Blood at week 20. Why is there bleeding during pregnancy? Necessary medical observations, analyzes and examinations

Bleeding is a very dangerous phenomenon, and during the period of carrying a baby it is doubly dangerous, as it simultaneously threatens both the child and the mother.

With severe bleeding, a pregnant woman can quickly lose a large amount of blood, however, the severity of the woman's condition cannot always be determined by the strength of the bleeding. Sometimes it happens that most of the blood accumulates inside, between the wall of the uterus and the placenta. Let's see what are the possible causes of bleeding during pregnancy.

Possible reasons

Bloody discharge can occur at any stage of pregnancy, so doctors conditionally divide them into 2 main groups:

• bleeding in early pregnancy (first 3 months);
• bleeding in the 2nd half of pregnancy (20-40th week).

The additional group includes bleeding that appeared under the influence of external factors not related to pregnancy. They arise for the following reasons:

• trauma to the external genital organs;
• violation of the integrity of the veins of the vagina;
• pathological changes in the vagina and cervix;
• infectious lesion of the genitals;
• pathology of the blood coagulation system.

First trimester

The first trimester of pregnancy is the most important period of the baby's intrauterine development.

The appearance of discharge at the beginning of pregnancy should alert the expectant mother, because only in one case, doctors consider their presence as one of the signs of pregnancy. We are talking about implantation bleeding. During the attachment of a fertilized egg to the wall of the uterus, small capillaries can be damaged. Some blood enters the uterine cavity and is excreted, so pregnant women often confuse implantation bleeding with menstruation.

All other causes of bleeding in early pregnancy are dangerous for the baby and the expectant mother:

• Risk of miscarriage... This is the most common cause of bleeding early in pregnancy. The main sign of this condition is the release of bright scarlet blood or mucus streaked with blood, which is accompanied by cramping pains in the lumbar region or lower abdomen. The threat of miscarriage is usually the result of a chronic genital infection, excessive physical activity, impaired development of the embryo, or long-term medication.
• Incomplete miscarriage (abortion in progress). It is characterized by mucous discharge with blood clots, as well as increasing paroxysmal pain in the lower abdomen. In this case, it is impossible to maintain pregnancy, most often it is necessary to cure the uterus and the use of hemostatic agents.
• Complete miscarriage (spontaneous completed abortion). In this condition, the bleeding is insignificant, there is practically no pain. On ultrasound, the uterine cavity looks empty, doctors observe the patient and prescribe hemostatic drugs.
• Frozen pregnancy... Signs - scanty mucous discharge with blood, softening and reduction of breasts, pain in the abdomen. Surgical cleaning of the uterine cavity is the logical conclusion of a frozen pregnancy.
• Bubble drift... The pathological development of pregnancy, in most cases not dangerous for the mother, in which, instead of the embryo, unformed tissue grows in the uterine cavity. The doctor makes an accurate diagnosis only after receiving the ultrasound results.

Second and third trimester

Let's list the most common causes of bleeding in the 20-40th week of pregnancy:

• Placenta previa... Hormonal changes, excessive physical or emotional stress sometimes lead to detachment of certain parts of the placenta, which is accompanied by bloody discharge from the vagina, severe weakness and cramping abdominal pain. The pregnant woman is urgently hospitalized and a decision is made about surgery or conservative treatment.
• Placental abruption... The most common manifestation is the release of blood clots and cramping pain in the abdomen. It is necessary to continuously monitor the state of the embryo by CTG in order to carry out a cesarean section in a timely manner, if necessary.
• Damage to the vessels of the embryo... No less dangerous, but quite rare cause of bleeding during pregnancy. Bloody discharge is not the first sign of this condition. The future baby suffers first: at first, his heartbeat increases, and then sharply weakened until the heart stops completely.

Thus, bleeding during pregnancy can be life-threatening for the expectant mother and her baby. Therefore, when a vaginal discharge appears, a woman should definitely consult with her doctor.

From the 20th week, half of the gestation period passes. Usually, the baby is born at the 40th week, so the fetus will have to be carried out for about the same time.

The twentieth obstetric week is determined from the first day of menstruation prior to pregnancy, which corresponds to the 18th week from the moment of conception. At this time, the cessation of toxicosis associated with a change in hormonal levels is noted. The woman is no longer tormented by pulling pains in the lower abdomen, caused by the intensive growth of the fetus. Weight gains steadily, provided that the correct diet is formed. The main feature of the 20th week is the first manifestation of fetal movements, felt by the mother and visible during the ultrasound examination.

At the 20th week, the volume of the uterus increases significantly, the abdomen grows, and with them the pressure on the internal organs of the mother increases. The waistline practically disappears. Due to the fact that the center of gravity shifts, the gait of the pregnant woman changes significantly. Low back pain, caused by the expansion of the pelvic bones and changes in the structure of the cruciate-femoral ligaments, may be troubling.

Particular attention should be paid to the edema characteristic of this period. It will not be possible to completely avoid them, but if you have alarming symptoms, you should not postpone your visit to the doctor.

Normal at this time is the presence of a light, creamy discharge with a liquid consistency and a sour odor. Leucorrhoea can be quite profuse due to the increased work of the hormone estrogen.

Pink, brownish or bloody discharge are reasons for urgent medical attention, especially if such signs are accompanied by pain in the lower abdomen. If you have frothy, cheesy, yellow or purulent discharge, you should immediately go to the hospital or call an ambulance.

Mid-term baby development

1. By the middle of pregnancy, all organs and systems of the baby are fully formed. He distinguishes between sounds and can turn his head. His body is covered with thin skin, under which fat begins to accumulate. The fruit can already turn upside down on its own and will do this more than once.
   
2. By the 20th week of pregnancy, the child begins to produce hormones, and the thyroid gland begins to work. This influences the formation of brain receptors. The pancreas begins to produce insulin, which is essential for the fruitful growth of the fetus. The number of nephrons in the kidneys increases.
3. The baby's weight is about 260 g, height is 140-160 mm. There is a fetal heartbeat with a frequency of 120-160 beats / min. The size of the fruit is about 25 cm. Soft marigolds are already growing on the fingers, the original pattern is discernible on the pads. The weight of the child increases daily, which indicates his successful development in the womb.
4. It is obligatory to carry out an ultrasound examination of the fetus at the 20th week. At this time, it is possible to determine the sex of the baby.
5. The child's senses begin to respond to light by forming photoreceptors. A blink reflex appears, which can be noticed during an ultrasound scan. Mimicry appears on the child's face: he smiles, lowers the corners of his mouth, closes his eyes or frowns.
6. On a 3D or 4D ultrasound, you can examine the back, head, facial features of the child, count the fingers and toes. The organs are studied in detail on the 20th week. The stomach, bladder and lungs are visible. The location of the valves of the heart, heart chambers and the functionality of the blood system are determined. The intestines begin to produce meconium - the original feces. If abnormalities are found, the woman is sent for additional research to exclude a heart defect.
7. Necessarily at the 20th week of pregnancy, the frequency of contractions of the muscles of the uterus is recorded during an ultrasound scan. The place of attachment of the placenta, the volume of amniotic fluid are checked.

   Vitamins of group B can be obtained by eating buckwheat, A - from carrot juice, phosphorus - from fish products, folic acid - from broccoli. Food should be baked or simmered, not fried in oil. You should forget about smoking, as such dishes will cause heartburn and water retention in the body, and, as a result, swelling due to the high salt content.

   1. On the 20th week, a general urine test is provided. Tests for blood, suspicious vaginal discharge and other examinations are carried out according to medical indications. If from the 16th to the 19th week the "Triple test" - a biochemical blood test was not done, then it should be taken immediately. The results will show the level of hCG, a pregnancy hormone, the presence of alpha-fetoprotein elements in the blood, indicating the full development of the child or the presence of chromosomal abnormalities.
   2. At this time, the threat of gestosis is checked. Symptoms include high blood pressure, protein in the urine, swelling of the extremities, and a sharp weight gain of 0.5 kg.
   3. Signs of varicose veins are a particular problem. To eliminate the expansion of blood vessels and the appearance of "blood asterisks", it is recommended to wear special underwear.
   4. For severe low back pain, a bandage should be purchased. For those in the office, avoid wearing high heels and wedges to relieve pressure on the spine. In addition, accepting a high position changes the inclination of the uterus, which can adversely affect the well-being of the child.
   5. A pregnant woman needs to control her fluid intake. Calculate the approximate amount of water consumed and removed. On average, you need to consume 1.5-2 liters of water per day, that is, about 30 ml per 1 kg of a woman's weight. It is important to prevent a deficiency of water in the body, since the body will retain residues in case of its absence. Note that at this time, receptors responsible for urge to use the toilet are blocked. For this reason, the pregnant woman should monitor urination so that excess water in the body is not retained.
   6. The recommendations for the woman's lifestyle are the same as for the 18th and 19th weeks. Long walks must be avoided. However, you should also refuse to sit for a long time, for example, at a desk. Every hour you should do a little warm-up, walk for at least 5-10 minutes.
   7. If you find white discharge from the breast - colostrum, do not press on the nipples, as this can cause premature uterine contraction. Better to put napkins or special pads in the bra to eliminate fluid leakage.
   8. The twentieth week is the time to take care of the beauty of the mother from stretch marks. To do this, you need to purchase a special cream for pregnant women. Natural oils can also be rubbed into the skin of the abdomen: olives, jojoba, aloe vera. The main thing is that the skin is moisturized. The use of medications containing hormones is prohibited.
      
   9. To avoid the appearance of age spots, during this period, you should limit exposure to the sun. When going outside in the summertime, apply a cream that protects against ultraviolet rays. It is not recommended to visit hot countries, such as Egypt, Thailand, due to the sharp climate change, which can provoke a change in hormonal levels.
   10. A significant increase in weight, more than 5 kg, should be reported to the doctor. Excess pounds will put pressure on the internal organs of the mother and child, which may affect their health.
   11. Sexual life at this time is allowed, unless the doctor has prescribed otherwise. It is worth choosing positions that are comfortable for the mother, without pressure on the abdomen. It is necessary to inform the doctor about the sensations of uterine contraction during intercourse, as this may be a sign of increased uterine tone, which can lead to premature contractions.
   12. Fetal movement should be noted every 10-15 minutes. However, do not panic if the baby does not move - he is probably just sleeping.
   13. A visit to the doctor from the 20th week should be carried out twice, and not once a month, as before.
   14. Some women in this period are already starting to purchase clothes, since there is a high probability of determining the sex of the child. Although many consider this a bad omen, those who give birth not for the first time know that in the last stages of time and physical opportunities to go shopping are becoming less and less. So the middle of the term is a good time to buy rompers, vests, caps, socks, diapers and other things depending on the season when the baby is born.
   15. In order to mentally prepare for childbirth, the expectant mother can attend special courses organized at the maternity ward or at private clinics. Doctors will explain in detail how to behave during labor, what to take with you to the hospital, how to breathe correctly.
       
   16. A pregnant woman in the 20th week needs to master a new "science" - correct getting out of bed. You need to get up smoothly, first throwing your legs over, and not completely turning your body. It is also necessary to pay attention to the quality of the sleeping mattress: it must necessarily be firm from high-quality hypoallergenic materials. The room should be well ventilated, air circulation should be ensured so that the baby's and mother's sleep is sound and healthy. After the woman wakes up, you can lie down for 10-15 minutes so that the whole body is toned, and only then get up.
   17. And one more important point, you should not keep your hand up for a long time. If you need to take an item from the top shelf, it is better to ask your husband or loved ones about it.
   18. An important psychological moment is the appearance of the first outlines of the child on an ultrasound scan for the future father. Often men begin at this moment to believe that a woman no longer needs them, and all her thoughts will soon revolve only around the baby. Surprisingly, it is now that a man begins to feel unnecessary and lonely. He increasingly seeks friends, trying to justify his worth. At this moment, a woman needs to calmly explain to her spouse that their relationship remains the same, and now another person will appear in them, who will bring love and a new understanding of the family into the house.

   Features of bearing twins

   A pregnant twin's heart works twice as hard as more blood needs to be pumped. The woman, accordingly, gets more tired, and the load on the kidneys increases by 14-15 weeks.

   This is due to the fact that there is a shunt between the two placentas - a kind of vessel through which blood flows. More blood can flow to one placenta, and less blood to the other. It is impossible to change this state, and it does not pose a threat to women and children. In addition, the size of children in multiple pregnancies may be reduced.

   Video - 20th week of pregnancy what is happening, the size of the fetus, sensations in the abdomen, sleep patterns, driving

At 20 weeks, a pregnant woman can be congratulated - half the way has already been passed. There are still four months left before the meeting with the baby.

Pregnancy, according to doctors' estimates, lasts from the moment of fertilization to the moment of delivery 266 days (or 38 weeks). Since it is rather difficult to determine the exact date of conception, doctors begin counting the "interesting position" from the first day of the last menstruation, thus adding 2 more nonexistent, "phantom" weeks.

Fruit size

The length of the baby is about 18-19 cm. The length of the baby reaches about 17 cm. In size at 20 weeks, it can be compared to a pineapple.

Crumbs weight

The child's weight is about 250 grams. This is the weight of an average apple!

Fetal development at 20 weeks gestation

Retinal photoreceptors continue to form, the number of nerve cells is rapidly growing, the rudiments of future teeth are actively developing, the brain is working, and the immune system is improving. The child hears the beat of the mother's heart, begins to distinguish the sounds of the outside world.

Heartbeat

The heart rate does not change and is 140–160 beats per minute.

What does a fetus look like at 20 weeks of gestation

The baby's skin thickens but remains wrinkled. The nose, lips, ears, eyes (cilia have already appeared on them!) Acquire clearer and thinner outlines. The body is covered with the original fluff - lanugo. This hair has a protective function - it traps the waxy secretion (original lubricant) and helps regulate the baby's body temperature. The child actively moves in the uterus, the mother, as a rule, already feels the first movements of the fetus during pregnancy.

Body changes and new sensations of a woman

At 20 weeks, some women begin to bulge their belly button on their stomach. There is nothing terrible or unusual in this. An increase in the umbilical ring occurs due to the fact that the uterus rises up and presses on the umbilical cord. After giving birth, the "button" that appears will disappear.

Does the navel hurt during pregnancy? The phenomenon is also quite common - the appearance of painful sensations is associated with a stretching of the abdomen while carrying a child. If the pain persists for a long time, it makes sense to see a doctor.

As for the umbilical piercing, its doctors recommend that expectant mothers still remove it - the hole from the piercing during the "interesting position" can be greatly stretched, and the earring itself can cause skin irritation.

Weight gain

Starting from the second half of pregnancy, the mother will recover a little less - 250-300 g per week. The total weight gain by the end of 20 weeks for women of normal physique is 6.5 kg.

Mom's belly

At week 20, the abdomen already has significant dimensions, rising higher and higher above the level of the pubis. Because of this, stretch marks appear on the body during pregnancy. Apply a cream for stretch marks (you can also use plain olive oil) with light massaging movements. The best cosmetic products to combat emerging skin defects are those that contain extracts and essential oils of plants, seaweed, panthenol, as well as vitamins A and E.

Analyzes and ultrasound

Doctors call 20 weeks the best time for a second scheduled ultrasound scan during pregnancy. On an ultrasound scan, the doctor checks the likelihood of fetal malformations, examines the internal organs of the child, determines the sex of the baby. The placenta (the place of its attachment to the uterus, how well it provides the baby with oxygen, nutrients) and the umbilical cord (how many vessels pass through it) are carefully examined.

To clarify the results of an ultrasound, a woman may be offered to do a biochemical blood test - a "triple test" during pregnancy (according to its results, the level of hCG hormones, estriol and alpha-fetoprotein is estimated).

Nutrition at 20 weeks of gestation

A woman should still eat properly (no junk food and canned food in small portions 5-6 times a day). But more than one month has passed since my mother found out about her “interesting position”. Of course, during this time she could miss the dishes that she ate with pleasure before pregnancy, and now she can no longer afford. What to do? Try replacing "harmful" foods with healthy ones. For example, instead of potato chips, eat chips made from fruits and vegetables, instead of chocolates, try sweets made from dried fruits, instead of milk chocolate, try a small piece of black. And always carry a bag of snacks with you!

Vitamins

Vitamins at week 20 play a very important role. Diversify your diet with fresh fruits and vegetables, include foods high in vitamins C (citrus fruits, however, do not overuse if you do not want your child to be born allergic), B, D, E, calcium, phosphorus, iron and iodine.

Sex at 20 weeks pregnant

If the pregnancy is going well, there are no contraindications for intimacy at week 20. And let neither you nor your partner be embarrassed by a rounded tummy - it is not at all an obstacle to lovemaking (rough sex and pressure on the belly are prohibited!). Long-term abstinence can harm the health and emotional state of the mother, not to mention the father and family relationships in general.

Lifestyle

Celebrate mid-pregnancy with a theater trip with your husband! But it is better to give up watching performances with heavy psychological plots - neither you nor your child need negative emotions now, because stress hormones, according to scientists, contribute to an increase in a woman's pulse, an increase in blood viscosity, blood pressure and a deterioration in uteroplacental circulation.

You should also not visit cinemas and rock concerts - very loud and long-lasting sounds can scare the baby and even lead to underdevelopment of his hearing aid.

Beauty and accessories

Do you keep going to work, and your favorite business suits are too small for you? Fortunately, today there is a large selection of items for pregnant women. In specialized stores, you can buy excellent suits for women in position. The best option is a three-piece suit (from includes pants, jacket and skirt). Various shirts and tops can be combined with these wardrobe items. And stylists recommend complementing the image with fashionable accessories - glasses, capes, hair jewelry, elegant gloves and bags. When choosing the color of a business suit, give preference to black and white. By the way, the black bottom can hide your "interesting position" for a long time - as you know, this color has the ability to "drop" a few centimeters.