Belly during pregnancy - Causes, symptoms and treatment. MF.

So, you're pregnant! Now your life will change significantly. And we will tell you how your tummy will grow and change outwardly and what will happen inside, how to respond to those or other sensations and how to approach the time of births prepared and happy.

Sizes and shape of the abdomen during pregnancy

As a rule, after learning about the desired pregnancy, young girls begin to wait, when the tummy will be seen and often worried in vain. The tummy becomes visible to others around the time of 13-15 weeks. When pregnancy twins, the tummy becomes noticeable as early as 11 weeks and then grows faster.

Dynamics of abdominal growth for calendar months.

Dimensions and shape of the abdomen are very individual and depend on:

- initial weight and height of the mother
- total weight gain
- sports training, development of abdominal muscles, posture
- presence of one or two fetuses in the uterine cavity
- fetal weight
-fetal position( longitudinal, transverse, oblique)

- fetal presentation( cephalic or pelvic)
- placenta previa
is the amount of amniotic fluid that increases unevenly during pregnancy( a biologically active liquid that isfetus surrounds the fetus and is its natural environment)
- first pregnancy or repeated

Contrary to the multitude of signs and beliefs, the shape of the abdomen does not depend on the sex of the child. In the case of placenta previa and pelvic presentation of the fetus, the stomach will be more rounded, the presenting part is high( there is distance between the articulation and the lower abdomen).

The first picture depicts the abdomen of the primipara, it will be more "sharp", and on the second miter, due to a weakened ligamentous apparatus, it looks somewhat hanging.

On account of the obstetrician-gynecologist, a woman's consultation should be up to 12 weeks. Each turnout to the doctor will be measured by the abdominal circumference, the height of the standing of the bottom of the uterus and the weight of the body.

The height of the bottom of the uterus( VDM) is the distance in centimeters between the upper edge of the pubic articulation and the bottom of the uterus.
Abdominal circumference( OC) - measured in centimeters at the level of the navel.

According to these data, you can conclude on the pace of development of your baby. Below is a table from which you will learn how much the child should weigh at each stage of development, and what it should be "growth".

Fetal weight and growth by month

Fertility period( in lunar months)	Fetal length in cm	Fetal weight in kg
End of the first month	0.8	-
End of 2nd	2-2.5	-
3rd	7-9	0.03-0.04
of the 4th	10-16	0.04-0.05
of the 5th	16-25	0.2-0.25
of the 6th	25-30	0.6-0.75
of the 7th	30-35	1.2-1.5
8th	35-40	1.6-1.8
9th	40-45	2-2.4
10th	45-55	3-3.5

You need to know which type of VDM should normally bebe on your deadline. VDM in centimeters approximately corresponds to the time in weeks( 32 weeks 32 cm, etc.).The lag behind the normal indicators may indicate a delay in fetal growth for various reasons. However, not always the small size of the fetus is an occasion for anxiety, it may happen that both you and your spouse are of small height and fragile physique, and then your situation will be called "constitutionally small fruit".All conclusions should be made by your doctor, the leading pregnancy.

The results of the measurement of VDM are recorded in the graph. Your results normally fall within the specified interval.

Dependence of uterus height on gestational age

The total weight gain( OPV) for pregnancy is normally about 7-16 kilograms. OPV depends on the initial body weight, future mothers with a deficit of weight gain more than women with the original normal weight or obesity.

The first stir in the abdomen

Along with the growth of the tummy, you begin to experience new sensations. The most exciting of them is the child's first stirring. Wiggling is one of the indicators of a child's well-being, too violent, painful or on the contrary, rare and weak movements should alert. In primiparas, the first stirring is observed at a period of about 20 weeks, in the case of re-births at 16 weeks. If the mother is slim, without excess weight, she can begin to feel the stir a little earlier. The child's movements are felt by the woman at first as "bubbling" or "stroking" from the inside, and from 24 weeks as painless shocks from the inside, sometimes accompanied by a brief increase in the tone of the uterus.

The child is in continuous motion, excluding sleep periods. At 20 weeks he performs about 200 movements per day, in 26-32 weeks the number of movements increases to 600, and then the motor activity gradually decreases, this is due to the growth of the fetus. Most of the movements of the pregnant mother does not feel.

Motor activity depends on the following factors:

- emotional state of women( stress condition can cause unusually violent perturbation is associated with elevated levels of glucose and adrenaline in the blood)
- exercise( perturbation felt stronger and more frequent in the rest mother)
- time of day( most often the child will be more active in the evening and at night)
- the mother's nutrition( in a state of hunger and after eating sweeter food more active and distinct)
- ambient sounds( a baby can react to loud sounds, especially with vibration, increased movements or contrary to calm down)
- tactile effects( when the stomach stroking, examined by a doctor the child can begin to move more actively)
- inconvenient mother posture for a long time( quickeningbecome not only active, but also painful).

You should have a simple method of counting the movements of the fetus and know what is the norm, and what should be alarming.

The Cardiff method is based on calculating movements for 12 hours, the time of the beginning of the study is determined by the mom herself. The time of the beginning of counting and the time when the tenth stir occurred. If the tenth movement of the fetus occurred earlier than 12 hours later, the counting can be stopped. If the child does not commit ten movements within 12 hours, a compulsory medical consultation is necessary.

The method of Sadovski is based on calculating fetal movements after dinner between 19.00 and 23.00( in the evening and after a meal, the child's movements must be strengthened).Mom records the counting start time and lies on the left side( this position strengthens the motor activity of the child).If the child makes ten or more perturbations during the first hour, the counting can be stopped. If the wiggling was less, then the woman should continue to count the fetal movements further. An alarming prognostic sign is the slowing of fetal movements less than ten within two hours, in which case urgent medical consultation is needed.

ATTENTION!A terrible sign is a sharp decrease in motor activity or a complete lack of movements of the child. If you do not feel the perturbations for more than 6 hours, you should immediately contact a obstetrician-gynecologist. You can contact your local obstetrician-gynecologist or call an ambulance.

To clarify the situation, the doctor will conduct the following studies:

- auscultation( listening) of the child's cardiac tones with the help of a midwife stethoscope.

Normally, the child's heart rate is 120-160 beats per minute and should be clear and rhythmic.

- CTG( cardiotocography test) is a method of examination that reflects the child's palpitations, the number of his movements and the contractile activity of the uterus. During the study, two sensors are attached to the abdomen by special straps, one in the projection of the child's heart, the other on the right corner of the uterus. The study is conducted 15-40 minutes( the minimum informative time).CTG can be conducted from 30-32 weeks. If the palpitations are monotonous, without accelerations, the pregnant woman may be asked to turn to the other side or resemble, then repeat the recording.

- Ultrasound with dopplerometry( registration of blood flow in the vessels of the uterus and umbilical cord) is conducted in doubtful cases.
Based on the survey, examination and research data, the doctor will make a conclusion about the condition of your baby and give recommendations.

Abdominal pain during pregnancy

In addition to the child's movements, you can experience pains of a different nature. In the early stages( up to 22 weeks), pulling and stitching pains in the lower abdomen may indicate:

- the threat of abortion( miscarriage) of
- acute gynecological pathology( ectopic pregnancy, torsion of the ovarian cyst)
- sprain of the ligamentous apparatus,for the growing uterus( more often observed in women who had painful and / or irregular menstruation before pregnancy)
- abnormal bowel work, spasms
- renal colic

In later terms( 22 weeks or more), we canWe think about:

- the threat of premature birth
- the threat of a rupture( if there was a caesarean section before)
- a premature detachment of the normally located placenta
- acute gynecological pathology( abnormal feeding of the fibroids node, torsion of the ovarian cyst)
- intestinal colic
- renal colic
- acute surgical pathology( acute appendicitis)

During the period of implantation( in the first weeks of pregnancy) there may be short-term sighing pains in the lower abdomen( pulls the stomach) localizingAbove the bosom, which are stopped on their own, do not grow and are not accompanied by other complaints( pronounced weakness, nausea, discharge from the genital tract, do not give to the right or left).Normally, slightly "pull the belly" can only in the early stages, when implantation occurs. And then pulling sensations should not be. Jolts, wiggling, short-term tone after examination on the chair - this is the norm, but not pain.

Pain in the right or left iliac regions that build up and cause tension in the anterior abdominal wall, which eventually lead to a sharp, shooting pain and are accompanied by dizziness, until loss of consciousness, nausea, sometimes bloody discharge from the genital tract, may indicate an ectopic( tubal) pregnancy with the formation of a ruptured tube or other acute gynecological pathology( torsion of ovarian cysts, hemorrhage in the cyst).

Drawing pains above the bosom, accompanied by increased uterine tone and, in some cases, bloody, spotting discharges are an urgent condition, and indicate a possible threat of miscarriage.

If the pains are periodic, spasmodic, spread to the entire abdomen and are accompanied by bloating, constipation, you hear "grumbling" in the abdomen, then most likely it is a violation of bowel function and it is necessary to revise the diet, adding more fresh vegetables, oatmeal, prunes, dried apricots and if necessary( with constipation more than three days) use glycerin suppositories 1 time per day rectally.

If the colitis is painful in the abdomen, the pain is streaking and localized to the right or left, given in the back and accompanied by urination disorder( difficult to urinate, pain, resists, change of urine color to dark, brown, muddy), then you may have renal colic.

At a period of more than 22 weeks, periodic pulling pains above the bosom, accompanied by an increase in the tone of the uterus may indicate a threat of premature birth.

If you have a caesarean section and if there are sharp pains above the bosom that do not have periodicity, possibly increasing and accompanied by common symptoms( weakness, dizziness, nausea) and delay or absence of fetal movements, then you should exclude a terrible condition -rupture of the postoperative cicatrix on the uterus.

Acute surgical pathology during pregnancy can be with unusual symptoms and atypical location of pain. Should be alerted to the pain that began in the epigastrium( the area "under the spoon"), the right hypochondrium and then descended into the right side, the suprapubic region.

WARNING!Self pain in the lower abdomen is not treated in any case. In the presence of complaints it is necessary to consult an obstetrician / gynecologist. In case of difficulty in diagnosing you, other narrow specialists( surgeon, urologist) will examine you and prescribe additional studies( ultrasound of internal organs and kidneys, general blood and urine tests and others).

If treatment is indicated, you can be recommended to take drugs( pills, candles) at home, send to a day or 24-hour in-patient department.

Skin on the abdomen during pregnancy

With the progression of pregnancy, you note also such peculiar skin changes as stretch marks and pigmentation.

stretch marks are internal scars of the skin, they arise from stretching of the skin, elastin fibers break and replace scar tissue. Blame for this rapidly changing balance of hormones and rapid growth of the abdomen. Predicting the appearance of stretch marks is difficult.

Prevention consists of regular walking tours, wearing special anatomical linen and daily soft massage in circular motions with the use of special creams permitted for pregnant women. Massage is contraindicated in women, whose pregnancy occurs against the background of the threat of interruption, as this is an additional stimulation of the muscles. You can use creams from stretch marks MamComfort, Vichy, Avent, Sanosan, Chicco Mamma Donna, Clarins, Bioterm. Creams and gels should be bought at the pharmacy and have a hygienic certificate and a label "hypoallergenic" or "tested for allergens" and be approved for use in pregnant and lactating women. If you do not want to use cosmetics, you can do massage with warmed olive oil, almond oil or jojoba oil, cocoa, grape seeds.

When pregnant, products rich in potassium( raisins, dried apricots, banana, pears) and the optimal drinking regime( non-carbonated mineral water, natural fruit drinks, green tea up to 2 liters a day, if you were not recommended to limit the liquid) are useful.

Pigmentation - discoloration of the skin( darkening or lightening) in separate areas.

Pigmented spots can form not only on the abdomen, but also on the face( on the forehead, chin, around the eyes, on the upper part of the cheeks, upper lip or arch from temple to temple), inner thighs, halos of the mammary glands, nipples. On the abdomen, pigmentation manifests itself in the form of a strip( the Alba band), which appears from 10 weeks.

Stripe of Alba on the stomach

Again, refuting the beliefs, we will say that the pigmentation does not depend on the sex of the child. This is again to blame for hormonal imbalance, as well as stress. In women with freckles, the probability of pigmentation is higher. After delivery, almost all the pigmented spots disappear, or become much paler.

It is recommended that pregnant women avoid excessive sun exposure and take folic acid( or metafolin preparations) in a prescribed dosage. If you have spots after birth and you are worried about it, correction of skin tone in cosmetology( chemical or laser peeling, abrasive therapy, mesotherapy) is possible.

If the skin of the anterior abdominal wall becomes "lemon peel" when compressed into a fold, this indicates swelling. Surely the swelling of the abdominal wall is accompanied by edema of the feet, shins and brushes. This condition requires consultation of the obstetrician-gynecologist( if necessary, and the therapist) and is subject to treatment.

The abdomen before the birth of

is considered to be a pregnancy from 37 weeks to 41 weeks, an average of 280 days( counting from the first day of the last menstruation) or 10 midwifery months. Or 9 calendar months.

The abdomen "drops" before birth because the baby's head is pressed against the entrance to the small pelvis and the uterus's bottom becomes slightly closer to the navel than before. In some, the abdomen falls 2-4 weeks before the birth, and someone in the process of childbirth itself.

How do you know if your stomach is down?

- short-term episodes of sensation are felt that the stomach "stiffens"
- heartburn and eructation of
disappear - breathing is facilitated because the uterus does not exert pressure on the diaphragm
- discomfort appears when walking and sitting
- urge to urinate
-there are unusual sensations in the perineum, pulling in the back

Frequently asked questions about the belly in pregnant women:

1. Do I need to wear a bandage?
A bandage is a special orthopedic device for supporting the stomach and unloading the spine:

- the pregnant woman should lead an active life, walk a lot, in this case, the bandage helps to withstand the load for a longer time.
- weak pelvic floor muscles and anterior abdominal wallstretched
- low fetal position( the bandage does not allow the child to fall earlier)
- multiple pregnancy
- scar on the uterus after cesarean section or myomectomy( mindnshenie pressure scars)

2. When can I find out the sex of the child?
Ultrasound specialists determine the sex, starting from the 15th week.

3. Is it possible to visit the pool?
It is possible and necessary, if to this there are no contraindications( threat of abortion, colpitis).The muscles of the abdomen relax in the water, and the load on the spine becomes easier. Loads should be reasonable, regular and combined with respiratory gymnastics, which allows you to partly prepare for childbirth. The same applies to swimming in the sea and fresh water.

4. From what period of pregnancy can you not sleep on your stomach?
In the first trimester, a pregnant woman's dream is no different from a nonpregnant sleep, from the age of 12 weeks the uterus begins to protrude due to a pubic joint, sleep on the abdomen is allowed if it is convenient for a pregnant woman. As a rule, women experience psychological discomfort( "I sleep on a child") and refuse this position, preferring to sleep on their side or put cushions under their belly. By the way the special pillow for pregnant women is now popular, it is useful and at feeding of the kid.

5. When is it not recommended to lie on your back?
It is not recommended to lie on your back after 16 weeks, as the pregnant uterus squeezes large vessels. This causes a decrease in blood flow to the placenta, and the child experiences oxygen starvation, as well as provokes dizziness and fainting in the woman herself.

6. How do I understand that I'm already giving birth exactly?
If the contractions go regularly in five minutes for 30-45 seconds - you can not doubt that this is the beginning of childbirth. It is necessary to go to the hospital. Another urgent indication for going to the hospital is the water drainage. If water has flowed away, you can not delay, otherwise, with prolonged anhydrous period, the child may die.

Let all that you read do not scare you, but only help you navigate in a new and exciting reality. Do not be afraid to consult a doctor once again, your health and child's health is a priority.

We also recommend, if possible, to involve the partner in the experience of all significant moments. Responsibility begins with an unborn baby. A partner's support will serve as the most favorable background for the course of pregnancy and childbirth. Grow big and healthy!

Doctor Petrova A.V.