The rate of weight gain in the 3rd trimester. Weight in the third trimester. What are the average rates of weight gain at different stages of pregnancy

03.11.2019

The third trimester of pregnancy - fetal, or late fetal, lasts from 29 to 40 weeks. This is a trimester, which is characterized by the preparation of the mother and the child for the upcoming birth, the final intrauterine, the formation of organs and systems to the extent that it is necessary to enter the outside world. The rest of the processes of formation and growth will occur outside the mother's womb, and in order for these processes to take place normally, in the perinatal period, development should be carried out in a normal course. This period requires compliance with the requirements for a pregnant woman and medical supervision.

In the third trimester, a woman should attend an antenatal clinic weekly and undergo a routine examination. Ideally, a weekly visit to the doctor for the entire duration of the gestation process, but if everything is proceeding normally and without visible negative signs, visits to the consultation may not be so frequent. By 37-38 weeks, not only there is more time due to maternity leave, but preparation for childbirth is also launched, which must be under strict control. A change in the hormonal background, which occurs due to the natural course of events, during which the prevalence ends, and estrogens come into force, which begin to be actively synthesized as soon as the baby reaches a certain degree of readiness for life outside. Estrogens determine several processes at once:

the tone of the uterus increases;
training contractions begin to appear;
the cervix matures and shortens;
the cervical canal opens slightly;
the mucous plug leaves;
the formation of a generic dominant, a state when all thoughts and aspirations are directed at the earliest possible birth of a child, begins.

When estrogens reach their peak concentration, the fetus stimulates the production of prostaglandins in the maternal body, which becomes the start for the onset of the labor process. In addition to measuring blood pressure, weight, the height of the fundus of the uterus, diagnostic palpations to determine the tone of the uterus and auscultation of the fetus using a stethoscope, the expectant mother is checked for hidden edema in order to identify gestosis, which also occurs in healthy women. The main purpose of listening to a raft is to determine its heartbeat.

Tests in the third trimester of pregnancy

During this period, an exchange card is drawn up, which will be urgently needed in the future, first of all, upon admission to the hospital. To issue an exchange card, you will need to go through the following analyzes:

once every 6 weeks - a smear from the vagina;
biochemical blood test (blood test for HIV antibodies, hepatitis B and C, syphilis, which are taken every half month for the last 2 months of the trimester;
triple screening, which includes ultrasound, cardiotocogram, Doppler ultrasound and biochemical studies in case of certain contraindications, or diagnosed disorders;
to identify hidden processes of inflammation;
every 2 weeks urinalysis to monitor the condition of the kidneys and the absence of pathological processes in the body.

All these tests must be taken, because on their basis, and on the results of visual examination, palpation and listening, the doctor can draw up not only a general clinical picture of the course of the last trimester, but also take measures if necessary, or the appearance of pathology, ascertain not only the readiness of the body for childbirth, but also quite reliably establish the date when the childbirth will take place. Modern technologies make it possible not only to undergo 3D / 4D-ultrasound, in which the child can be seen in motion in a three-dimensional visual image, but also to receive a disc with a memory record.

Signs of a frozen pregnancy in the third trimester

At the very beginning of pregnancy, expectant mothers often experience fear, hearing from all sides about the increase in cases of missed pregnancies. This often turns into an obsessive thought.

Constant monitoring with the help of laboratory data will make it possible to get an impression of how normal the gestation of the fetus is, and whether its condition corresponds to those parameters that, in an average value, indicate the norm for all components. there is a discrepancy between the size of the uterus and the gestational age, the cessation of the fetal heartbeat and general negative feelings of severe malaise. To identify them, routine examinations are needed. The pregnant woman herself should also be on the alert, constantly monitoring her condition and at the first negative observations she should immediately consult a doctor.

Condition of a pregnant woman in the third trimester

In the third trimester, it is difficult to predict the possible scenario of events. In some women, it no longer grows during this period, and the placement of the fetus occurs due to the capacity of the pelvis. On the contrary, it increases in small and thin ones. The body of some pregnant women gains weight, despite strict control and diet, more than during the entire period of pregnancy, while others, on the contrary, lose weight. Because the body gets rid of excess fluid, rebuilding itself in the process of preparation.

The process of the body's activity is purposefully directed towards the implementation of a single goal, the placenta begins to decrease in it, and the launch of the corresponding hormones becomes a natural consequence of this. In the last weeks of pregnancy, the uterus tightly embraces the fetus, the adrenal glands of which begin to secrete the stress hormone, which contributes to the appearance of a generic dominant, which carries out not only stimulation, but also a push to the triggering mechanism. A kind of barrier for protecting the female body from external reaction factors is formed, the hormone produced by the pituitary gland () stimulates preparatory measures.

In the third trimester, a woman's pelvic bones move apart, the cervix acquires elasticity, blood circulation becomes more active, and training contractions appear. During this period, under the pressure of an enlarging uterus and a growing fetus, a woman may experience pain in the back and lower back, and sometimes in the lower extremities, if the blood vessels are pressed down, hemorrhoids may progress, the process of defecation is disrupted, pressure on the bladder leads to more frequent urination, and deteriorated kidney function - lead to the appearance of edema. A fairly large percentage of pregnant women develop varicose veins, there is a danger of thrombosis, and other vascular pathologies. All this especially applies to those who have already had unsuccessful pregnancies, or women in labor after 35 years. The increased weight and size of the fetus lead to rapid fatigability, decreased physical activity, and a large belly interferes with bending over, tying shoes and performing other usual actions.

Nausea in the third trimester of pregnancy

Nausea in the third trimester, according to representatives of certain medical circles, may be the result of natural processes in the body and be the same normal concomitant symptom as similar phenomena in the first trimester. However, it is more widely believed that nausea during this period becomes a sign of any negative diseases present in the body. If a pregnant woman regularly undergoes examinations by the attending physician, and passes all the necessary tests, then she should certainly inform her doctor about this phenomenon.

In any case, the third trimester requires from the woman in labor the utmost attention to the state of her health, and the indispensable notification of the doctor about the emerging pathological condition. The reason must certainly be revealed and eliminated, so that its action does not negatively affect the condition of the fetus. We should not forget that nausea is a sign of certain problems with the kidneys, which is very dangerous before future childbirth, and in the process of their course.

Pain in the third trimester of pregnancy

Pain in the third trimester can be both temporary and spastic in nature, and every woman faces this. These can be back and lower back pain due to stress on the spine, abdominal pain caused by malfunctions of the digestive tract, which are usually caused by fetal pressure on the intestines. Pain may appear during the discharge of the mucous plug, or training contractions, which sometimes appear several weeks before childbirth. Many doctors believe the main cause is hormonal dysfunction, which implies an increase in the level of male hormones. Women most often face such problems long before conception. Hormonal dysfunction can trigger a frozen pregnancy. If pain occurs, you must immediately go to the hospital for an examination.

If pain is accompanied by prolonged, unbearable seizures and bloody discharge, it may be a threat of termination of pregnancy, or premature birth, if the term for normal delivery has not yet come. In this case, you should call an ambulance and go to the hospital, where they will either help you calm down and calm down the pain, or they will help, or they will be saved.

Discharge in the third trimester of pregnancy

A pregnant woman should normally have leucorrhoea. This is a consequence of natural processes occurring in the body, therefore, if there is no discharge, or they are very scarce, you should consult your doctor on this topic. The consistency and volume of leucorrhoea change when the term of labor approaches, they become more liquid and increase in volume. And this is also a normal process. During this period, brown discharge may appear, indicating the adherence of the placenta, or reddish, which indicates the loss of blood by the vessels of the uterus. The appearance of yellow or green mucus does indicate a pathogenic process, with which you should immediately consult a doctor.

Colds in the third trimester of pregnancy

A cold during this period is an extremely undesirable phenomenon. The expectant mother should carefully monitor her health. Dress warmly in winter and avoid drafts and air conditioning in hot weather. In any case, taking medications at such a late date is extremely undesirable, therefore, treatment is carried out with proven folk remedies in the form of herbal teas, medicinal decoctions, gargling and other methods. Raspberries, lemon and citrus fruits should be used with caution because they are potential allergens.

Temperature in the third trimester of pregnancy

Temperature in the third trimester of 37-37.4 degrees may be the norm in some cases. A slight increase may be due to an increased level in the body, or general changes in hormonal levels, the natural course of pregnancy. A high temperature, for no apparent reason in the form of a cold, is the basis for immediate medical attention, since it indicates the presence of an acute inflammatory process.

Nutrition

Nutrition during pregnancy should be as complete as possible, balanced and provide all the necessary nutritional components for a complete one. In the presence of certain pathologies, a therapeutic diet is prescribed, which must by all means be agreed with a nutritionist and correspond to the goals of its appointment. In the normal version, fractional nutrition in small portions will be optimal, with thorough chewing of food, which is not redundant, but in no way makes the body starve.

Fetal size and weight in the third trimester

The size and weight of the fetus is calculated according to different formulas and depends on various individual indicators. The norm can be 2 kg and 4 kg, depending on many factors, for example, the height and weight of the parents.

For more than half a year, the baby "who settled" there six months ago has been living and developing safely in the mother's tummy. Mom entered the 7th month without any special complications, which means that the third trimester of pregnancy has begun: the last stage and meeting with an already beloved baby.

The baby is already actually formed, and now the improvement of his organs and systems is actively taking place. The baby is gradually gaining weight and growing, its movements become more and more tangible: either the baby pushes with the handle from the inside, then it rests on the leg. If at the beginning of the third trimester the movements are frequent, then as the term increases, the baby has less and less space in the uterus, the movements become less frequent, but stronger, sometimes even painful.

Over the past time, the uterus has significantly increased in size - the mother's tummy has rounded and proudly protrudes forward, with the increase in the term, the woman more and more feels clumsy and helpless, and by the end of pregnancy, she often cannot tie the laces on her shoes without outside help.

In late pregnancy, the appearance of training contractions, the so-called Braxton-Hicks contractions, is typical, through which the uterus "stretches" in preparation for the upcoming birth.

Frequency of urination is also considered normal for this period: the grown uterus presses on the bladder, "forcing" it to empty more often. At the same time, the significant size of the abdomen provokes frequent pain in the lower back and back, and such phenomena as edema and varicose veins are common in the third trimester of pregnancy.

From now on, mom should take care: more often to rest lying down with legs raised on the pillow, regularly be in the fresh air, making long 2-hour walks. It is very important to continue to monitor your weight: normally, the increase per week should not exceed 300 g.

Nausea in the third trimester of pregnancy

The third trimester, like the first, is considered a rather difficult and dangerous period of pregnancy, so a woman needs to carefully listen to her feelings and pay close attention to any changes in her condition. Indeed, if for the first trimester nausea, as one of the "components" of toxicosis, is considered normal, then nausea in the second trimester of pregnancy may indicate a serious complication - gestosis. Gestosis in the second half of pregnancy poses a sufficient threat to the development of the fetus and to the health of the mother; other indications of it, in addition to nausea, may be a sharp increase in weight, significant edema, and an increase.

In addition, nausea in the third trimester of pregnancy may indicate liver function problems, possible poisoning (some women even share their memories of how nausea in their case was a consequence of iron poisoning).

But, at the same time, experts reassure that nausea does not necessarily signal any serious problems, but it can be caused only by changes in the size of the uterus, which now pushes the stomach up, occupying most of the abdominal cavity.

Be that as it may, if it is advisable to immediately and without hesitation, consult a doctor: to find out whether such a condition poses a threat, it is possible only with specialized intervention.

Discharge in the third trimester of pregnancy

In the third trimester of pregnancy, the nature of the discharge may either persist or change somewhat - both in the absence of blood in the discharge, abdominal pain, and qualitative changes in the discharge are considered the norm. So, discharge in the third trimester of pregnancy can be thick, liquid and even watery, the main thing is that an unpleasant odor is not mixed with it, the discharge is not curdled or foamy and is not accompanied by itching or burning. The appearance of yellow or greenish discharge, as well as discharge with an unpleasant odor against a background of discomfort, indicates an infection. Establish which pathogen caused such qualitative changes should be examined by a doctor, who will prescribe adequate treatment.

A more formidable situation is one in which the discharge in the third trimester of pregnancy takes on the character of bleeding. In this case, most likely, we will talk about low placentation, when the placenta is too tightly attached to the uterine pharynx or enters the cervix, scarlet blood with this diagnosis can be separated after physical exertion or intercourse.

In addition, bleeding can be caused by premature placental abruption: external bleeding is then similar to menstrual bleeding, accompanied by unpleasant and even painful sensations in the abdomen. If even blood clots appear in the discharge, and, even more so, if their appearance is accompanied by pain, it is necessary to seek medical help as soon as possible. After all, it is quite possible that the situation poses a certain danger, you may need bed rest, and in some cases, hospitalization. In addition, if the placenta on its own in the future does not take the correct position, childbirth will be carried out by cesarean section. In the worst case, with poor performance, it may even be necessary to stimulate premature delivery.

If pregnancy is not accompanied by such complications and everything goes on as usual, then a few days before giving birth, mommy will still face changes in discharge. So, at some point in the last stages, thick mucous discharge, painted in pink, will make itself felt. This is a mucous plug, the discharge of which indicates the immediate proximity of the onset of labor: when the mucous plug leaves, one should be prepared for the fact that labor pains will begin from day to day.

Ultrasound in the third trimester of pregnancy

Ultrasound in the third trimester of pregnancy is a mandatory routine examination, it is usually carried out at a period of 32-34 weeks. The task of the last, actually "prenatal" ultrasound examination is to assess the development of the baby's organs and systems, as well as to determine the readiness of the mother's body for the upcoming birth. So, during an ultrasound scan in the third trimester of pregnancy, the doctor assesses the size of the fetus and confirms the date of delivery, determines the compliance of the development of the fetus with the appointed date of delivery.

The presentation of the fetus is determined during the ultrasound examination, which makes it possible to determine the tactics of labor management (breech or breech presentation may become an indication for cesarean section). The task of ultrasound in the third trimester of pregnancy is also to determine the degree of maturity of the placenta and its location, to assess the uteroplacental and fetoplacental blood flow.

As in earlier periods, in the third trimester of pregnancy, ultrasound can detect fetal development. Although gross pathologies can be determined even during the first and second planned ultrasound, some diseases of the baby, for example, hydronephrosis of the kidneys (fluid in the kidneys), appear only towards the end of pregnancy. Having identified this or that pathology, the doctor will be able to decide on further tactics: it is possible that a premature delivery will be needed or a decision will be made on surgical intervention immediately after the baby is born.

Colds in the third trimester of pregnancy

In the third trimester of pregnancy, the risk of catching a cold increases again, and at this stage colds again pose a rather serious danger. Although at the beginning of the third trimester, the placenta sufficiently provides a barrier to the penetration of viruses and infections, in some cases the placental obstruction may not work, allowing pathogens to enter the baby. The entry of viruses into the amniotic fluid can be threatening if they "break" through the weakened placental barrier: a child can swallow toxic water, which threatens with serious complications.

Dangerous cold in the third trimester of pregnancy and its "ability", with a protracted course, lead to premature birth. In the late "prenatal" terms, a cold significantly complicates the process of childbirth - a weakened woman's body copes with childbirth with great difficulty. In addition, colds in the last stages of pregnancy often become an indication for hospitalization - immediately after childbirth, the baby is isolated from the mother in order to avoid an infection attack on the infant's defenseless organism.

A cold in the third trimester of pregnancy requires compulsory and urgent treatment, which is further complicated by the ban on most drugs. First of all, the patient will need bed rest - in no case should a cold be carried on his feet. Permitted remedies for the treatment of colds are strictly regulated, by and large, only decoctions based on medicinal herbs and their roots (for rinsing the throat and ingestion), saline solutions (for rinsing the nose and rinsing the throat), inhalation using, again, are used medicinal herbs and with the addition of soda and salt. By the way, the expectant mother should also be careful with herbs, not all of them have an exclusively and guaranteed positive effect. Permitted herbs include linden blossom, coltsfoot, plantain, licorice (teas), as well as thermopsis herb, calendula flowers, oregano, chamomile, marshmallow root or herbs (decoctions for expectoration). You can gargle a sore throat with a decoction of chamomile with the addition of soda, and use saline solutions or drops for rinsing the nose.

For the prevention of colds, in the first place, you should avoid places with large gatherings of people, especially during the "virus rampant" seasons. In addition, it will not be superfluous to dress in accordance with the weather conditions, avoid drafts, follow a diet with the use of sufficient amounts of vitamins.

Temperature in the third trimester of pregnancy

But it is not always possible for a pregnant woman to endure a cold without an increase in temperature: viral and infectious diseases, as you know, are very often accompanied by a reaction of the body in the form of a temperature syndrome. And in this case, too, many problems can arise: high temperature weakens the placental barrier and makes the baby vulnerable to viruses and infections. Therefore, the temperature must also be "dealt with", but this must be done competently and in accordance with certain rules.

So, experts recommend not knocking down temperatures up to 37.7-38 degrees, but with a significant increase in temperature, use exclusively folk remedies. But we are not talking about rubbing with vinegar or vodka - although such actions can lower the temperature, they can also harm the baby due to the penetration of toxic substances into the skin and blood. But a safe "helper" in the fight against high temperatures is a warm drink: warmed milk with honey, linden blossom tea, tea with raspberries and lemon, dried fruit compote. Warm drinks help to sweat and therefore lower the temperature by separating the sweat.

It is also not recommended to lie down under a warm blanket at elevated temperatures, wear woolen socks, because this way you can, on the contrary, increase the temperature even more. As an antipyretic agent, as a last resort - if teas and decoctions do not help - a one-time intake of Paracetamol is allowed. In no case should you use Aspirin! This drug is capable of provoking uterine bleeding, and is toxic to the fetus.

And one more thing: in some cases, the temperature in the third trimester of pregnancy at levels of 37-37.4 degrees can be considered the norm. A slightly elevated temperature may be due to hormonal changes during pregnancy and an increased level of progesterone in the body.

Nutrition in the third trimester of pregnancy

Nutrition in late pregnancy is of great importance for the normal well-being and full development of the child. Now the baby is already practically formed and is actively gaining weight, the task of the mother is to “provide” him with the necessary nutrients and useful substances for this. So, nutrition in the third trimester of pregnancy must necessarily provide for a daily intake of protein, the source of which is boiled lean meat and fish. But you should be careful with pregnant fish: some varieties of fish contain a fairly large amount of mercury, which is harmful to the baby. The best "option" for a woman is cod, salmon, tuna, but it is better to refuse the king mackerel. Again, eggs, dairy and fermented milk products will provide the baby with protein and additional calcium.

It is advisable to enrich the diet with fresh vegetables and fruits - a sufficient amount of fiber will prevent constipation, and vitamins and minerals will support vitality and the body in good shape. Useful foods for pregnant women at any time, including the third trimester of pregnancy, are beef, beef liver, pomegranate and tomato juice, which maintain hemoglobin levels and prevent the development of anemia.

It is better to give up flour products, confectionery, sweets, sweet soda for a while - they can provoke additional weight gain, which is undesirable during pregnancy. In addition, fatty and spicy foods should be excluded from the diet: in addition to the fact that such food can cause heartburn, it also retains fluid in the body and the development of edema. To avoid such a situation, you should limit salt intake, as well as carefully observe the water-drinking balance: the amount of fluid consumed per day should not exceed 1.5 liters, including juices, soups, milk, fruits.

It is better to take food fractionally, often and in small portions, eating when there is a need for it. Food should be healthy and natural, it is better to refuse from instant food and all kinds of semi-finished products. In general, the daily calorie intake should be around 3,000 kcal.

Vitamins in the third trimester of pregnancy

Vitamins in the third trimester of pregnancy are still "relevant" and necessary, both for the mother and the baby growing by leaps and bounds. Of course, the option is considered optimal in which the expectant mother receives all vitamins and trace elements from food - and therefore, such attention is also paid to the issue of balanced nutrition. But it happens that a woman may be shown an additional intake of vitamins, in this case, the choice of the most suitable multivitamin complex should be discussed with a doctor. So, what vitamins in the third trimester of pregnancy must be supplied to the body of the expectant mother?

Vitamin A- is necessary for the growth and development of the baby's skin, bones, mucous membrane of the eyes, for the normal functioning of the liver and the mother's immune system, as well as for the prevention of anemia (promotes the absorption of iron);

B vitamins- participates in the creation of blood cells of the child and prevents the appearance of seizures in the mother;

Vitamin C- strengthens the walls of blood vessels, supports the immune system, however, it is not recommended to exceed the dose, as this may lead to the development and / or aggravation of gestosis;

Vitamin E- prepares the baby's lungs for spontaneous breathing, reduces the threat of premature birth;

Vitamin K- takes part in the regulation of blood clotting, prevents possible bleeding;

Vitamin D- together with calcium, it maintains the normal state of bone tissue, it is required for the development of the bones and teeth of the child.

Sex in the third trimester of pregnancy

The third trimester, in fact the final stage of pregnancy, a woman is already looking forward to the moment when the chores associated with carrying a child and its further birth will remain in the past. Since by the end of a woman’s pregnancy, “tasks” for future parents are even more added (by the time of contractions, one should be fully “fully armed”, taking care of accessories for the baby in advance), intimate pleasures somewhat recede into the background. Yes, and the expectant mother's sexual attraction is somewhat “fading away”: a big belly interferes with normal movement and turning over in bed, from time to time exhausting heartburn makes itself felt, a pregnant woman is increasingly tired and increasingly requires rest.

This means that a man will have to be as attentive and patient as possible to his wife in a position, partly “pacifying” the desires of the flesh for the time being. So, the third trimester of pregnancy is considered one of the responsible and rather dangerous periods during which it is desirable to limit sexual activity. This is especially important at 8 months, when intense physical contact can provoke uterine contractions and cause premature birth.

You should not practice intimate caresses when the baby has taken a head presentation - there is a danger of injury to the placenta during muscle contractions of the uterus. Sex in the third trimester is also prohibited if the amniotic fluid has already departed, when the child, in the absence of protection from the fetal bladder, is vulnerable to infections.

The doctor will tell the couple how much it is possible to practice sex in the third trimester of pregnancy. In general, if the pregnancy is proceeding normally and without any serious complications, infrequent love joys are still permissible, the main thing is to choose positions that allow avoiding pressure on the stomach and excessively deep "male penetration".

What happens to the baby at this time, what problems may the expectant mother have and how to avoid them?

The last trimester begins at the 29th week of pregnancy and continues until delivery. A period of 28 weeks is considered the border between the second and third trimesters, because if a child is born after 28 weeks, he reaches a weight of more than 1000 g, a height of more than 35 cm and, with appropriate nursing and treatment, acquires high chances for further life and development outside the womb. Since the load on the woman's body in the last trimester is maximum, the risk of various complications of pregnancy increases.

3rd trimester of pregnancy: fetal development

During the third trimester, the fetus becomes large enough, so it can no longer easily and repeatedly change its position in the uterine cavity. In response to fetal movements, the uterus may come into a short-term tone: in this way, it guides the baby so that he is located head down - in a cephalic presentation, since it is in this position that it will be easiest for him to overcome the birth canal. The final position of the fetus is formed, as a rule, by 34–35 weeks of pregnancy, since after this period the uterus becomes too cramped to significantly change the position.

7 month. At 29–32 weeks of gestation, the baby is actively improving the nervous system: a myelin protective sheath is formed around the nerve fibers, the brain is actively developing - the number and depth of convolutions increases. At this stage of pregnancy, the fetus has already functioning sensory organs: he hears sounds and distinguishes the mother's voice, feels the taste, is able to see and touch!

By 32 weeks of pregnancy, subcutaneous fatty tissue has sufficiently accumulated, folds in the skin straighten, the structure of the fetus's body becomes more proportional due to a decrease in the size of the head relative to the body and limbs. The development of internal organs reaches a fairly high level: in the lungs there is an accumulation of surfactant - a surfactant that covers the pulmonary alveoli from the inside and does not allow them to collapse on exhalation. The pancreas already secretes the hormone insulin, which is responsible for normalizing blood glucose levels. The structure of the liver and kidneys is finally formed. By the end of 32 weeks, there is a significant increase in fetal weight due to the active accumulation of fat: the child's body weight reaches 1700 g, his height is 40–41 cm.

8 month. From 33 to 36 weeks of pregnancy, the growth of the fetus proceeds at an active pace, the average weight gain is 28 g per day - about 1?% Of body weight! On the fingers and toes, marigolds have grown, on the hands they reach the tips of the fingers, on the legs until they reach the end of the nail phalanges. The baby already has well-developed swallowing, sucking and breathing reflexes. Being in the uterus, he actively swallows amniotic fluid, of which up to 500 ml of urine per day is formed in the kidneys. The fetus urinates in the amniotic fluid, thus taking part in their production. The whole body of the baby is abundantly covered with cheese-like grease, and the amount of vellus hair (lanugo) gradually decreases, the cartilage of the nose and ears gain elasticity. In boys, the testicles descend into the scrotum. The fetus already has an individual rhythm of periods of sleep and activity, which, unfortunately, does not always coincide with mother's. By the end of the 36th week of pregnancy, the baby's height reaches 45–48 cm, weight - 2400–2500 g.

9 month. During the last month of pregnancy (37–40 weeks), the processes of fetal maturation are completed, it is already finally ready for life outside the womb. By the time of birth, the baby reaches a maximum weight and height, which can vary significantly: the weight of the fetus at birth can be from 2500 to 4500 g, height - from 45 to 55 cm and more. Such significant differences can be explained, firstly, by the peculiarities of the constitution of the parents of the unborn child: all people have a different physique, height and weight, which, naturally, will be inherited by the child. In addition, the "size" of the baby may be due to various features of the course of pregnancy, since the level of functioning of the placenta largely depends on this, and, consequently, the intensity of providing the fetus with nutrients necessary for its full growth and development.

By the end of pregnancy, the baby occupies the entire uterine cavity, and, since it becomes cramped for him, the nature of fetal movements changes: they become less amplitude, more reminiscent of jerks with legs and arms. At this time, much less large-amplitude movements are observed - turns, overturns, so some pregnant women begin to worry about a decrease in the motor activity of the fetus. In fact, there is no reason for concern: with a full-term pregnancy, this is normal. Usually, the intensity of fetal movements increases in the evening.

In the last month of pregnancy, the amount of cheese-like lubricant on the skin of the fetus decreases, vellus hair - lanugo - practically disappears, remaining only in a small amount on the shoulders. Since the processes of preparation for childbirth begin in the mother's body, the presenting part - the head or pelvic end of the fetus - descends and presses against the entrance to the small pelvis.

By the time of birth, the baby acquires signs of maturity, which indicate the degree of readiness for existence outside the womb:

the weight of a mature child is on average 3200–3400 g, height is on average 50–53? cm (fluctuations are possible in the direction of both increasing and decreasing the above average statistical parameters);
in boys, the testicles are descended into the scrotum, in girls, the labia majora cover the small ones;
the chest of the fetus is convex, the umbilical ring is located in the middle of the distance between the bosom and the navel;
a layer of subcutaneous fat is well developed, the nails reach the edge of the fingers;
ear and nasal cartilage is quite elastic.

3rd trimester: expectant mother

In the last trimester of pregnancy, the woman's body experiences significant stress, since the fetus becomes quite large. In this regard, the pregnant uterus puts pressure on neighboring organs. The fundus of the uterus "supports" the diaphragm, and it can be difficult for a woman to take a deep breath, to fully expand her lungs. The large uterus puts more and more pressure on the bladder, which forces the expectant mother to frequent the toilet and wake up several times during the night to urinate. Compression of large vessels of the abdominal cavity makes it difficult for venous outflow from the lower extremities, which leads to the development of a feeling of heaviness in the legs, the appearance of edema at the end of the day.

The mother-to-be becomes less mobile, as a large belly does not allow for movements that were easily performed before pregnancy. The softening of the ligaments, due to the influence of the pregnancy hormones progesterone and relaxin, increases the likelihood of twisting the legs and even falling, which requires increased caution from the expectant mother.

By the beginning of the third trimester of pregnancy, the weight gain is approximately 7–8? Kg, and by the time of delivery, another 4–5? Kg will be added. Thus, the total body weight gain during pregnancy is 10–12 kg. If there was a weight deficit before pregnancy, then the gain can reach 15 kg.

The large size of the uterus, as well as an increase in the motor activity of the fetus in the evening and at night, which is observed quite often and is not a sign of pathology, are the cause of sleep disturbances in the 3rd trimester of pregnancy. The future baby becomes so large that its movements can not only be felt, but also seen, since small knees or elbows are now and then protruding through the front abdominal wall. The large size of the fetus can cause painful sensations at the time of movement. To avoid this, the pregnant woman needs to change her body position, take a comfortable posture. Weight gain, large abdomen are often the cause of back pain in the expectant mother.

At 30 weeks of pregnancy, a woman is granted paid prenatal and postnatal leave, which lasts 70 days before delivery and 70 days after delivery. If the birth of twins is expected, then the vacation begins earlier - from 28 weeks.

After going on maternity leave, the expectant mother has time to prepare for the arrival of a new family member. In addition, a sign of the third trimester is the narrowing of the range of interests of a pregnant woman: she is worried about issues related to bearing, giving birth and raising a baby, her social circle is closed on the same expectant mothers. Friends and acquaintances with whom the woman communicated before the onset of pregnancy fade into the background for a while. A peculiar manifestation of the change in the range of interests is the so-called “nesting” syndrome, in which there is a pronounced motivation for arranging a children's room - repairing, buying furniture, as well as purchasing a dowry and toys for a baby. These changes are caused by hormonal changes and are a necessary adaptive mechanism to create the best conditions for nursing a child after birth.

By 37–38 weeks in the body of a pregnant woman, processes are launched aimed at preparing for childbirth, which are caused by a change in hormonal levels. Progesterone, which "reigned" throughout pregnancy, is replaced by the hormones estrogens, the synthesis of which is significantly increased when the fetus reaches a sufficient degree of readiness for extrauterine life. Under the influence of estrogens, the tone of the uterus increases: the so-called training contractions, or Braxton-Hicks contractions, appear, which are characterized by irregularity and are practically painless. Under the influence of estrogens, the cervix begins to "mature": the cervical canal shortens, softens, opens slightly, which is manifested by the discharge of a mucous plug - a lump of mucus, sometimes with small streaks of blood. The expectant mother is developing a "dominant of childbirth", which is manifested by the desire to give birth to a baby as soon as possible, all interests are aimed at expecting childbirth and preparing for it.

When all the processes of preparation for childbirth are completed, the level of estrogen reaches its "peak", under the influence of the precursors secreted by the fetus ready for extrauterine existence, the synthesis of prostaglandins begins in the mother's body, which triggers regular labor.

3rd trimester of pregnancy: possible complications

Since in the third trimester the body of the expectant mother is under the maximum load, in the presence of predisposing factors or concomitant chronic diseases, rather serious complications of pregnancy are possible. It is necessary to know about them, since early diagnosis and timely treatment significantly improve the prognosis for the mother and fetus.

Gestosis. This condition, which is also called preeclampsia, nephropathy or late toxicosis, is one of the most serious complications of pregnancy, which is completely cured after delivery.

Clinical manifestations of preeclampsia are edema, which at first may not be obvious and manifest itself only by a pathological increase in body weight - more than 350 g per week, the appearance of protein in the urine - proteinuria (normally protein is not detected in the urine) and an increase in blood pressure. The causes and mechanisms of the formation of preeclampsia, despite the active study of this complication, are still not fully known. It has been established that the risk factors for the development of preeclampsia are chronic diseases, against the background of which pregnancy has occurred; of primary importance here are kidney diseases, hypertension, diabetes mellitus, etc. The likelihood of gestosis increases in pregnant women younger than 18 or older than 35 years, with multiple pregnancies, hereditary predisposition to this condition, as well as primiparous.

Gestosis is dangerous because it is the cause of the development of complications that threaten the life of the mother and fetus. The most severe of these is eclampsia, an attack of seizures with loss of consciousness that occurs as a result of cerebral edema. One of the typical complications of preeclampsia is premature detachment of a normally located placenta, in which the placenta is separated from the uterine wall not after the birth of the fetus, as is normal, but when it is in the uterus. This leads to the development of internal bleeding, and in severe cases - to intrauterine fetal death, the development of massive blood loss in the mother. Also, with gestosis, severe disturbances in the work of internal organs can develop - acute renal, respiratory, liver failure, etc.

In view of the danger of gestosis, the treatment of this complication is carried out only in an obstetric hospital. The number of therapeutic measures includes the creation of a therapeutic and protective regimen, magnesia therapy, and means for lowering blood pressure. With the development of severe forms of preeclampsia or the absence of the effect of treatment in the interests of the life of the mother and the fetus, early delivery is carried out.

Placental insufficiency. This is the name for a violation of the normal functioning of the placenta, in which it does not fully perform one or more of its functions - respiratory, barrier, immunological, nutritional. The most pronounced manifestations of placental insufficiency are fetal hypoxia resulting from impaired respiratory function of the placenta, and fetal growth retardation syndrome - impaired nutritional function. This condition is a consequence of a number of complications of pregnancy, such as preeclampsia, long-term threat of termination of pregnancy, improper location of the placenta, etc. The causes of placental insufficiency can be chronic diseases, against which this pregnancy occurred: hypertension, chronic anemia , diabetes mellitus, kidney pathology, - as well as bad habits, such as smoking, and unfavorable social conditions.

Placental insufficiency leads to chronic fetal hypoxia - insufficient supply of oxygen and essential nutrients. In case of violation of the nutritional function of the placenta, fetal growth retardation syndrome (FGRP) is formed, that is, the growth and weight of the fetus lags behind the average norms characteristic of a certain period of pregnancy. Diagnosis of this complication is carried out by ultrasound in combination with Doppler analysis - a study of blood flow in the uteroplacental circulation system. For the treatment of placental insufficiency and FGR, drugs are prescribed that improve uteroplacental blood circulation: ACTOVEGIN, INSTENON, KURANTIL, etc. In this case, if possible, the disease or pregnancy complication that caused the development of placental insufficiency is eliminated or corrected, sedatives, multivitamin complexes are prescribed.

Dyspnea. It is a feeling of shortage of breath resulting from a disturbance in the depth, frequency, or rhythm of breathing. For women, the chest type of breathing is characteristic, in which breathing movements are carried out mainly due to the movement of the chest and diaphragm - the muscular septum between the chest and abdominal cavities. In the third trimester, the bottom of the uterus is so high that it begins to press on the diaphragm, which prevents good expansion of the lungs on exhalation, so breathing becomes less deep, but compensatory more frequent for the mother and fetus to fully supply the body with oxygen.

In pregnant women, dyspnea can occur at rest, especially in the supine position, due to increased pressure of the fundus of the uterus on the diaphragm, increasing with exercise and stress. Fortunately, shortness of breath is a temporary phenomenon, since at the end of pregnancy, about 2 weeks before childbirth, under the influence of preparatory processes for childbirth, the head of the fetus sinks to the entrance to the pelvis, and the expectant mother clearly feels relief of breathing.

To prevent shortness of breath, you need to avoid overfilling the stomach, stay in stuffy and smoky rooms, lie only on your side. If shortness of breath does not go away after rest, is accompanied by pathological symptoms: cyanosis - blue skin, chest pains, etc., - it can be a sign of serious lung diseases or cardiovascular pathology, therefore, in this case, you should immediately consult an obstetrician. gynecologist or therapist.

Insomnia. Sleep disturbances are a common complication of pregnancy. Insomnia can manifest itself in various ways - in violation of falling asleep, too light sleep, frequent awakenings with the inability to fall asleep again. The reasons for this condition in pregnant women are varied: these are fetal movements, and an uncomfortable posture during sleep due to the large size of the abdomen, and frequent waking up at night to go to the toilet. At the end of pregnancy, training contractions and anxiety about the upcoming birth can be added to this list.

To establish sleep, it is necessary to ensure the comfort of a sleeping place; special pillows for pregnant women will help to do this, with which it is very convenient to sleep on your side. Before going to bed, it is good to take a walk for 30 minutes in the fresh air, take a warm shower, ventilate the bedroom. Regarding the use of medications that improve sleep, it is necessary to consult a doctor, since many sleeping pills are contraindicated during pregnancy. The use of herbal preparations is possible.

Constipation. This nuisance is a frequent and rather typical pregnancy companion. The appearance of constipation in expectant mothers, even if they have never encountered this problem before waiting for the baby, is due to the relaxing effect of the pregnancy hormone progesterone not only on the muscles of the uterus, but also on the smooth muscles of the intestines, as well as other hollow organs - the esophagus, ureters, bladder etc. Constipation may be accompanied by a feeling of bloating, bitterness and an unpleasant taste in the mouth, a feeling of intestinal fullness.

To combat constipation, first of all, you need food with a sufficient content of fiber, which, swelling, activates peristalsis and bowel emptying. Cereals, vegetables and fruits (carrots, pumpkins, beets, apples, zucchini, etc.), prunes and dried apricots, coarse bread are rich in fiber. Fermented milk products - kefir, bifidok, curdled milk have a good laxative effect. To prevent constipation, it is necessary to consume a sufficient amount of liquid - at least 1200-1500 ml per day. The second important point that helps to cope with constipation is sufficient physical activity - walking in the fresh air, gymnastics, swimming, etc.

If non-drug methods are ineffective, sometimes it is necessary to resort to the appointment of laxatives, but this can be done only after consulting a doctor: many drugs that increase intestinal motility are contraindicated during pregnancy, as they also increase the contractile activity of the uterus.

Phlebeurysm. During pregnancy, conditions are created to obstruct venous outflow. This occurs, firstly, due to the weakening of the vascular wall under the influence of hormones, secondly, due to a significant increase in the volume of circulating blood, which reaches 2000-2500 ml by the end of pregnancy, and thirdly, due to the obstruction of venous outflow from the lower extremities due to compression of the vessels of the abdominal cavity by the enlarged uterus. For these reasons, many expectant mothers are faced with leg edema, which worsens in the evening, with pain and heaviness in the lower extremities, leg cramps, as well as the appearance of knotty protruding bluish veins on the legs.

Measures for the prevention of varicose veins in pregnant women are the wearing of compression hosiery - special tights and stockings that support the vessels of the legs in good tone; the doctor will tell you their size. It is necessary to wear comfortable shoes with a low, stable heel, and also to exclude prolonged static loads - standing on your feet, motionless sitting in one position. It is especially undesirable to sit cross-legged. For the prevention of varicose veins in the evening, you need to lie down with raised legs for at least 30-40 minutes (they can be put on a pillow), take a cool foot bath.

Medical treatment of varicose veins is carried out only after agreement with an obstetrician-gynecologist, phlebologist or therapist.

Fundamental rules

Since in the last trimester of pregnancy, the load on almost all organs and systems increases, monitoring the condition of the expectant mother becomes more thorough: up to 30 weeks it is necessary to see a doctor once every two weeks, after 40 weeks - weekly.
It is necessary to organize food properly - eat 5-6 times a day in small portions: 3 main meals and 2-3 snacks. It will reduce the feeling of fullness in the stomach, heartburn, and shortness of breath. Food should contain fiber - vegetables, fruits, cereals, grain bread.
It's time to take care of choosing a maternity hospital. It is necessary to find out in advance whether the maternity hospital you have chosen will close for a planned "wash", what rules and conditions are there for partner childbirth. Preparing in advance will help you avoid force majeure circumstances in the development of labor, even if it happens unexpectedly, and will also contribute to calmness and confidence in a favorable pregnancy outcome.
Preparation for childbirth takes time, so if you are not attending school for expectant mothers yet, do not leave it for the last weeks - you may not have time to complete the entire course. It is possible that the maternity hospital of your choice has courses on preparation for childbirth.
To train the muscles of the perineum, do Kegel exercises daily: they are an excellent prevention of tears during labor, increasing the elasticity of the pelvic floor muscles.
For a period of 34–36 weeks, the antenatal clinic doctor will examine you on the gynecological chair, take a swab for examination and determine the indications for treatment if pathological microflora of the vagina is detected before childbirth. At 30 weeks, you will be prescribed a general and biochemical blood test, a study of blood sugar levels, a coagulogram - a study of blood coagulation.
At 34-36 weeks of pregnancy, the third compulsory ultrasound is performed, which determines the compliance of the size of the fetus with the gestational age, its position in the uterus, localization and structure of the placenta, the amount of amniotic fluid, and identifies possible abnormalities that could not be diagnosed at an earlier date. With ultrasound, dopplerometry is performed - a study that determines the state of blood flow in the vessels of the uteroplacental circulation, which makes it possible to identify signs of fetal hypoxia.
In the third trimester of pregnancy, cardiotocography (CTG) is used to determine the intrauterine state of the baby - registration of the fetal cardiac activity, which is usually prescribed after 32 weeks of pregnancy. This simple and informative method allows you to timely diagnose signs of oxygen starvation - hypoxia - and take appropriate measures. In the normal course of pregnancy, CTG is recorded 2–3 times per pregnancy; in the presence of complications, the question of the frequency of studies is decided individually.
After 38 weeks, all things and documents should be ready, as hospitalization may be required at any time. It is especially important not to forget the documents - exchange card, passport, medical policy, birth certificate and birth contract (if it was concluded).

Another important task is to correctly assemble a bag for a maternity hospital, without taking unnecessary things and not forgetting what is necessary. Until 37–38 weeks, you need to think about what things you will need, and purchase what is missing, make a list. It is best to put things in a new plastic bag, as fabric bags may not be accepted by the maternity hospital due to the strict sanitary and epidemiological regime.

One of the most pleasant moments of the final trimester of pregnancy is the preparation of the baby's dowry, since the choice of clothes, furniture, and accessories for newborns is simply enormous. In this matter, the main thing is not to lose a sense of proportion. A typical mistake of future parents is the excessive acquisition of children's things; some of them may not wait for their intended use. Do not forget that after the birth of the baby, a lot of things will be presented, so get the necessary minimum, and the desired gifts for the newborn can be discussed with friends and relatives after the birth.

It is quite natural and correct to believe that a woman should gain weight during pregnancy. Everything is clear: the child grows and gains weight, the uterus and mammary gland increase in size, the amount of amniotic fluid increases - it seems that the weight gain of the pregnant woman is guaranteed.

But this rule, like any other, has its exceptions. Sometimes women lose weight during pregnancy.

Today we will understand why there is weight loss during pregnancy, when possible. We will analyze the reasons for weight loss by trimester, find out if this situation is a cause for concern and how it threatens the mother and child.

Why you can lose weight in the first trimester

The main cause of weight loss in early pregnancy is toxicosis. Each woman has a different severity of manifestations of toxicosis. Moreover, even with each subsequent pregnancy, there is a different degree of severity of toxicosis.

In the first half of pregnancy, women often experience decreased appetite, nausea, vomiting, and aversion to certain foods. It happens that the body does not perceive certain foods.

Normally, for the first trimester, an increase of 0.5 to 3 kg is normal. But weight loss during this period is also common. And this is also an absolute norm, since during this period the size of the child is tiny, the uterus is also the size of a fist, and there is still very little amniotic fluid.

It is worth noting that weight loss is more typical for women who had well-developed subcutaneous fat even before pregnancy. In other words, there is a certain reserve, which, if necessary, can be used for the full development of the child with a decrease in the supply of nutrients.

Thus, moderate weight loss in a woman in the first trimester is not considered a pathology and is not dangerous for the expectant mother and the fetus. But at the same time, it is impossible to lose vigilance in any case.

With pronounced weight loss, the body uses up reserves of adipose tissue. The disintegration of one's own tissues always occurs with the production of ketone bases (ketone bodies), the excessive concentration of which in the blood is of particular danger to the baby. This decay product is able to penetrate the placental and blood-brain barrier and have a negative effect on the development of the nervous system and especially the fetal brain.

With severe toxicosis and significant loss of body weight, the expectant mother is hospitalized and the water-mineral balance is corrected using intravenous infusions.

Since the gynecologist examines a pregnant woman in the early stages once a month, a woman should know what changes she needs to see a doctor without waiting for the date of the appointment.

For example, if a future mother vomits 3-4 times daily and at the same time has weight loss, then this condition threatens with dehydration. This, in turn, can lead to disastrous consequences for the fetus and the mother herself.

Tell your doctor about it. In this case, the doctor will conduct an examination and examination and decide on the need for hospitalization and restoration of water, mineral, energy balance with the help of medicines.

Do not be afraid of inpatient treatment, because nothing can be more important than the health and well-being of your baby!

Reasons for weight loss in the second trimester

As a rule, during this period, weight loss in pregnant women is much less common than in the first and third trimester. The fact is that during this period the child grows and develops most intensively. Usually, women gain from 4-6 kg during this period. Still, there are exceptions to the rule.

During pregnancy, a woman is generally distinguished by a special emotional lability and a quick change in mood, a tendency to worry and worry for various, even insignificant reasons. Therefore, weight loss can be the result of a stressful situation and a change in the regime of the day and rest of the pregnant woman.

Weight loss in the second trimester should be immediately reported to your doctor, since there are no physiological reasons for losing weight at this stage of pregnancy. If the weight still falls, then there is a problem with the health of the mother or child. Perhaps there are certain diseases or metabolic pathology. The doctor should conduct additional tests in a timely manner to exclude the most common causes of weight loss in the second trimester of pregnancy.

In the third trimester, it is common.

In late pregnancy, weight loss is quite natural. This is how the woman's body prepares for childbirth. That is why the phenomenon of weight loss in the last stages of pregnancy is interpreted as one of the harbingers of childbirth.

It is worth explaining that this is considered the norm in the last weeks of pregnancy (2-3 weeks before childbirth). The fact is that the woman's body gets rid of excess fluid before childbirth, therefore, the urge to urinate in the mother becomes more frequent, edema decreases.

At this time, there is no longer a need for such an intensive renewal of the amniotic fluid of the fetus, as before. In this regard, the body no longer needs to store and retain fluid. Also in the mother's body there is a thickening of blood and a decrease in the total volume of circulating blood. So nature took care of the woman to reduce the risk of blood loss during childbirth.

What should a pregnant woman know about weight control?

In the first half of pregnancy, a woman visits a doctor every month. Before taking it, it must be weighed, and at the appointment, the doctor assesses the monthly weight gain, an increase in abdominal circumference and the height of the fundus of the uterus. Based on all this, he can make a conclusion about whether these indicators are embedded in the accepted norms or not.

You need to properly control your weight in the morning on an empty stomach. This should be done not once a month, but at least weekly.

It is completely normal for women to experience temporary, subtle changes in weight gain and weight loss. That is, the expectant mother can lose weight in one week, and gain weight to the original figures over the next. Only a sharp weight gain or loss negatively affects the health of a pregnant woman and is perceived by the body as stress.

Many mothers are too afraid of gaining excess weight, even during pregnancy they set themselves some kind of limits or dietary restrictions. Weight loss in this case is natural and suggests that there is not enough nutrition for the baby.

The principles of healthy eating (frequent, 4-5 times a day, fractional meals in portions of 200-250 g, boiled and stewed foods instead of fried foods, a minimum of fatty, baked goods and sweets) during the period of gestation has not been canceled. Such a diet will allow the body to better digest food and assimilate nutrients under conditions of a double load on the internal organs (liver, kidneys).

Moreover, such nutrition will help not to gain excess weight and provide the child with useful substances, and not empty calories. Also, with this diet, it is possible to minimize such common phenomena during pregnancy as heartburn and constipation.

How does the weight loss of the expectant mother threaten the baby?

I must say that normally, the baby will still take everything that he needs from the mother's body for its development. And if mommy eats normally and still loses weight, then this may mean that the baby at this stage of development does not have enough incoming nutrients, and he receives a supplement from the stored resources of the mother's body.

Your pregnancy doctor should be aware of your weight loss. If he deems it necessary, he will prescribe an additional examination in order to reliably know how the baby grows and develops.

A biochemical analysis of the mother's blood will show if there are disturbances in the water-electrolyte balance, loss of blood electrolytes, trace elements (sodium, potassium, magnesium, calcium). After all, these violations lead to a disruption in the work of the nervous system, the work of muscles (convulsions), including the contractility of the muscles of the heart, in the formation of the bones of the skeleton.

With the help of ultrasound, it is possible to track the development of the child, the amount of amniotic fluid (oligohydramnios, polyhydramnios), whether there are blood flow disturbances in the mother-placenta-fetus system, signs of hypoxia (lack of oxygen) and fetal trophism disorders.

A study as simple as a complete blood count can tell the doctor about blood thickening, which is a consequence of dehydration, for example, with toxicosis.

Since a pregnant woman who is registered at the clinic and regularly monitored, in any case, takes these tests and undergoes these examinations, then you should not worry. The doctor will notice dangerous changes in the condition of the mother and the fetus. Your task is to come to an appointment regularly and fulfill all the doctor's appointments.

So, now you know that weight loss during pregnancy is not a pathology, but an occasion for careful monitoring of the health of the expectant mother and fetus. Reasonable attitude to your diet and proper interaction with your doctor will save you from such problems during pregnancy. As a result, the mother will be healthy and her baby will be healthy.