When a baby is born with a lot of weight, many people rejoice and consider this a sign of the health of mother and baby. Being pregnant, women, on the contrary, are afraid of this, since a large fetus is associated with many dangers, in particular, it can significantly complicate the course of childbirth.
In fact, a golden mean is needed: this is not a pathology and a very serious problem, but this fact cannot be taken lightly. This is simply a risk factor, and if you are in this group, you should learn all the nuances, pitfalls and features of childbirth when the baby is too large.
Many people mistakenly believe that a baby is born with a large weight due to the fact that the parents are not small, i.e. the heredity factor is triggered. In fact, the skeletal features and general body type transmitted to a person from mother or father begin to manifest themselves in much more late age, but not immediately after birth.
There are special reasons for a large fetus during pregnancy, and if you know about them in advance, you may not be at risk. Among them, the most common are:
- poor maternal nutrition: eating large amounts of carbohydrates (flour, confectionery, sweets), excess weight up to obesity;
- number of children: each subsequent child, according to statistics, is born larger than the previous one; so all subsequent ones, most likely, can be complicated by the large size of the fetus;
- sedentary lifestyle;
- a woman has a metabolic disorder due to hypothyroidism or diabetes mellitus - accordingly, a large amount of glucose enters the child’s blood in the womb, which leads to an increase in his body weight; so if at some point in pregnancy a large fetus is diagnosed at the same time, the mother is sent to get tested for sugar;
- long-term use of certain medications: a version not confirmed by research, but doctors take it into account as one of the reasons for a large fetus, especially if during pregnancy the expectant mother took Actovegin and other drugs that improve uteroplacental blood flow;
- the thickened placenta provides intensive intrauterine nutrition, which leads to the formation of a large fetus;
- active intake nutrients may occur due to the fact that the placenta is attached to the posterior wall of the uterus;
- postmaturity is also one of the reasons for a large fetus, and it can be diagnosed at 40 weeks if, in addition to high weight, the child has a number of other signs of postmaturity: he has dry wrinkled skin, there is no vernix, long nails and hair, too hard skull bones, already closing fontanelles;
- There is a theory that the fetus can be large if the mother took multivitamin complexes during pregnancy, but it does not find scientific confirmation.
Usually, if a large fetus is suspected, the doctor tries to establish the cause of this peculiarity of pregnancy. Sometimes this makes it possible to identify diseases in the mother (for example), or placenta previa, or to put in order the woman’s diet and lifestyle before giving birth. Sometimes there is enough time for the baby’s weight to return to normal - then the course of labor is not complicated in any way. However, here another question arises: how to understand whether the fruit is large or not, should you sound the alarm or not worry about it?
We replenish our vocabulary. The birth of a large baby is called macrosomia in obstetrics.
Signs
Doctors rarely make mistakes in this diagnosis: there are certain signs of a large fetus that can be identified during pregnancy. It’s worth noting right away that these include not only the baby’s weight: other factors are important here.
Large is a child whose birth will be difficult due to its size and weight. For a woman in labor, for example, even a 3.5-kilogram baby can be considered large.
Dimensions
During studies (ultrasound), all kinds of measurements of the fetus are made, as a result of which a conclusion is made whether it is large or not. With a full-term pregnancy at 40 weeks, these indicators should not exceed the following standards.
Fetal parameters:
- BPR (biparietal, i.e. between the opposite bones of the crown, skull size) ≈ 93.9 mm;
- LTP (fronto-parietal, i.e. the gap between the forehead and the crown of the head, the size of the skull) ≈ 120 mm;
- DB (this is the length of the small hip) ≈ 75.8 mm;
- SDCH (stands for the average diameter of the child's chest) ≈ 99.9 mm;
- SDJ (as the average abdominal diameter is designated) ≈ 108.2 mm;
Mother parameters:
- weekly in the absence of edema and symptoms of gestosis ≈ 500 g;
- Coolant (this is the abdominal circumference) ≈ 100 cm;
- VDM (designation for the height of the uterine fundus) ≈ 40 cm.
Having studied all these indicators, you can understand which fetus is considered large: if these indicators exceed the specified values, the mother is at risk. In addition, doctors have an interesting formula that can be used to calculate the approximate weight of a baby still in the womb: GMR is multiplied by coolant.
Symptoms
If the baby is heavy, he takes up a lot of space. Accordingly, various organs of his mother, located nearby, are subjected to severe pinching and compression, experiencing enormous stress. Therefore, a pregnant woman in such cases may notice the following symptoms during the last 2-3 weeks before giving birth, which will indicate a large fetus:
- frequent urination;
- constipation;
- fainting when lying on your back, as the enlarged uterus puts strong pressure on the lower vein;
- pain in the legs, ribs, spine, lower back is explained by the increased load on the musculoskeletal system;
- development or exacerbation of varicose veins;
- stretch marks on the stomach;
- increased uterine tone.
You need to think about all these symptoms and signs several weeks before giving birth and bring them to the attention of doctors. If for some reason you have to give birth prematurely and you know for sure, consult your doctor about which fetus is considered large at 38 weeks (or at the time your baby arrives). As a rule, for such a calculation you need to subtract 5-6 units from the above parameters (sizes of mother and child). For example, the coolant should be ≈ 94-95 cm.
Keep in mind! Many people mistakenly believe that big belly in a pregnant woman's first and most sure sign large fruit. This is not at all true: it may also indicate polyhydramnios or multiple births. It's even possible small belly and large fruit.
What to do?
If, 2-3 weeks before giving birth, at the next examination, the gynecologist informed you that you have a large fetus, do not panic and immediately start talking about a caesarean section. You still have time to correct this risk factor, so consult a doctor who will tell you what to do in this situation. You will need:
- undergo medical examinations to exclude multiple pregnancy and polyhydramnios;
- conduct a glucose tolerance test and visit an endocrinologist to make sure there is no diabetes;
- find out the expected weight of the fetus;
- do therapeutic exercises daily;
- adjust your diet: avoid sweets and starchy foods, i.e. easily digestible carbohydrates and refractory fats;
- cancel or limit (in accordance with medical recommendations) the use of anabolic steroids.
If you follow these tips, by 40 weeks the situation may completely improve and the doctor will be happy to inform you that the baby’s weight is now within the normal range. In this case, you don’t have to resort to: you will have a natural birth with successful outcome, without any complications associated with the large size of the child.
But what if it’s too late or the correction failed? Then you will have to intensively prepare for the unexpected, and perhaps even for a surgical delivery.
The most useful advice. Very often, young mothers, having heard that they have a large fetus, begin to worry so much and exhaust themselves with all kinds of diets that they only worsen the situation. As a result, they end up on the maternity table ahead of schedule, and the baby is born restless and nervous. So the most important thing is not to panic, calm down and rely on the experience and professionalism of the doctors in everything.
Possible complications
Why is it that when a large fetus is detected during pregnancy, the question is often raised: cesarean or natural birth? It's all about the complications that come with independent birth. big baby. They can affect not only the health, but also the life of the baby. And it will be very difficult for the mother. Among the consequences, the following are considered the most dangerous.
- Narrow pelvis
This pathology is diagnosed if the baby has a large skull that does not correspond to the size of the woman’s pelvis (they, by the way, can meet the standards) even with the uterine pharynx fully dilated. Strong, good contractions do not save the situation. If a woman in labor is diagnosed with a narrow pelvis and a large fetus, in most cases she is advised to have a caesarean section.
- Premature rupture of water
Due to its large size, the fetal head cannot press against the pelvic bones, and early birth occurs. This is fraught with the fact that a loop of the umbilical cord and even an arm or leg of the baby may fall out, the uterine os opens much more slowly, and childbirth is delayed and exhausting for the woman. Without amniotic fluid, the baby will last no more than 12 hours: further intrauterine infection may occur.
- Anomalies of labor
A large fetus delays labor, which depletes the mother's strength. It is diagnosed when the intensity and frequency of contractions is significantly reduced. This can lead to intrauterine hypoxia. The way out of this situation is stimulation of labor, which, however, does not have the best effect on the fetus.
- Breaks
Due to the large size of the fetal head, the lower uterine segment is overstretched, which leads to numerous ruptures in the uterus. The pubic symphysis is often damaged - ligaments are torn, the pubic bones are separated. All this will have to be corrected surgically after childbirth.
- Fistulas
If the fetal head, due to its large size, puts pressure on the pelvic bones for too long, the cervix, vagina, bladder, and anus experience enormous stress. Among the consequences are circulatory disorders in soft tissues, ischemia, necrosis, and in the future, rectovaginal fistulas.
- Birth injuries in a child
Due to its large size, the fetus cannot pass through the birth canal on its own without injury. The bones of the skull are damaged (and with them the brain), fractures of the shoulders, collarbone, and neck are diagnosed. The child may remain disabled for life or die. For the same reason, cerebral hemorrhage can occur.
Considering all these complications, the woman, together with the doctor, needs to make the right decision on how to give birth: or through a cesarean section. If the risk of complications is not so great, the size of the fetus is only slightly larger than normal and can be corrected, and the parameters of the mother’s pelvis allow it to be born on its own, there is no need to insist on surgical intervention. But if the situation is critical and doctors advise a CS, there is no need to resist: the life and health of the unborn baby is at stake.
Facts, facts. If doctors suspect that you have a large fetus, get ready to go to the hospital early: at 37-38 weeks of pregnancy.
Indications for caesarean section
Proper management of labor with a large fetus reduces the risk of complications by 80%. An experienced doctor who knows his business, even if the decision was made to give birth naturally, will always keep a team of doctors and the necessary equipment ready to carry out the procedure. After all, at any stage of labor, unforeseen circumstances may arise, life threatening mother or child.
As a rule, a caesarean section for a large fetus is prescribed for the following indications:
- age under 18 and after 30 years;
- breech presentation;
- a large fetus detected by ultrasound and - in this case, a CS is necessarily prescribed, because such a baby will not be able to be born on its own;
- post-term pregnancy;
- anatomically narrow pelvis;
- third births, if both previous ones were complicated by a very large fetus;
- myomatous nodes and any other pathologies of the uterus;
- contraindications for pushing: problems with the heart and blood vessels, myopia;
- poor obstetric history: if stillbirth, prematurity, infertility, etc. have previously been observed.
Polyhydramnios or moderate oligohydramnios with a large fetus are not considered absolute medical indications for caesarean section. In these cases, the baby is not in danger and in the absence of other pathologies, he is quite capable of being born on his own.
Statistics. According to the latest data, 75% of cases with a large fetus end in caesarean section.
Features of childbirth
Doctors know all the features of cesarean delivery for a large fetus, which require them to have high professional skill and certain experience. Newcomers are not trusted with such operations. Doctors take into account the following nuances:
- Caesarean section is performed under monitor control;
- a partogram is maintained - drawing up a schedule indicating the time of the labor period, parameters of throat opening, indicators of the intensity of contractions;
- All sizes are re-measured;
- pain relief is given, antispasmodics are used;
- V for preventive purposes cutting agents are used;
- a narrow pelvis must be diagnosed in a timely manner;
- bleeding is prevented.
If doctors have diagnosed a large fetus during pregnancy, you should not be afraid of such news. You need to know all the risks associated with this fact and how to avoid them. Consultation with a doctor is simply necessary here.
Do not rush to insist on a caesarean section, fearing ruptures: this will not be the best for the baby. the best option developments of events. Perhaps its size is not so colossal as to seriously harm you during childbirth. Listen to the recommendations of doctors - and complications can be avoided.
Pregnancy is a time of expectations, dreams of a beautiful and future baby. During pregnancy, there is a specific observation plan with the doctor and certain number routine ultrasound examinations. And during one of the ultrasounds, any woman can hear the phrase “You are carrying a hero.” This means that a large fetus is developing inside you.
There are certain norms for the weight and height of the baby at the time of birth. It is considered normal when a child with a height of 48–54 cm weighs up to 4,000 kg. If the baby weighs from 4 to 5 kg at the time of birth, then they talk about a large fetus during pregnancy. But it is strange that in this case they do not take into account the height of the children. After all, large babies are always taller than children, who, as they say, are part of the norm. The height of large babies is usually 54 – 56 cm.
According to statistics, today the number of large children accounts for 5-10% of all pregnancies. Doctors believe that this is due to improved working conditions, nutritious and healthy nutrition, as well as the living conditions of pregnant women.
There are also cases of the birth of giant babies: weight over 5 kg. But such cases are recorded much less frequently.
How to identify a large fruit?
Starting from the 12th week of pregnancy, at each examination the doctor listens to the baby’s heartbeat, measures the girth of the pregnant woman’s hips and abdomen, and the pregnant woman’s weight and blood pressure are also measured in the pre-medical office. All these measurements are not made in order to indicate to the woman how much she has gained and to offend her. All this is done in order to clearly paint a picture of the course of pregnancy and monitor the baby’s health and expectant mother.
Diagnosis of a large fetus during pregnancy is made not only on the basis of examination of the woman. An experienced doctor always takes into account heredity and diseases. The doctor should ask about the father’s physique and what weight the future parents themselves were born with. If, from all the examination and interview data, a suspicion of a large fetus is diagnosed, only then is a referral for an ultrasound scan given. Based only ultrasound examination You can calculate the estimated weight of the baby.
This unscheduled study determines the size of the fetal head, the diameter and circumference of the abdomen, and the length of the baby’s femur and humerus. And based on these data, it becomes possible to calculate the estimated weight of the fetus.
Causes of a large fetus
There can be many reasons why you are carrying a hero. Some of them are associated only with heredity, some are a reflection of the mother’s lifestyle or an echo of her health. Let us dwell in more detail on the reasons that the fetus weighs more than normal during pregnancy.
1. Increased pregnancy duration. There are two terms that are associated with a long period of gestation: prolongation physiological pregnancy and post-term pregnancy. The prolongation is due to the fact that the due date was incorrectly set. In this case, it is born healthy baby, but 10-14 days later than the deadline set by doctors. The health of the baby is determined by the absence of signs of post-maturity and aging of the placenta. With a true post-term pregnancy, a baby is born with the following signs:
- skin wrinkling;
- greenish or grayish tint of amniotic fluid;
- lack of vernix lubrication; dryness.
2. A disease such as diabetes, can lead to a large fetus during pregnancy. Pregnant woman who is sick diabetes mellitus, should be examined more thoroughly than others. Among such women, the statistics of having large children is much higher.
Such pregnant women should be hospitalized no later than 32 weeks of pregnancy. In the hospital, they undergo a thorough examination, after which a decision is made on the timing of delivery. If a diabetic patient is carrying a large fetus, then the issue of artificial induction of labor is decided no earlier than 36 weeks. This decision is also made when the woman’s health deteriorates (preeclampsia, low blood sugar, etc.). In this case, childbirth takes place under the careful supervision of a therapist. Insulin is administered throughout labor. Insulin treatment continues after childbirth, depending on test results.
3. Hemolytic disease of the fetus– a serious reason for the development of a large fetus during pregnancy. This disease is caused by Rh incompatibility between mother and child. Occurs in women with a negative Rh factor when the baby inherits Rh positive father factor. As a result of this disease, not only does the baby’s hemoglobin level decrease and jaundice appears, but also overweight due to the accumulation of fluid in the body cavities (swelling appears), the spleen and liver enlarge.
4. Heredity plays an important role in the development of a large fetus. If the baby's mom or dad is tall and large at the moment, then there is a high probability that the child will be big. Also today, small parents could be born large. Then the baby can inherit exactly this fact and will also be a hero.
5. There is also a tendency for the fetus to develop larger in subsequent pregnancies. According to statistics, the second and subsequent children are born weighing 30% more than their older brothers and sisters. This is primarily due to psychological factor(during the second pregnancy, the mother no longer experiences such enormous stress and fear). The second reason is the readiness and training of the woman’s body to bear a baby (now the metabolism between mother and baby improves due to better blood circulation).
6. Nutrition for a pregnant woman can also affect the baby's size. A large number of Food containing carbohydrates (baked goods, sweets) contributes to obesity of mother and child. In this case, the baby’s body begins to work like the mother’s and gains excess weight. Obesity can develop already in the womb.
Danger with large fruit
The final stage of pregnancy - childbirth, is one of the most responsible and difficult moments baby's expectations. Carrying a large baby can cause certain difficulties during the delivery process. These difficulties can affect both the health of the mother and the health of the newborn.
First of all, with a large fetus during pregnancy, there may be discrepancy between the size of the baby's head and the mother's pelvis . Even if the pelvis is not narrow, the head of a large baby may not fit through birth canal. In this case, even good, strong labor activity will not be able to ensure natural delivery.
The head of a large fetus stands high in the pelvic cavity, this is the reason for the lack of differentiation into anterior and posterior amniotic fluid. This difference from normal physiological labor causes early rupture of amniotic fluid. If the fetus is large, then the umbilical cord or the baby’s hand may fall out along with the effusion into the vagina. In this case, immediate surgical intervention is required. Early rupture of water slows down the process of uterine dilatation, and makes the period of contractions very painful. What baby long time is without water, it can cause infection of it and the uterus.
The development of a large fetus during pregnancy can cause labor disturbances . This disorder is characterized by good and strong activity in the first stage and a decrease in labor activity in the later stages of labor. As a result, the woman in labor gets tired and cannot push. Also, cases of disruption of the nervous and cardiovascular systems are not uncommon. A large fetus in this situation suffers from a lack of oxygen - hypoxia. This disorder may be characterized by very weak contractions in the first stage of labor.
During pushing, when the baby's head takes the shape of the woman's pelvis, it may occur uterine rupture problem . This occurs, again, due to the discrepancy between the sizes of the small pelvis and the head of a large fetus.
Emergence genitourinary or rectovaginal fistulas not a rare occurrence at the birth of large children. This is due to the prolonged standing of the baby's head in the woman's pelvic area. In this case, tissue death occurs Bladder, rectum and urethra. The dead tissue is then rejected, forming fistulas. The problem can only be solved by surgical intervention after childbirth.
If the baby is born for a long time, it may pinched nerve in the leg , there is also a possibility of damage to the articulation of the pubic bones. This is reflected in the gait of the young mother, a limp appears and painful sensations when moving your leg. If the degree of nerve damage is high, then surgery is required to solve the problem. For mild paresis, bed rest and a bandage are recommended. According to the doctor's decision, painkillers may be prescribed.
All of the above can occur even before the birth of the baby’s head, which was considered large during pregnancy. But even when, it would seem, the most difficult thing is over, problems can arise. After the birth of the head of a large fetus, difficulties may arise in removing the baby's shoulder girdle. If the child is large, then, first of all, the neonatologist pays attention to the condition of his collarbones and arms.
A discrepancy between the mother's pelvis and the baby's head can cause cerebral hemorrhage in a child or cephalohematoma. If there are no complications, then after 6-8 weeks the hematoma subsides without having any effect on the child’s health. Hemorrhage may also have no consequences for the development and health of the baby. It all depends on its size and the zone of outpouring.
We must not forget that a woman who has given birth to a large baby may have insufficient uterine contraction . As a result, bleeding may occur after the baby is born. The causes of bleeding include retained placenta in the uterus and ruptures of the tissues of the genital tract.
What to do?
If, after your next examination with a doctor, you are told that you have a large fetus, you should not panic. A large fetus during pregnancy means the need for more careful monitoring later and during childbirth. Having learned that the baby is large, the doctor will first try to find out the reason.
If the cause is any pathology of fetal development or the woman’s health, hospital treatment will be prescribed. In this case, in most situations, the woman is under observation until childbirth, since there is a need for constant instruction in drug treatment.
If the cause of a large fetus is heredity or overeating of the mother, then a diet is prescribed. According to the diet, mother should only receive healthy food, which will not contribute to excess weight gain.
There is also no need to be afraid of childbirth when a large fetus develops. The only thing you need to do in advance is to talk to your doctor about the course of your labor. In some cases, a caesarean section is immediately prescribed, in others a wait-and-see approach is adopted.
Indicators to caesarean section already during labor there are signs of a discrepancy between the baby’s head and the mother’s pelvis within 4 hours.
That is, if a natural birth is scheduled, then provided that labor progresses spontaneously and the waters break, the doctor can decide on an operation if there is a threat to the life of the mother or child.
A frozen pregnancy is a condition in which the fetus inside the mother dies and the pregnancy stops developing. Most often, this occurs asymptomatically and the woman learns about her diagnosis only during a routine ultrasound.
Why does pregnancy stop?
The life of the fetus, especially in the first 12 weeks, is very fragile and can be cut short by any, even minor factors: air travel, prolonged exposure to the sun, stress, poor ecology, etc. Doctors name several of the most likely reasons for the fading of pregnancy in the early stages:
- congenital pathologies and developmental defects in the fetus- doctors consider this the most common reason and call it “natural selection”: nature interrupts the development of “poor quality” ovum and thus prevents the birth of a child with genetic disorders;
- the woman has infectious diseases(flu, herpes, rubella, chlamydia, toxoplasmosis, etc.) - this is the second most common cause;
- consequences of Rh conflict between mother and child or hormonal disorders.
In addition, the risk of fetal death in the early stages significantly increases bad habits expectant mother: smoking, alcohol and, especially, drugs.
The fetus died, the pregnancy no longer develops, and the woman may not suspect anything. In the early stages, it is difficult to recognize the signs of a frozen pregnancy at home. But women, especially those who have already experienced terrible diagnosis, carefully monitor the course of their new pregnancy. There are only indirect symptoms by which a pregnant woman may suspect something is wrong.
Unreasonable decrease or complete disappearance toxicosis can be noticed, and even then not always. If a pregnant woman suffered from severe toxicosis, then its disappearance, of course, will not go unnoticed. And if the signs of toxicosis were weak, then little attention is paid to this factor.
Breast softening may indicate intrauterine fetal death. In almost all pregnant women, immediately after conception, the mammary glands swell and become painful. When the fetus dies, the chest relaxes. But you should not immediately panic when this symptom occurs. During 9 months of pregnancy, according to many women, the breasts can relax and tighten several times. This is most likely due to hormonal changes during pregnancy.
Demotion basal temperature
can be caused by a frozen pregnancy. This happens due to a decrease in the level of progesterone, the hormone that supports pregnancy. Basal temperature should be measured in the morning in the rectum as soon as you wake up. Prepare the thermometer in the evening, since it is important to remain motionless for at least 6 hours before and during measurements. But this method is also an unreliable indicator of fading pregnancy, as other factors can also affect the value of basal temperature: intake hormonal drugs, sex, illness with fever, etc.
Bloody discharge and nagging pain in the lower abdomen do not always occur during frozen pregnancy. This is its difference from a miscarriage. But in any case, this is a very alarming sign during pregnancy, requiring immediate consultation with a doctor.
Discrepancy between the size of the uterus and the gestational age may be noticed by a gynecologist during a vaginal examination, but this fact does not always indicate that pregnancy is fading. In this case, the dynamics of pregnancy development are monitored. And if in 2-3 weeks the uterus has not grown, but, on the contrary, has become smaller and softer, then the doctor can make a preliminary diagnosis of “frozen pregnancy” and, to confirm it, send the patient for an hCG hormone test and an ultrasound.
Decreased hCG hormone H - a regular pregnancy test may respond to this indicator (it will show a negative result). But it is better to take a special analysis.
Ultrasound indications- this is the most reliable and reliable indicator confirming the presence of a frozen pregnancy. Errors occur only in the early stages of pregnancy, when the doctor may mistake it for an empty fertilized egg that is developing normally. In this case, if the patient’s condition does not cause concern, you can wait up to 6-7 weeks and repeat the ultrasound. At this stage, an experienced doctor, using modern equipment, can already clearly see the embryo and hear its heartbeat.
What's next?
If the terrible diagnosis is nevertheless confirmed, then two scenarios are possible.
First. Doctors wait for spontaneous miscarriage, while monitoring the woman’s health. They can help stimulate a miscarriage by administering special medications. This wait-and-see approach is most often followed by foreign doctors.
Second. After the diagnosis is confirmed, the woman is immediately sent to clean the uterus, without waiting for a miscarriage and possible negative consequences From him. Staying a dead fetus in the uterus for a long time can cause inflammatory process. This option for terminating a frozen pregnancy is used by Russian doctors.
Doctors recommend planning your next pregnancy after a frozen one no earlier than six months, or better yet, a year. During this time, it is advisable for both parents to take tests and undergo an examination to identify the cause of fetal freezing.
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Pregnancy is a physiological process in which the uterus develops new organism resulting from fertilization. Pregnancy lasts on average 40 weeks (10 obstetric months).
In the intrauterine development of a child, two periods are distinguished:
- Embryonic(up to 8 weeks of pregnancy inclusive). At this time, the embryo is called an embryo and acquires characteristic human features;
- Fetal(from 9 weeks until birth). At this time, the embryo is called a fetus.
The growth of a child, the formation of his organs and systems occurs naturally in different periods intrauterine development, which is subject to the genetic code embedded in the germ cells and fixed in the process of human evolution.
Embryo development in the first obstetric month (1-4 weeks)
First week (days 1-7)
Pregnancy begins from the moment fertilization- mature fusion male cage(sperm) and female egg. This process usually occurs in the ampullary section of the fallopian tube. After a few hours, the fertilized egg begins to divide exponentially and descends through the fallopian tube into the uterine cavity (this journey takes up to five days).
As a result of division turns out to be a multicellular organism, which is similar to a blackberry (in Latin “morus”), which is why the embryo at this stage is called Morula. Approximately on the 7th day, the morula penetrates the uterine wall (implantation). The villi of the outer cells of the embryo connect with the blood vessels of the uterus, and subsequently the placenta is formed from them. Other outer morula cells give rise to the development of the umbilical cord and membranes. Over time, various tissues and organs of the fetus will develop from the internal cells.
Information At the time of implantation, a woman may have slight bleeding from the genital tract. Such discharge is physiological and does not require treatment.
Second week (8-14 days)
The outer morula cells grow tightly into the lining of the uterus. In the embryo the formation of the umbilical cord and placenta begins, and neural tube, from which it subsequently develops nervous system fetus
Third week (15-21 days)
The third week of pregnancy is a difficult and important period. At that time important organs and systems begin to form fetus: the rudiments of the respiratory, digestive, circulatory, nervous and excretory systems appear. At the site where the fetal head will soon appear, a wide plate is formed, which will give rise to the brain. On day 21, the baby's heart begins to beat.
Fourth week (22-28 days)
this week laying of fetal organs continues. The rudiments of the intestines, liver, kidneys and lungs are already present. The heart begins to work more intensely and pumps more and more blood through the circulatory system.
From the beginning of the fourth week in the embryo body folds appear, and appears vertebral primordium(chord).
Completed by day 25 neural tube formation.
By the end of the week (approximately 27-28 days) the muscular system and spine are formed, which divides the embryo into two symmetrical halves, both upper and lower limbs.
During this period it begins formation of pits on the head, which will later become the eyes of the fetus.
Development of the embryo in the second obstetric month (5-8 weeks)
Fifth week (29-35 days)
During this period the embryo weighs about 0.4 grams, length 1.5-2.5 mm.
The formation of the following organs and systems begins:
- Digestive system: liver and pancreas;
- Respiratory system: larynx, trachea, lungs;
- Circulatory system;
- Reproductive system: precursors of germ cells are formed;
- Sense organs: eye and inner ear formation continues;
- Nervous system: the formation of parts of the brain begins.
At that time a faint umbilical cord appears. The formation of limbs continues, the first rudiments of nails appear.
On the face the upper lip and nasal cavities are formed.
Sixth week (36-42 days)
Length embryo during this period is about 4-5 mm.
Starts in the sixth week formation of the placenta. At this stage, it is just beginning to function; blood circulation between it and the embryo has not yet been formed.
Ongoing formation brain and its departments. At the sixth week, when performing an encephalogram, it is already possible to record signals from the fetal brain.
Begins formation of facial muscles. The fetal eyes are already more pronounced and uncovered by eyelids that are just beginning to form.
During this period they begin upper limbs change: they lengthen and the rudiments of hands and fingers appear. The lower limbs still remain in their infancy.
Changes in important organs occur:
- Heart. The division into chambers is completed: ventricles and atria;
- Urinary system. Primary kidneys have formed, the development of the ureters begins;
- Digestive system. The formation of sections of the gastrointestinal tract begins: the stomach, small and large intestines. The liver and pancreas had practically completed their development by this period;
Seventh week (43-49 days)
The seventh week is significant because The formation of the umbilical cord is completed and uteroplacental circulation is established. Now the breathing and nutrition of the fetus will be carried out due to blood circulation through the vessels of the umbilical cord and placenta.
The embryo is still bent in an arched manner; there is a small tail on the pelvic part of the body. The size of the head is at least half of the embryo. The length from the crown to the sacrum increases by the end of the week up to 13-15 mm.
Ongoing development upper limbs . The fingers are visible quite clearly, but their separation from each other has not yet occurred. The child begins to perform spontaneous movements with his hands in response to stimuli.
Fine eyes are formed, already covered with eyelids, which protect them from drying out. The child can open his mouth.
The formation of the nasal fold and nose occurs, two paired elevations are formed on the sides of the head, from which they will begin to develop ears.
Intensive continues development of the brain and its parts.
Eighth week (50-56 days)
The body of the embryo begins to straighten, length from the crown to the coccyx is 15 mm at the beginning of the week and 20-21 mm on day 56.
Ongoing formation of important organs and systems: digestive system, heart, lungs, brain, urinary system, reproductive system (boys develop testicles). The hearing organs are developing.
By the end of the eighth week the child's face becomes familiar to the person: the eyes are well defined, covered with eyelids, the nose, the ears, the formation of the lips is ending.
Intensive growth of the head, upper and lower horses is noted In particular, ossification of the long bones of the arms and legs and the skull develops. The fingers are clearly visible; there is no skin membrane between them.
Additionally The eighth week ends embryonic period development and fetal stage begins. From this time on, the embryo is called a fetus.
Fetal development in the third obstetric month (9-12 weeks)
Ninth week (57-63 days)
At the beginning of the ninth week coccygeal-parietal size fetus is about 22 mm, by the end of the week - 31 mm.
Happening improvement of blood vessels of the placenta, which improves uteroplacental blood flow.
The development of the musculoskeletal system continues. The process of ossification begins, the joints of the toes and hands are formed. The fetus begins to make active movements and can clench its fingers. The head is lowered, the chin is pressed tightly to the chest.
Changes occur in the cardiovascular system. The heart beats up to 150 times per minute and pumps blood through its blood vessels. The composition of blood is still very different from the blood of an adult: it consists only of red blood cells.
Ongoing further growth and brain development cerebellar structures are formed.
Organs are developing intensively endocrine system , in particular, the adrenal glands, which produce important hormones.
Improves cartilage tissue: auricles, laryngeal cartilages, vocal cords are being formed.
Tenth week (64-70 days)
By the end of the tenth week fruit length from the coccyx to the crown is 35-40 mm.
Buttocks begin to develop, the previously existing tail disappears. The fetus is in the uterus in a fairly free position in a semi-bent state.
Nervous system development continues. Now the fetus performs not only chaotic movements, but also reflex ones in response to a stimulus. When accidentally touching the walls of the uterus, the child makes movements in response: turns his head, bends or straightens his arms and legs, and pushes to the side. The size of the fetus is still very small, and the woman cannot yet feel these movements.
The sucking reflex is formed, the child begins reflex movements with his lips.
The development of the diaphragm is completed, which will take an active part in breathing.
Eleventh week (71-77 days)
By the end of this week coccygeal-parietal size the fetus increases to 4-5 cm.
The fetal body remains disproportionate: small body, big sizes heads, long arms and short legs, bent at all joints and pressed to the stomach.
The placenta has already reached sufficient development and copes with its functions: ensures the supply of oxygen and nutrients to the fetus and removes carbon dioxide and products of exchange.
Further formation of the fetal eyes occurs: At this time, the iris develops, which will later determine the color of the eyes. The eyes are well developed, half-closed or wide open.
Twelfth week (78-84 days)
Coccygeal-parietal size fetus is 50-60 mm.
Goes clearly development of the genital organs according to the female or male type.
Happening further improvement of the digestive system. The intestines are elongated and arranged in loops, like those of an adult. Its periodic contractions - peristalsis - begin. The fetus begins to make swallowing movements, swallowing amniotic fluid.
The development and improvement of the fetal nervous system continues. The brain is small in size, but exactly replicates all the structures of the adult brain. The cerebral hemispheres and other sections are well developed. Reflex movements are improved: the fetus can clench and unclench its fingers into a fist, grabs the thumb and actively sucks it.
In fetal blood Not only red blood cells are already present, but the production of white blood cells - leukocytes - also begins.
At this time the child single respiratory movements begin to be recorded. Before birth, the fetus cannot breathe, its lungs do not function, but it makes rhythmic movements of the chest, imitating breathing.
By the end of the week the fetus eyebrows and eyelashes appear, the neck is clearly visible.
Fetal development in the fourth obstetric month (13-16 weeks)
Week 13 (85-91 days)
Coccygeal-parietal size by the end of the week is 70-75 mm. The proportions of the body begin to change: the upper and lower limbs and torso lengthen, the size of the head is no longer so large in relation to the body.
Improvement of the digestive and nervous systems continues. The embryos of baby teeth begin to appear under the upper and lower jaws.
The face is fully formed, the ears, nose and eyes are clearly visible (the eyelids are completely closed).
Week 14 (92-98 days)
Coccygeal-parietal size by the end of the fourteenth week it increases up to 8-9 cm. Body proportions continue to change to more familiar ones. The face has a well-defined forehead, nose, cheeks and chin. The first hair appears on the head (very thin and colorless). The surface of the body is covered with vellus hairs, which retain skin lubrication and thereby perform protective functions.
The musculoskeletal system of the fetus is improved. Bones become stronger. Motor activity increases: the fetus can turn over, bend, and make swimming movements.
Development of the kidneys, bladder and ureters is complete. The kidneys begin to secrete urine, which mixes with the amniotic fluid.
: pancreatic cells begin to work, producing insulin, and pituitary cells.
Changes in the genital organs appear. Boys develop prostate In girls, the ovaries migrate into the pelvic cavity. At the fourteenth week, with a good sensitive ultrasound machine, it is already possible to determine the sex of the child.
Fifteenth week (99-105 days)
Coccygeal-parietal size of the fetus is about 10 cm, fruit weight – 70-75 grams. The head still remains quite large, but the growth of the arms, legs and torso begins to outstrip it.
Improving circulatory system . In the fourth month, a child’s blood type and Rh factor can already be determined. Blood vessels (veins, arteries, capillaries) grow in length and their walls become stronger.
The production of original feces (meconium) begins. This is due to the ingestion of amniotic fluid, which enters the stomach, then into the intestines and fills it.
Fully formed fingers and toes, an individual design appears on them.
Sixteenth week (106-112 days)
The weight of the fetus increases to 100 grams, the coccygeal-parietal size - up to 12 cm.
By the end of the sixteenth week, the fetus is already fully formed, he has all the organs and systems. The kidneys are actively working, a small amount of urine is released into the amniotic fluid every hour.
The skin of the fetus is very thin, subcutaneous fatty tissue is practically absent, so blood vessels are visible through the skin. The skin appears bright red, covered with vellus hairs and grease. Well defined eyebrows and eyelashes. Nails are formed, but they only cover the edge of the nail phalanx.
Facial muscles are formed, and the fetus begins to “grimace”: frowning of the eyebrows and a semblance of a smile are observed.
Fetal development in the fifth obstetric month (17-20 weeks)
Seventeenth week (days 113-119)
The weight of the fetus is 120-150 grams, the coccygeal-parietal size is 14-15 cm.
The skin remains very thin, but subcutaneous fatty tissue begins to develop under it. The development of baby teeth continues, which are covered with dentin. The embryos of permanent teeth begin to form under them.
There is a reaction to sound stimuli. From this week we can say for sure that the child began to hear. When strong sharp sounds appear, the fetus begins to actively move.
Fetal position changes. The head is raised and is almost in vertical position. The arms are bent at the elbow joints, the fingers are clenched into a fist almost all the time. Periodically, the child begins to suck his thumb.
The heartbeat becomes clear. From now on, the doctor can listen to him using a stethoscope.
Eighteenth week (120-126 days)
The child's weight is about 200 grams, length - up to 20 cm.
The formation of sleep and wakefulness begins. Most While the fetus is sleeping, movements stop during this time.
At this time, the woman may already begin to feel the baby moving, especially with repeated pregnancies. The first movements are felt as gentle jolts. A woman may feel more active movements when she is nervous or stressed, which affects the emotional state of the child. At this stage, the norm is about ten episodes of fetal movement per day.
Nineteenth week (127-133 days)
The child’s weight increases to 250-300 grams, body length – to 22-23 cm. The proportions of the body change: the head lags behind the body in growth, the arms and legs begin to lengthen.
Movements become more frequent and noticeable. They can be felt not only by the woman herself, but also by other people by placing their hand on their stomach. Primigravidas at this time can only begin to feel movements.
The endocrine system is improved: the pancreas, pituitary gland, adrenal glands, gonads, thyroid and parathyroid glands are actively functioning.
Blood composition has changed: In addition to erythrocytes and leukocytes, the blood contains monocytes and lymphocytes. The spleen begins to take part in hematopoiesis.
Twentieth week (134-140 days)
Body length increases to 23-25 cm, weight – up to 340 grams.
The fetal skin is still thin, covered with protective lubricant and vellus hairs, which can persist until childbirth. Subcutaneous fatty tissue develops intensively.
Well formed eyes, at twenty weeks the blink reflex begins to appear.
Improved movement coordination: The child confidently brings his finger to his mouth and begins to suck it. Facial expressions are pronounced: the fetus may close its eyes, smile, or frown.
This week all women are already feeling movements., regardless of the number of pregnancies. Movement activity varies throughout the day. When stimuli appear (loud sounds, stuffy rooms), the child begins to move very violently and actively.
Fetal development in the sixth obstetric month (21-24 weeks)
Twenty-first week (days 141-147)
Body weight grows to 380 grams, fetal length – up to 27 cm.
The layer of subcutaneous tissue increases. The skin of the fetus is wrinkled, with many folds.
Fetal movements become more active and tangible. The fetus moves freely in the uterine cavity: it lies head down or buttocks, across the uterus. Can pull on the umbilical cord, push off the walls of the uterus with hands and feet.
Changes in sleep and wakefulness patterns. Now the fetus spends less time sleeping (16-20 hours).
Twenty-second week (148-154 days)
At week 22, the size of the fetus increases to 28 cm, weight - up to 450-500 grams. The size of the head becomes proportional to the body and limbs. The legs are bent almost all the time.
The fetal spine is fully formed: It has all the vertebrae, ligaments and joints. The process of strengthening bones continues.
Improves the fetal nervous system: The brain already contains all the nerve cells (neurons) and has a mass of about 100 grams. The child begins to take an interest in his body: he feels his face, arms, legs, tilts his head, brings his fingers to his mouth.
Heart size increases significantly, the functionality of the cardiovascular system is improved.
Twenty-third week (155-161 days)
The length of the fetal body is 28-30 cm, weight is about 500 grams. Pigment begins to be synthesized in the skin, resulting in the skin acquiring a bright red color. The subcutaneous fatty tissue is still quite thin, as a result the child looks very thin and wrinkled. The lubricant covers the entire skin and is more abundant in the folds of the body (elbow, axillary, inguinal, etc. folds).
Development of internal genital organs continues: boys have the scrotum, girls have the ovaries.
Respiratory frequency increases up to 50-60 times per minute.
The swallowing reflex is still well developed: the child constantly swallows amniotic fluid with particles of protective skin lubricant. The liquid part of the amniotic fluid is absorbed into the blood, leaving a thick green-black substance (meconium) in the intestines. Normally, the bowel should not have a bowel movement until the baby is born. Sometimes swallowing water causes hiccups in the fetus; a woman can feel it in the form of rhythmic movements for several minutes.
Twenty-fourth week (days 162-168)
By the end of this week, the weight of the fetus increases to 600 grams, body length to 30-32 cm.
The movements are becoming stronger and clearer. The fetus takes up almost all the space in the uterus, but can still change position and turn over. Muscles grow rapidly.
By the end of the sixth month, the child has well-developed sense organs. Vision begins to function. If a bright light hits a woman’s belly, the fetus begins to turn away and closes her eyelids tightly. Hearing is well developed. The fetus determines pleasant and unpleasant sounds for itself and reacts to them differently. When hearing pleasant sounds, the child behaves calmly, his movements become calm and measured. When unpleasant sounds occur, it begins to freeze or, conversely, moves very actively.
An emotional connection is established between mother and child. If a woman experiences negative emotions (fear, anxiety, melancholy), the child begins to experience similar feelings.
Fetal development in the seventh obstetric month (25-28 weeks)
Twenty-fifth week (169-175 days)
The length of the fetus is 30-34 cm, body weight increases to 650-700 grams. The skin becomes elastic, the number and severity of folds decreases due to the accumulation of subcutaneous fatty tissue. The skin remains thin with a large number of capillaries, giving it a red color.
The face has a familiar appearance to a person: eyes, eyelids, eyebrows, eyelashes, cheeks, ears are well defined. The cartilage of the ears remains thin and soft, their bends and curls are not fully formed.
Bone marrow develops intensively, which takes on the main role in hematopoiesis. The fetal bones continue to strengthen.
Important processes occur in lung maturation: small elements of lung tissue (alveoli) are formed. Before the baby is born, they are without air and resemble deflated balloons, which straighten out only after the first cry of the newborn. From week 25, the alveoli begin to produce a special substance (surfactant) necessary to maintain their shape.
Twenty-sixth week (176-182 days)
The length of the fruit is about 35 cm, the weight increases to 750-760 grams. The growth of muscle tissue and subcutaneous fat continues. Bones are strengthened and permanent teeth continue to develop.
The formation of genital organs continues. In boys, the testicles begin to descend into the scrotum (the process lasts 3-4 weeks). In girls, the formation of the external genitalia and vagina is completed.
Improved sense organs. The child develops a sense of smell (smell).
Twenty-seventh week (183-189 days)
Weight increases to 850 grams, body length - up to 37 cm.
The organs of the endocrine system are actively functioning, in particular the pancreas, pituitary gland and thyroid gland.
The fruit is quite active, makes freely various movements inside the uterus.
From the twenty-seventh week in the child individual metabolism begins to form.
Twenty-eighth week (190-196 days)
The child’s weight increases to 950 grams, body length – 38 cm.
By this age the fetus becomes practically viable. In the absence of organ pathology, the child good care and treatment can survive.
Subcutaneous fat continues to accumulate. The skin is still red in color, the vellus hair begins to gradually fall out, remaining only on the back and shoulders. Eyebrows, eyelashes, and hair on the head become darker. The child begins to open his eyes frequently. The cartilage of the nose and ears remains soft. The nails do not yet reach the edge of the nail phalanx.
This week starts more one of the cerebral hemispheres is actively functioning. If the right hemisphere becomes active, then the child becomes left-handed; if the left hemisphere becomes active, then right-handedness develops.
Fetal development in the eighth month (29-32 weeks)
Twenty-ninth week (197-203 days)
The weight of the fetus is about 1200 grams, the height increases to 39 cm.
The baby has already grown enough and takes up almost all the space in the uterus. Movements become less chaotic. The movements manifest themselves in the form of periodic kicks with the legs and arms. The fetus begins to take a definite position in the uterus: head or buttocks down.
All organ systems continue to improve. The kidneys already secrete up to 500 ml of urine per day. The load on the cardiovascular system increases. The blood circulation of the fetus is still significantly different from the blood circulation of the newborn.
Thirtieth week (204-210 days)
Body weight increases to 1300-1350 grams, height remains approximately the same - about 38-39 cm.
Subcutaneous fat tissue constantly accumulates, skin folds straighten out. The child adapts to the lack of space and takes a certain position: curls up, arms and legs crossed. The skin still has a bright color, the amount of grease and vellus hair decreases.
Alveolar development and surfactant production continues. The lungs prepare for the birth of the baby and the start of breathing.
Brain development continues brain, the number of convolutions and the area of the cortex increases.
Thirty-first week (211-217 days)
The child's weight is about 1500-1700 grams, height increases to 40 cm.
Your child's sleep and wake patterns change. Sleep still takes a long time, during which time there is no motor activity of the fetus. While awake, the child actively moves and pushes.
Fully formed eyes. During sleep, the child closes his eyes, while awake, the eyes are open, and the child blinks periodically. The color of the iris is the same for all children (blue), then after birth it begins to change. The fetus reacts to bright light by constricting or dilating the pupil.
Brain size increases. Now its volume is about 25% of the volume of the adult brain.
Thirty-second week (218-224 days)
The child's height is about 42 cm, weight - 1700-1800 grams.
Accumulation of subcutaneous fat continues, due to which the skin becomes lighter, there are practically no folds left on it.
Internal organs are improved: organs of the endocrine system intensively secrete hormones, surfactant accumulates in the lungs.
The fetus produces a special hormone, which promotes the formation of estrogen in the mother’s body, as a result, the mammary glands begin to prepare for milk production.
Fetal development in the ninth month (33-36 weeks)
Thirty-third week (225-231 days)
The weight of the fetus increases to 1900-2000 grams, height is about 43-44 cm.
Skin becomes increasingly lighter and smoother, the layer of fatty tissue increases. The vellus hair is increasingly wiped off, and the layer of protective lubricant, on the contrary, increases. Nails grow to the edge of the nail phalanx.
The baby becomes increasingly cramped in the uterine cavity, so his movements become more rare, but strong. The position of the fetus is fixed (head or buttocks down), the likelihood that the child will turn over after this period is extremely small.
The functioning of internal organs is becoming more and more improved: heart mass increases, alveoli formation is almost complete, tone increases blood vessels, the brain is fully formed.
Thirty-fourth week (232-238 days)
The child's weight ranges from 2000 to 2500 grams, height is about 44-45 cm.
The baby now occupies a stable position in the uterus. The bones of the skull are soft and mobile thanks to the fontanelles, which can close only a few months after birth.
Head hair grows rapidly and take on a certain color. However, hair color may change after childbirth.
Intensive strengthening of bones is noted, in connection with this, the fetus begins to take calcium from the mother’s body (the woman may notice the appearance of seizures at this time).
The baby constantly swallows amniotic fluid, thereby stimulating the gastrointestinal tract and the functioning of the kidneys, which produce at least 600 ml of clear urine per day.
Thirty-fifth week (239-245 days)
Every day the child gains 25-35 grams. Weight during this period can vary greatly and by the end of the week it is 2200-2700 grams. Height increases to 46 cm.
All internal organs of the child continue to improve, preparing the body for the upcoming extrauterine existence.
Fatty tissue is intensively deposited, the child becomes more well-fed. The amount of vellus hair is greatly reduced. The nails have already reached the tips of the nail phalanges.
A sufficient amount of meconium has already accumulated in the fetal intestines, which normally should go away 6-7 hours after birth.
Thirty-sixth week (246-252 days)
The weight of a child varies greatly and can range from 2000 to 3000 grams, height - within 46-48 cm
The fetus already has well-developed subcutaneous fatty tissue, skin color becomes lighter, wrinkles and folds disappear completely.
The baby occupies a certain position in the uterus: more often he lies upside down (less often, with his legs or buttocks, in some cases, transversely), his head is bent, his chin is pressed to his chest, his arms and legs are pressed to his body.
Skull bones, unlike other bones, remain soft, with cracks (fontanelles), which will allow the baby's head to be more pliable when passing through the birth canal.
All organs and systems are fully developed for the existence of a child outside the womb.
Fetal development in the tenth obstetric month
Thirty-seventh week (254-259 days)
The child's height increases to 48-49 cm, weight can fluctuate significantly. The skin has become lighter and thicker, the fat layer increases every day by 14-15 grams per day.
Cartilages of the nose and ears become denser and more elastic.
Fully lungs are formed and mature, the alveoli contain the necessary amount of surfactant for the newborn to breathe.
The digestive system has matured: Contractions occur in the stomach and intestines to push food through (peristalsis).
Thirty-eighth week (260-266 days)
A child's weight and height vary greatly.
The fetus is fully mature and ready to be born. Externally, the child looks like a full-term newborn. The skin is light, the fatty tissue is sufficiently developed, and vellus hair is practically absent.
Thirty-ninth week (267-273 days)
Typically two weeks before birth the fruit begins to descend, pressing against the pelvic bones. The child has already reached full maturity. The placenta begins to gradually age and its metabolic processes deteriorate.
The weight of the fetus increases significantly (30-35 grams per day). Body proportions completely change: well developed rib cage and shoulder girdle, rounded belly, long limbs.
Well developed sense organs: the child catches all sounds, sees bright colors, can focus vision, taste buds are developed.
Fortieth week (274-280 days)
All indicators of fetal development correspond to new to the awaited one. The baby is completely ready for birth. The weight can vary significantly: from 250 to 4000 and above grams.
The uterus begins to periodically contract(), which appears aching pain lower abdomen. The cervix opens slightly, and the fetal head is pressed closer to the pelvic cavity.
The skull bones are still soft and pliable, which allows the baby’s head to change shape and pass the birth canal more easily.
Fetal development by week of pregnancy - Video
