Normal course of pregnancy. How a normal pregnancy proceeds How to determine that the pregnancy is proceeding normally

Instruction

Keep track of your condition. Morning sickness, drowsiness, aversion to certain foods, sensitivity to odors, swelling and soreness of the mammary glands - these signs indirectly confirm both the presence of pregnancy and its development. Although the disappearance of any of the symptoms or their combination does not in itself mean that, this fact should alert you.

If the breasts have decreased in size, toxicosis has disappeared, you do not feel the ailment that has haunted you in recent weeks, consult a doctor to make sure that it is progressing. Perhaps these changes will be a feature of your body, but everything is in order with the baby.

From the moment of a fertilized egg in the uterine cavity in a woman's body, human chorionic gonadotropin (hCG) can be detected - a pregnancy hormone produced by the tissue of the chorion - the embryonic membrane, on the basis of which the placenta is formed. From weeks 1 to 11, the level of hCG in a woman’s blood is constantly growing, and from 11-16 weeks it begins to gradually decrease, since by this time it has been converted into the placenta.

To control the development of pregnancy for periods up to 16 weeks, periodically donate blood to determine the level of hCG. If such an analysis is not done in your antenatal clinic, contact a specialized medical center or laboratory. A blood test for hCG is taken on an empty stomach: in the morning or during the day, but not earlier than 2 hours after a meal.

With regular visits to an obstetrician-gynecologist, you will be able to track the development of your pregnancy by objective signs: an increase in the height of the uterine fundus and abdominal circumference, which may not be noticeable to you. When the doctor takes these measurements, ask them to give you their values, write them down and compare them with previous measurements.

If your doctor has a fetal doppler in his arsenal, you will be able to listen to your baby's heartbeat from 12 weeks - a reliable sign of a developing pregnancy. Of course, if funds allow, you can purchase this device for personal use and regularly monitor the condition of the child, but keep in mind that it is not cheap.

The best way to determine a progressing pregnancy is an ultrasound examination (ultrasound). Already after 5-6 obstetric weeks, the doctor can see the heartbeat of the embryo. Therefore, if you want to make sure that your pregnancy is developing in accordance with the term, contact your antenatal clinic or other medical institution for an ultrasound doctor. There is no consensus in the medical literature and among practitioners about how often ultrasound can be done, but if there is any doubt about the correct course of pregnancy, it is still better to do it.

From about 18-22 weeks, the expectant mother begins to feel the movements of the fetus. From this period, additional studies will not be required: record the movements of the baby daily, and go through all the necessary tests, ultrasound and determine the heart rate of the child in a planned manner.

Unfortunately, today there are sad statistics associated with cases of pregnancy fading. Studies show that the risk of developing this pathology after the age of 45 increases to 18%, while at the age of 25-30 this figure is only 10%.

However, the risk still exists, but, as they say, aware means armed.

The possibility of determining the fading of the fetus independently depends on the period at which this occurs. At an early stage, it is very difficult to understand at home that the pregnancy has stopped, since the fetus is still small and the mother does not feel its movement. But, if you carefully listen to your body every day, then this unpleasant fact can be immediately recognized.

The first thing to be concerned about is bloody discharge from the vagina, the appearance of cramping pains in the lower abdomen and in the lower back, a sharp increase in temperature. If you had early toxicosis, but suddenly stopped abruptly (before 12 weeks), this may also indicate a fading pregnancy.

If you planned your pregnancy correctly, then you paid attention to change in basal temperature before conception and after conception. Normally, the temperature in the first trimester should be elevated (37.3-37.1).

By the end of the first month of pregnancy, it begins to gradually decline. But, if you noticed this decrease earlier and by 1 degree immediately, then this is a clear sign of a missed pregnancy. The decrease in temperature is associated with a decrease in the level of progesterone in the blood. This hormone becomes unnecessary if the fetus does not develop, since progesterone is responsible for the safety of the pregnancy.

The fading of pregnancy at a later date is primarily determined by lack of fetal movements. Do not ignore "Method 10", according to which you must count at least 10 movements of the child from 9:00 to 21:00.

The fading of pregnancy in the second or third trimester can also be recognized by the appearance sharp painful contractions and back pain. The fact is that the body is trying to get rid of the fetus, which is no longer developing. There is a sharp change in general well-being in the negative direction (nausea, weakness, fever). Sudden cessation of toxicosis, if any, and the absence of pain in the chest.

You should also pay attention to vaginal discharge. If they acquire a brownish or red tint, then this is a reason to sound the alarm.

Temperature increase when pregnancy fades, it may indicate that intoxication of the body has occurred. This is fraught with serious consequences for a woman's health, up to and including death.

Many people think that it is necessary to do a pregnancy test only until this happy fact is clarified. But experts advise taking it throughout the first trimester. The fact is that with a frozen pregnancy, the test will show a negative result. This is due to the fact that the level of the hormone hCG in the blood of a woman falls.

It may also be effective to test for hCG several times after determining conception. As it was said, when pregnancy fades, its level will fall, or even at the next analysis it will be equal to zero.

How is a missed pregnancy diagnosed?

Upon examination, a gynecologist may suspect fading if the size of the uterus does not correspond to the deadlines. But the diagnosis of “frozen pregnancy” will not be made to you without an ultrasound. This stage of diagnosis can be omitted only with a late visit to the doctor, when intoxication of the body has occurred, and inflammatory processes in the uterus have begun.

Treatment of missed pregnancy

In the early stages of fetal fading, medical abortion is used. If the fetus froze in the last stages of pregnancy, then labor is stimulated to cause the birth of a child. If it is too early to stimulate childbirth, and the size of the fetus does not allow the use of medical abortion, then curettage is used.

With a frozen pregnancy, it is important to undergo postoperative treatment. The doctor prescribes medications that will help the body recover and remove inflammation, if any.

Be sure to prescribe a complete examination after a frozen pregnancy. This is necessary to find out the causes of fading and eliminate them in the future. Also, after the pregnancy fades, histology is performed, that is, the study of a smear and a section of the uterus.

Why does pregnancy stop? Can this be prevented?

Fading pregnancy can occur for many reasons, for example:

• development of fetal pathologies incompatible with life;
• frequent abortions in the past, which led to the accumulation of antibodies in the body. The latter simply do not give the child a chance to survive by attacking him in the womb;
• infectious diseases of the mother;
• diseases of the kidneys, the cardiovascular system of the mother;
• trauma;
• stressful situations;
• excessive physical activity;
• bad habits;

Pregnancy is a difficult and exciting period in a woman's life, especially if she is expecting her first child. In the body of the expectant mother, physiological changes occur, which can be both absolutely normal and indicate the course of pathological processes. How to understand in the early stages that the pregnancy is proceeding well?

How to understand that pregnancy develops normally according to physiological changes?

A pregnant woman on her own can only notice external physiological changes that occur with her body. Also, discharge, intestinal disturbances and weight changes can tell a lot about the course of gestation. What changes are normal?

Appearance of a pregnant woman

In the first trimester, the appearance of a woman practically does not change. Some note that their limbs begin to swell, and veins become visible on their legs.

In the first weeks, subfebrile temperature up to + 37.5 ° C can be observed. This is a reaction to ongoing hormonal changes and the growth of the embryo in the womb.

Some women claim that already in the first months the breasts increase, the nipples swell. Usually, the growth of the mammary glands occurs in the middle of the period, but it can also be in the early stages.

The state of the cardiovascular and respiratory systems

In the 1st trimester, due to the fact that the cardiovascular system did not have time to adapt to the new state of the woman, hypotension is observed. The expectant mother feels weakness, drowsiness, dizziness. Hormonal imbalance often causes the development of arrhythmia and extrasystole.

With the growth of the embryo, the load on the respiratory system increases. There is shortness of breath, a feeling of lack of air, especially after a little physical exertion. In late gestation, shortness of breath becomes worse.

Changes in the digestive and urinary systems

The biggest changes occur in the work of the digestive tract. In the first weeks of gestation, many women experience toxicosis - morning sickness, vomiting, sensitivity to smells. Heartburn appears, increased gas formation, taste preferences change.

The nature of the discharge from the vagina also changes. They become profuse and thick due to the increased viscosity of the cervical mucus. 5-7 days after conception, a woman may find red-brown discharge on her underwear. This is evidence that the fetal egg implanted in the endometrium of the uterus.

What should I pay attention to in the early stages (weight, pain, discharge, etc.)?

What signs indicate that there is a threat of miscarriage? Pregnant women should pay attention to the following symptoms:

• prolonged, pulling or sharp pains in the lower abdomen and in the lower back - indicate a tubal pregnancy;
• heavy bleeding is a sign of miscarriage;
• yellow-green, purulent discharge with an unpleasant odor - a urinary tract infection develops (most antibiotics are prohibited during pregnancy, so it is recommended to urgently consult a specialist);
• rapid weight gain - weight gain is normal for the end of pregnancy, but not in the early stages;
• heat.

If alarming symptoms appear, a woman should immediately contact a gynecologist. With timely treatment, doctors can prevent miscarriage.

It is impossible to independently determine whether everything is fine with pregnancy. Specialists should monitor the condition of the expectant mother and fetus, therefore, it is recommended that all pregnant women be registered at the antenatal clinic.

It is advisable to register immediately after the doctor confirms the pregnancy. The sooner a woman does this, the sooner she can pass the necessary tests and make sure that gestation is developing normally. Recommended terms - up to 12 weeks. Also, pregnant women who are registered early are entitled to material payments, so the expectant mother will be able not only to be examined by a doctor in a timely manner, but also receive financial incentives for this.

Most first-time mothers are naturally concerned about the question of how the pregnancy is going, whether it is going well, without complications, especially in the early stages. Currently, obstetricians and gynecologists are engaged in pregnancy management.

In order to optimally monitor the condition of the expectant mother and fetus, doctors recommend regularly attending a antenatal clinic.

Registration of a pregnant woman for dispensary registration

How can a woman understand that early pregnancy is going well? It is quite difficult to independently determine the nature of the course of pregnancy in the first trimester. Only qualified specialists can answer this question by conducting an appropriate examination. Therefore, it is very important that the pregnant woman visits the antenatal clinic as early as possible, preferably before 12 weeks.

If contraindications for maintaining pregnancy are identified, then in the first trimester you can still use gentle methods to terminate it. Timely registration at the dispensary and further regular visits to the obstetrician-gynecologist, according to the established schedule, largely determine the normal course of pregnancy.

The schedule of visits to the antenatal clinic, scheduled by the supervising doctor, must be observed unquestioningly.

Physiological changes in the body of a pregnant woman

How can you understand that pregnancy is developing normally without taking into account the opinion of doctors? To do this, you need to focus on your general condition and feelings. Bearing a child will necessarily lead to physiological changes in the body of a pregnant woman. What kind of changes in her body can a woman notice, which will indicate the normal course of pregnancy:

• Appearance.
• The performance of the cardiovascular and respiratory systems.
• The functionality of the kidneys, liver and gastrointestinal tract (GIT).

Appearance

It will be quite natural for a pregnant woman to acquire a characteristic appearance that was unusual for her before the conception of a child:

• In addition to the appearance of the tummy, there is a slight increase in the size of the limbs, a decrease in the range of motion in the hip joints, and a change in facial features. Due to the shift in the center of gravity, the gait and posture of a woman changes.


• There is a darkening of the skin (pigmentation) in the face, abdomen and peripapillary zone.
• Become more visible veins on the lower extremities. Varicose veins may even appear, which was not typical before conception.
• Due to an increase in the abdomen, so-called striae (stripes, stretch marks on the skin) are often formed on its surface.
• During the period of bearing a child, in some cases, a moderate increase in body temperature (subfebrile condition) is recorded. As a rule, this is observed up to 4 months and is associated with the usual hormonal changes in the body of a pregnant woman. By the way, an increase in rectal temperature is considered to be one of the early signs of pregnancy.
• The mammary glands undergo significant changes, swelling and an increase in the volume of which is simply impossible not to notice. The size of the nipples also increases. In addition, due to pigmentation, the nipples and areola become dark brown.

Cardiovascular and respiratory systems

As a rule, low blood pressure is characteristic in the first trimester, but already starting from about the 29th week, there is a tendency to increase, which sometimes makes it difficult to diagnose true hypertension. With the growth of the fetus and the increase in the uterus, the heart rate also increases slightly (within 84–90 beats per 1 minute).

Fluctuations in blood pressure and hormonal changes in the female body often lead to disruption of the heart, which can be manifested by arrhythmias and extrasystoles.

An additional load on the lungs, associated with the fact that you have to provide oxygen not only to yourself, but also to the fetus, leads to the development of shortness of breath. Pregnant women, especially in the later stages, have certain difficulties with performing normal physical activity. An attack of shortness of breath and fatigue can be observed even when climbing stairs only a few floors.

Nevertheless, all this is considered within the normal range, unless, of course, the pregnant woman suffers from any pathology of the cardiovascular and / or respiratory systems.

Digestive and urinary systems

Quite often, in women in position, taste preferences change dramatically. Some pregnant women have a sharp aversion to certain types of foods (for example, meat, cheese, sausages, butter), while others may generally be drawn to inedible things (clay, chalk).

In some cases, there is an increase in appetite, in others, on the contrary, a significant decrease. Also, due to a decrease in intestinal tone, pregnant women are more prone to constipation. This is normal and does not require correction with medications, only a change in diet.

Increased stress on the kidneys often leads to frequent urination. In the absence of other symptoms, frequent urination should be attributed to natural physiological changes in the body of a pregnant woman, and not to the clinical manifestation of any disease.

No one says that you have to endure any kind of discomfort or worse, pain. Any changes in your health should be reported to your doctor. And he will decide how serious it is.

Signs of a normal pregnancy

What you should pay attention to first of all in order to find out that pregnancy, both in the early and late stages, proceeds normally:

• Body weight gain.
• Enlargement of the abdomen.
• Fetal movement.
• Fetal heartbeat.
• Pain.
• Vaginal discharge.
• The appearance of colostrum.

Body mass gain

The development of the fetus, an increase in the uterus, fluid retention, the restructuring of metabolic processes - all this naturally causes a progressive increase in the weight of a pregnant woman. On average, the body weight of the expectant mother for the entire period of bearing a child increases by 10–12 kg, of which:

• About 6 kg are the fetus, afterbirth and amniotic fluid.
• 1-2 kg are due to the growth of the uterus and mammary glands.
• 3-4 kg is an immediate weight gain.

In the early stages of pregnancy, a woman's body weight practically does not change. By the end of the 12th week, there is some increase, which can be up to 2 kg. In the second trimester, a woman usually gains 300 grams per week. In the third trimester, the increase is already up to 400 grams per week.

A few days before childbirth, regular changes in metabolic processes lead to the fact that the body weight of a pregnant woman can decrease by 1–2 kg.

Please note that these are averages and may vary on a case-by-case basis. In addition, weight gain, among other things, can be affected by factors such as individual and constitutional characteristics of the body, as well as heredity.

fetal movement

The baby makes the first movements at 8 weeks, but they are not yet noticeable to the woman. It is generally accepted that fetal movement begins to be felt at 16–20 weeks. Multiparous mothers are familiar with this feeling firsthand, so they fix the motor activity of the unborn child earlier than primiparas. It is also worth noting that due to the lack of fat deposition on the front wall of the abdomen, more slender girls perceive the baby's movements faster than plump ones.

Note the date you feel the first movement of the fetus, as this will help your healthcare provider determine your due date. As a rule, for a primipara it is necessary to add 20 weeks, for a multiparous - the 22nd. The intensity of movements will help you assess the health of the baby. Excessively violent activity is just as bad as a significant reduction or complete cessation of movement.

To control the activity of the child, a specially designed test is used, which can also be used at home starting from the 28th week. From 9 am to 9 pm, it is necessary to count the number of movements and record every 10. Normally, the tenth movement is usually observed before 5 pm. If within 12 hours you notice that the child has moved less than 10 times, then this should be reported to the doctor. If for the whole day there is not a single movement, then you should immediately go to the hospital.

By the movement of the fetus, a woman herself can understand how her pregnancy is proceeding, everything is developing normally, or you need to immediately seek help.

Fetal heartbeat

One of the most important signs of the normal course of pregnancy is the fetal heartbeat. The first signs of the work of the heart of the unborn baby can be determined using a special vaginal ultrasound sensor already in the early stages of pregnancy (3-4 weeks). Features of changes in fetal heart rate:

• At 4-6 weeks, the heart rate will be 80-85 beats per minute.
• At 6–8 weeks, the heart rate will increase to 110–130 beats per minute.
• At 8-10 weeks, the heart rate can reach 190 beats per minute.
• From the 11th week until delivery, the heart rate will be in the range of 140-160 gifts per minute.

By heart rate, you can assess the general condition of the fetus. The child's heart instantly reacts to any changes that occur with a pregnant woman (stress, various diseases, physical activity). For example, a heart rate that is too fast can indicate long-term disruption of the fetal blood supply, leading to inadequate oxygen and nutrient supply.

The slowing of the rhythm will indicate a sharp deterioration in the condition of the fetus, requiring emergency measures, up to and including surgical delivery.

pain

During pregnancy, quite often there are painful sensations of a different nature, intensity and localization. Most of them are considered a natural physiological process in response to changes that occur in the body of a pregnant woman:

• In connection with the increase in the uterus, its own ligaments are stretched, which are attached to the iliac bones, and pain occurs in the inguinal folds and above the pubis. Sharp turns, quick movements, or even just a cough can be to blame. Such pains do not pose a danger to a woman or a child.
• Due to the tendency to constipation, pregnant women often experience pulling pains in the lower abdomen (usually on the left side). To prevent constipation, pay attention to your diet. Your diet should include a sufficient amount of fermented milk products and foods containing more fiber. In addition, regular exercise of moderate intensity has a positive effect on intestinal motility.
• Due to some divergence of the pubic joint under the influence of the hormone relaxin produced by the ovaries and placenta, pain in the pubic area may be noted. Such changes in the location of the pelvic bones are necessary in order to facilitate the passage of the baby through the birth canal.

If you experience sufficiently intense and pronounced pain, you should seek help from a qualified specialist. It is not recommended to take any medications or perform any manipulations to relieve pain without informing your supervising doctor.

Vaginal discharge

During the entire period of pregnancy, vaginal discharge is observed. And this is quite normal if their character meets a number of parameters. What vaginal discharge is considered normal?

Abundant, clear, white, without an unpleasant odor and not accompanied by itching or burning in the genital area. At the same time, the following discharges are considered pathological, requiring identification of the cause and undergoing special treatment:

• Yellow. It is necessary to pass the appropriate tests to exclude sexually transmitted diseases (for example, gonorrhea).
• Abundant white color, accompanied by itching and burning . Plus it has a creamy texture. The most common cause of such discharge is vaginal candidiasis or thrush.
• Green. The causes can be very diverse, but most often associated with infectious and inflammatory diseases of the genitourinary system.
• Brown. In no case should you delay visiting an obstetrician-gynecologist. This kind of discharge could be provoked by an ectopic pregnancy, placental abruption, cervical trauma, etc.
• Bloody . They are considered the most dangerous of all possible pathological discharges, if detected, it is necessary to urgently see your supervising doctor.

Most often, bleeding signals an ectopic pregnancy, the development of a miscarriage, premature detachment of the placenta, damage to the vagina and / or cervix.

Colostrum

For some pregnant women, any changes in the body that they have not been warned about cause serious concern. For example, the appearance of colostrum before childbirth can even cause them to have a panic attack. We hasten to assure you, there is no reason for concern. The secretion of colostrum during childbearing is normal. No pathology can be traced here.

In addition, the absence of colostrum before childbirth is also not considered a deviation from the norm.

If you cannot accurately understand whether the pregnancy is proceeding well and normally, then you should visit an obstetrician-gynecologist as soon as possible, which will dispel all your doubts or take appropriate measures in a timely manner.