What happens in the 20th week of pregnancy: the state of the mother and the fetus, tests

Twenty weeks is a period that is considered a "turning point" for a woman, because the second half of pregnancy begins at this point. This period is associated with global changes that occur in the mother and baby.

Fetal heartbeat is now heard using a normal obstetric stethoscope. Visibly rounded belly already clearly indicates the interesting position of a woman. At 20 weeks, pregnant women should especially carefully monitor their health, since during this period various complications are possible.

20 weeks of pregnancy - what happens to the baby?

The length of the fetus at the 20th week is about 25-30 cm, the weight ranges from 250-450 g. During this period, the fetal heartbeat is monitored using an obstetric stethoscope through the abdominal wall (previously it could only be determined by ultrasound).

The heart rate (HR) of the fetus is much higher than the adult heart rate and is 120-140 beats per minute.

From the 20th to the 28th week, the red bone marrow begins to assume the function of blood formation (previously, the hematopoiesis was hepatic). Hemoglobin (Hb) of a child, predominantly fetal (HbF), is closer to oxygen than adult hemoglobin, produced in the late fetal period.

Twenty-week fetus can independently produce all major classes of immunoglobulins (Ig). Lymphoid tissue is formed in the spleen on the twentieth week, the most active leukopoiesis (the formation of leukocytes) in this organ occurs in the fifth month of intrauterine life.

Baby actively sucks a finger, sometimes there is a hiccup. The fetus has fluff hair, eyelashes and eyebrows. A syrovid (generic) lubricant is formed from the fluff hairs and cells of the epidermis - a creamy white substance that performs the protective function of the skin.

Lubrication usually persists until the baby is born. At the end of the fifth - the beginning of the sixth month, the subcutaneous fatty tissue is actively developing.

The skin of the fetus is red, during this period the sebaceous glands begin to work. They produce a secret, which takes part in the formation of the original lubricant. In the gastrointestinal tract formed meconium - the original calories.

At 20 weeks the fetus has well-formed eyes, a blink reflex gradually develops. Mimic movements are quite pronounced: the child squeezes his eyes, frowns and even smiles.

From the 20th week, the first pregnant woman begins to feel the movement of the child. With subsequent pregnancies, fetal movement is felt from week 18.

Motor activity changes throughout the day. Under the influence of irritating factors (loud sound, stuffiness, etc.) the fetus is very actively moving.

Changes in the body of the future mother

Twenty weeks is the middle of pregnancy. Stomach visibly protruding. Striae (stretch marks) begin to appear on the skin, so it's time to get a special skin care cream.

Many pregnant women may experience breathing difficulties and heartburn due to compression of the enlarged uterus of the internal organs and pressing the diaphragm upwards.

After a while, when the fetus descends deeper into the pelvic cavity, the discomfort passes. In pervirutal, this happens 2-3 weeks before childbirth, in repetitive pregnancy - just before the birth activity.

A woman may notice a greater amount of vaginal discharge than before. This phenomenon is associated with increased blood flow to the genitals and quite natural. If there is a lot of discharge, you should use sanitary pads. Linen should be only natural (cotton).

Attention should be paid to the nature of the discharge. Normally, they are white or yellowish in color. If the discharge becomes bright yellow, green, have an unpleasant smell, you should contact your gynecologist. Abnormal discharge along with itching or burning may indicate infection.

If itching and burning occur during urination, cystitis may occur. All of these conditions require immediate medical attention.

Analyzes and examinations, baby photo

The complex of necessary surveys includes:

  • measuring the size of the abdomen and pelvis;
  • weight measurement;
  • measurement of blood pressure (blood pressure);
  • KLA (urinalysis).

Additionally, you may need a blood test.

In accordance with Order No. 457-MoH of the Russian Federation, the complex of prenatal diagnosis necessarily includes a triple screening ultrasound examination of pregnant women. At 20-24 weeks, it is performed to detect malformations and markers of chromosomal abnormalities.

During the screening ultrasound on the 20th week, it is possible to determine the sex of the baby. Also, the expectant mother can get a photo of the child with the appropriate capabilities of the ultrasound machine.

In terms of 16 to 20 weeks gestation according to the result of the study of the blood group of the mother for hCG (human chorionic gonadotropin) and AFP (alpha-fetoprotein) (the so-called duplex test), a risk group is formed among pregnant women for children with chromosomal diseases.

Possible hazards in the 19th and 20th week of pregnancy

The period from 18 to 22 weeks is the third critical period of pregnancy. At this time, the most important processes take place, during which the brain activity of the child, the hematopoietic system is formed, the most important hormones are produced, reflexes are developed.

The end of the twentieth week is the beginning of the second half of pregnancy. During this period, the most important systems of the body mature (nervous, cardiovascular, hematopoietic). At this time, the fetus is less sensitive to damaging factors.

The damaging agents are activated by penetration through the placental barrier, some of which may alter the normal permeability of the placenta. The placenta is a powerful protective barrier that protects the fetus from toxins and other harmful substances.

However, the placenta is vulnerable to most drugs (vitamins, hormones, narcotic analgesics, antibacterial agents, anti-inflammatory drugs, etc.). Thus, drugs taken by a pregnant woman, through the placenta enter the body of the fetus.

The amount of toxins produced by the fetus depends on the permeability of the placenta, blood flow, characteristics of the damaging agent, and the available complications of pregnancy.

In the event of complications, the barrier function decreases, and substances that under normal circumstances would not pass through the placenta begin to flow.

One of the most dangerous complications that can occur from the twentieth week of pregnancy is gestosis. Prerequisites for it and initial signs may appear as early as sixteen weeks. However, preeclampsia is considered to be the pathology of the second half of pregnancy.

Previously, this condition was referred to as late toxicosis. Its cause, in fact, is the pregnancy itself, that is, it does not occur in non-pregnant women. Gestosis disappears with the termination of pregnancy (childbirth or miscarriage).

The essence of preeclampsia can be characterized by the phrase "toxic-allergic reaction of the body to pregnancy." The etiology (cause) of preeclampsia is still not fully understood; there are only a number of theories. It was only possible to establish one thing: preeclampsia is caused by pregnancy.

Gestosis can take several forms: dropsy of pregnant women (appearance of edema on the extremities and anterior abdominal wall), nephropathy (complex of symptoms such as increased blood pressure, edema, and proteinuria (protein in the urine)), pre-eclampsia (adherence to nephropathy of the symptoms of CNS damage (headache , "flies" before the eyes, pain in the chest) and eclampsia (convulsive seizure, followed by loss of consciousness and coma).

With preeclampsia, global changes occur in a woman’s body: most organs no longer function normally.

The vascular permeability changes, the kidneys no longer properly filter salts and water, and protein is passed into the urine, and the heart compensates for vascular resistance, resulting in increased blood pressure.

During this period of pregnancy should pay special attention to edema. Often they signal from incipient nephropathy. Nothing bothers many women, except for edema of the extremities, but suddenly the blood pressure rises, cerebral haemorrhage occurs, which can end in disastrously for a woman and a fetus.

Gestosis during pregnancy (especially long-term, accompanied by an increase in blood pressure, even during treatment) is a dangerous condition, which is very difficult to manage.

Special scales have been developed to determine the severity of preeclampsia and predict possible complications, however, this pathology of pregnant women often does not fit the standard algorithms.

That is why, even if the woman feels fine, but the doctor insists on hospitalization, it is necessary to strictly follow his instructions. Preeclampsia can lead to premature termination of pregnancy, serious violations of fetal development and even death.

Premature detachment of the placenta can occur, causing bleeding to develop and the fetus to die. If a convulsive seizure occurs, the woman after it loses consciousness and may fall into a coma.

Thus, when any (hidden or visible) edema appears, it is necessary to consult a doctor as soon as possible.

If the results of the examination indicate a protein in the urine or increased blood pressure, the woman is urgently sent to the hospital to the department of pathology of pregnant women.

In most cases, therapy has a positive effect, however, in the absence of a proper result, premature delivery is possible (this issue is resolved strictly individually and only on the basis of objective signs of a threat to the health of the mother and child).

When dropsy is sometimes allowed to stay at home, if it is possible to provide conditions for treatment on an outpatient basis.

Physician advice

Recommendations for the threat of preeclampsia:

  1. Starting from the second half of pregnancy, the daily protein content in the diet should be 120 g, carbohydrates limit to 300 g, fats - up to 80 g, salt - up to 4-5 g;
  2. It is important to carefully monitor the amount of fluid you drink (up to a liter per day). Once a week, you can arrange unloading (on apples, yogurt, low-fat cottage cheese);
  3. The duration of sleep should be at least 10 hours; you should increase your daily walks in the fresh air.

Women with the threat of preeclampsia should keep a record of the fluid taken and excreted per day (daily diuresis), monitor changes in body weight. If the quantities of liquid consumed than the selected one are large, and no more than 300 g are added per week, then the measures taken are effective.

Recommendations for normal pregnancy:

  1. Full ration (mostly healthy natural food);
  2. Permissible consumption of up to 2 liters of fluid per day;
  3. Walks in the open air;
  4. The use of special creams for the skin of the chest and abdomen (to avoid stretch marks), the choice of bandage;
  5. Sex is allowed (except postures that put pressure on the stomach);
  6. Attending psychological training for pregnant women.

It is important to remember that the late appealing to a specialist in case of edema and non-compliance with its recommendations can lead to extremely negative consequences for the health of the mother and fetus.

And some more useful information about the 20th week of pregnancy - in the next video.

Watch the video: Halfway There! All Things 20-Week Ultrasound (March 2024).