the second trimester of pregnancy - by 30%. By this time, due to the increase in the size of the uterus, the center of gravity shifts with an increase in the load on the muscles of the back and spine. Also, vessels (in particular, veins) and leg muscles experience a large load. And in general, the second trimester is the safest period for sports.

During this period, it is recommended to perform exercises to strengthen the muscles of the back, legs, abs, as well as improve joint mobility. In a standing position, no more than a third of the exercises are performed. The recommended loading time is 30-45 minutes 2 hours after eating.

to strengthen the hip joints: 25 - 30 squats (feet shoulder width apart); adduction / abduction of the leg in the hip joint in the standing position and lying on the back;
to strengthen the press: in the supine position, alternating deep breaths and exhalations 3 times in a row; in the supine position, abduction / adduction / raising / lowering the legs;
exercises to strengthen the muscles of the legs: in the supine position, throwing alternately left and right foot. Approximate frequency - 6 times;
exercises to strengthen the muscles of the back: in a position on all fours (head in line with the spine), pulling the abdomen in and bending the spine with an arc upwards. The recommended frequency is 5-10 times.

Examinations in the fourth month

At the fourth month of pregnancy, the obstetrician-gynecologist conducts a second examination.

During the second trimester of pregnancy, a woman comes for an examination once a month (for comparison: during the third trimester of pregnancy, a woman undergoes an examination 2 times a month).

Since already in the fourth month the height of the bottom of the maca is above the pubic joint, it can be measured with a centimeter tape.

In addition, the circumference of the abdomen is measured. Subsequently, these data will be needed to measure the rate of growth of the abdomen: rapid increase can talk, for example, about fluid retention in the body, excess nutrition of the mother.

Survey methods include:

Ultrasound of the fetus - is carried out not only to clarify the duration of pregnancy, its normal development and number of fruits. Starting from the fourth month, the most severe fetal malformations (eg, absence of organs or body parts, severe malformations of the brain and heart, spine and nervous system, fetal dropsy) can be identified;
dopplerography - a study of the state of blood flow in the vessels of the umbilical cord, uterus and fetus. The state of uteroplacental blood flow is assessed. Can be carried out starting from the end of the 4th month;
determination of the level of alpha - fetoprotein (norm: 15 - 60 kU / l). At this time increased value AFP levels may be observed at multiple pregnancy, malformations of the neural tube of the fetus (anencephaly, spina bifida), non-closure of the anterior abdominal wall of the fetus. A low value indicates chromosomal pathology(Down's syndrome, trisomy 18), fetal growth retardation;
standard research including research general analyzes blood and urine measurement blood pressure and woman's weight.

Possible Complications

By the fourth month, the laying of the main organ systems is completed. Most dangerous periods(critical) early dates pregnancies also passed. Therefore, the main defects that can develop at this stage relate to the underdevelopment of organs or their incorrect formation. For example, this is the formation of such congenital malformations of cardio-vascular system like transposition of the great vessels or tetralogy of Fallot.

When to see a doctor immediately

signs of toxicosis, not typical for this period: nausea and vomiting;
visual impairment;
any vaginal bleeding;
severe, prolonged headache;
chills and fever;
signs of infection of the genital tract: pathological discharge pulling discomfort in the lower abdomen;
prolonged headache.