Looks belly at 4 months. Fourth month of pregnancy: changes in the body of the mother and fetus. Pathologies and complications of pregnancy in the fourth month

Pregnancy is a wonderful, but sometimes difficult period. Expectant mothers are very sensitive to every change that occurs with the body, they carefully monitor their condition, because it is directly related to the condition of the child.

The most difficult period is the first trimester. It is during this period that the fetus develops and in every possible way reminds its mother of this with toxicosis, a growing tummy and a brutal appetite.

The fourth month of pregnancy is considered the best period, since toxicosis passes, the body has already adapted to new conditions, the future mother blooms before our eyes, becomes more feminine and sexy. In order for this period to pass in your life as calmly as possible, we have prepared for you answers to frequently asked questions about the 4th month of pregnancy.

4 months pregnant - how many weeks?

According to an established tradition, pregnancy is calculated by weeks, which determines exact date childbirth (during the normal course of pregnancy). Four months of pregnancy is 16 obstetric weeks (1 month = 4 weeks) or 18 calendar weeks (due to the different number of weeks in each month). Start fourth month pregnancy starts at 13 weeks. The calculation of the term begins from the first day of the last menstrual cycle. Knowing the gestational age is extremely important for monitoring the normal development of the child and timely examination of the mother and fetus.

Belly at 4 months pregnant

Future mothers who are only in the first trimester are actively interested in the question: “What does the stomach look like at 4 months of pregnancy?”. This is not surprising, because in the first months there are practically no visible signs of "position", the tummy remains the same. Starting from the 12th (obstetric) week of pregnancy, the woman's body begins to change - the waist becomes smooth, the tummy is slightly convex, and the look of the future mother is blooming and attractive. As many men note, at 4-5 months, girls look very sexy and “appetizing”. But that is another question, which we will cover a little later.

Girls who, due to certain circumstances, hide their position, are interested in another question: “Is the stomach visible at 4 months of pregnancy?”. Yes, it is visible, but not much. Outwardly, you might think that the girl just had a hearty lunch. If you want to hide your pregnancy from prying eyes, give preference to loose clothing. In no case do not wear very tight pants that put pressure on the stomach and fetus! This is extremely dangerous for the baby.

Each woman has a special physiology, so you should not expect your belly to grow dramatically at 13 weeks. Moreover, some face a completely different problem, as discussed in forum threads such as: "4 month pregnant - belly does not grow." Don't panic! You can additionally consult a doctor and undergo an ultrasound in order to make sure that your baby is healthy and its normal development.

Abortion at 4 months pregnant

Not always the course of pregnancy goes smoothly and without problems. There are situations when abortion is simply necessary and vital for a woman. These are really difficult situations related to medical indicators. These include:

Detection of complex pathologies in the fetus;
Frozen pregnancy;
Deviations in the development of the fetus;
Serious threat to the life and health of the mother caused by pregnancy;
Somatic or psychological illness of a woman.

Despite medical indications and recommendations, the woman herself decides to have an abortion.

4 months is a late term for terminating a pregnancy, which indicates a possible risk to a woman's health. However, abortion at 4 months of pregnancy is possible. It is done surgically. The method seems creepy at first glance, but medicine does not stand still, offering safe ways to resolve the issue.

Signs of pregnancy at 4 months

Being curious about the course of pregnancy, you probably learned that in different periods of gestation, the symptoms vary slightly. For example, below are the symptoms of pregnancy at 4 months.

Attacks of toxicosis gradually decrease until they disappear completely.
The uterus stops pressing on the bladder as much as before;
Breast size continues to increase, but without painful manifestations;
Frequent heartburn, gas, indigestion;
Periodic weakness and malaise;
Increased appetite, the emergence of new eating habits;
Profuse white or clear discharge;
Frequent mood swings.

But the most interesting thing is the first pushes of your baby, which can be seen in a calm state.

4 months of pregnancy: fetal development

Although modern technologies do not stand still and continue to develop, we do not have the opportunity at any time to look at the condition of the fetus in the mother's stomach and evaluate visible changes. What changes does a child experience at 4 months of pregnancy?

The placenta becomes the main organ of metabolism;
The brain grows, as a result of which the first reflexes appear, the child begins to actively swarm in his mother's tummy;
The fetus begins to make the first respiratory movements, which indicates the development of the respiratory system;
Calcium is actively deposited in the bones of the baby, due to which the bones become harder;
The first hair appears on the head of the fetus, eyebrows and eyelashes appear on the face;
The proportions of the body are aligned;
The baby can already open his eyes;
Nails are being formed.

Feelings at 4 months pregnant future mother will change completely, as she will begin to feel her baby, his movements and manifestation of activity. This wonderful feeling is compared to a light tickling, flapping butterfly wings.

Sex at 4 months pregnant

During the second trimester, not only the baby changes, but also his mother. In the body of a woman, various kinds of hormonal changes occur, due to which she begins to shine, femininity and sexuality appear. Although it is not customary to discuss it in society, many men go crazy for their significant other during their pregnancy. Hence the question arises: is it possible to have sex at 4 months of pregnancy? Doctors not only do not prohibit making love, but even advise doing it regularly. Firstly, it allows you to improve blood circulation in the pelvis, and secondly, the good mood of the mother always affects the child. Explain to your man that it is possible to have sex, and this will in no way harm the baby. But at the same time, it is recommended to abandon rude behavior and abundant frictions.

Toxicosis at 4 months of pregnancy

As a rule, at the end of the first trimester, toxicosis practically disappears, the body adapts and begins to function normally. But there are individual examples when nausea and vomiting does not stop. This is no reason to panic! Only in rare cases does this indicate a problem. But if you are still worried about vomiting, see a doctor. Perhaps you should change your diet, start taking vitamins, or get a prescription for a safe anti-emetic drug to help you get through this difficult period.

If you are constantly throwing up at 4 months pregnant, use the following recommendations:

Increase your protein intake to 100 grams;
Do not deny yourself salty foods;
Drink more water, juices, avoiding tea, coffee and other drinks high in sugar, caffeine, dyes, and other harmful substances;
Completely give up convenience foods and fast food;
Try not to eat large portions;
Fill your diet with organic foods;
Give preference to whole fat milk;
Don't limit yourself to fruits and vegetables.

Ultrasound at 4 months pregnant

Ultrasound is a great opportunity to verify the normal development of the baby and look at the little miracle in real time. At the beginning of the second trimester, legs, arms and significant changes in the fetus will be visible. The examination will prevent the development of a particular disease, as well as other possible problems. In addition, you can get an ultrasound picture and paste it into a family album.

Discharge at 4 months pregnant

Dozens of processes take place in the body of a pregnant woman aimed at nourishing the fetus, maintaining tone, health, etc. Symptoms of changes and activity are completely different. The most visible is the manifestation of secretions. White and transparent indicate the normal state of your body and the fetus in your stomach. Brown discharge during pregnancy at 4 months should cause alarm in the mother, since in some cases they indicate possible deviations and pathologies. You can find out more at the appointment of a gynecologist.

The greatest concern is bleeding at 4 months of pregnancy. Small discharge is another reason to visit a doctor, but not a reason to sound a serious alarm. Perhaps this is just a sign of a burst vessel, a minor injury. In case of heavy bleeding, we recommend calling an ambulance.

Nutrition at 4 months pregnant

The wild appetite and strange eating habits of pregnant women are a classic joke among the people. When expectant mothers for the first time have a desire to taste herring poured with condensed milk, the question arises: what to eat at 4 months of pregnancy? You can eat almost anything. The only question is which of this will benefit your health and the growing body of the baby. Naturally, you should give preference to organic products, dairy products, meat, and refuse semi-finished products and food with a dubious composition. If you are prone to allergic reactions to certain foods, you should not use them during pregnancy so as not to harm the fetus.

Pregnancy 4 months: what happens

The 4th month is a great time to exhale for the expectant mother and stop worrying about the child. During this period, your baby has already learned to "eat", his body grows, his bones become stronger, weight gain is visible. The expectant mother blooms, a sparkle appears in her eyes, she rejoices at every push of the child. The risk of miscarriage is seriously reduced after the first trimester. But if you have a cold at 4 months pregnant or have ovarian pain, visit your doctor who will write a prescription for safe medicines.

Do's and Don'ts at 4 Months Pregnant

9 months is quite a long time. When preparing to become a future mother, you should know what is possible during pregnancy and what you should categorically refuse. From what is allowed, for example, flying on an airplane at 4 months of pregnancy will in no way harm you and your baby if you are completely healthy and feel good. It is also recommended to go to the sea, but not to be in the sun for a long time, to give up sunbathing.

List of standard "not" for pregnant women:

Tobacco, alcohol, caffeinated drinks and foods;
Raw meat;
Seafood;
unpasteurized milk;
abrupt movements;
Significant muscle tension;
Contact with toxic objects;
Use certain medications that can harm the fetus;
Carbonated drinks;
Uncomfortable clothes and shoes;
Irradiation with x-rays.

The list may be supplemented, depending on your individual characteristics, the tolerance of certain substances and the state of health for the current day.

The fetus at the seventeenth week of pregnancy photo: babycenter.com

The most fertile period of pregnancy has come - the 2nd trimester. A third of the way passed. Behind the difficulties of the first months: toxicosis, visiting doctors, passing tests. Anxiety and irritability replace lightness and energy. It is time to exhale and enjoy the position and new status. Pleasant changes await you.

4th month of pregnancy: signs

In the 2nd trimester, changes in the body of the expectant mother occur gradually, smoothly and do not greatly affect health. The symptoms of pregnancy at 4 months are minor and you may have already experienced them in previous months. In general, this relatively calm period will leave positive impressions.

The placenta has fully matured, and its work in ensuring the full and comfortable state of the baby has been established. In this regard, the volume of circulating blood in your body increases by an average of 40%. The heart starts to work harder. And if it is healthy, then such a load will not affect the general well-being.
Unpleasant signs of this period include constipation. Due to the size of the uterus and hormones, intestinal motility decreases, as a result of which this symptom occurs. If you do not pay attention to this, then hemorrhoids cannot be avoided, because the uterus will only grow. Therefore, it is better to take care of it now: drink more water, eat vegetables and fruits, walk and do gymnastics.
Unfortunately, many women at this stage develop warts (including in intimate areas), which cause anxiety. These are warts. If they increase in size, you need to inform your doctor. Don't worry, they are removed without the risk of complications in your position.
Other skin changes include hyperpigmentation. Freckles can darken, birthmarks grow. The strip from the navel to the pubis becomes more pronounced. Such changes are associated with the deposition of melanin, a substance that causes pigmentation. And the reason is in the hormones that are still rebuilding within you. After giving birth, everything will return to its place.

To prevent pigmentation, use safe cosmetics with sunscreens. If you want to lighten already existing spots, this can be done using masks based on lemon juice or sour-milk products.

Active growth of hair and nails will please any woman. In addition, their condition will improve significantly, which will be noticed even by others.
The mammary glands will continue to grow, especially the areola - the area covering the nipples.

The fourth month of pregnancy is the end of the first trimester and the beginning of the second. This period lasts from 12 to 16 weeks. By now, the condition of the expectant mother is stabilizing. The embryo is firmly established. Toxicosis replaces a good appetite. A more pronounced belly appears, the figure of a woman is rounded. It's time to think about changing your wardrobe.

Child development

The placenta is fully formed. It provides nutrition to the embryo, protects it from infections, removes waste products.

By this time, the laying of all the main internal organs had taken place. Some of them immediately take on the final form. And some, for example, the brain are formed gradually, in several stages.

Significant changes are observed in the embryo. For example, with regard to the nervous system, then:

The developing retina of the eye is already able to detect changes in light.
The auditory ossicles are formed. The fetus reacts to your voice or loud noises. During this period, it is recommended to start talking with the child.
There is a sucking reflex. On ultrasound, you can clearly see how the baby holds a finger or toe in his mouth.
Mimicry develops. He can squint, frown.
Swallows amniotic fluid and feels a change in their taste.
Active production of neutrons continues, up to 5000 nerve cells are formed in one second.
Grasping reflex. The kid catches his legs with his hands, pulls the umbilical cord.

At this time, you can already determine the sex of the child:

In boys, the testicles are sent to the scrotum, by the end of the 14th week the prostate is formed.
In girls, a uterus appears, a follicle is laid in the ovaries.

From the musculoskeletal system, the following can be observed:

The ossification of the skeleton begins. During this period, it is very important to consume enough calcium.
Milk teeth are laid and the dates when they will erupt.
Increases joint mobility.
Muscles are formed and strengthened. The child can already hold his head.

Endocrine system:

The adrenal glands are active.
The thyroid gland begins to produce thyroxine (it ensures the development and growth of cells, activates metabolism).
The pancreas secretes insulin, which controls the amount of sugar in the blood.
The pituitary gland produces a hormone (ACTH) responsible for the development of muscle tissue, skin pigmentation.
The work of the kidneys, which excrete urine into the amniotic fluid, is normalized.

As a result of the development of the muscles of the chest, a respiratory reflex is formed.
The lungs are not yet divided into alveoli, but the baby performs actions similar to inhalation / exhalation, absorbing and expelling amniotic fluid.

The immune system:

The thymus produces lymphocytes and teaches them to recognize and destroy viruses.
The bone marrow produces red blood cells and white blood cells.
Almost all the main components are present in the blood, and its group and Rh factor can be determined.

Digestive system.

The spleen is active.
Bile is produced by the liver.

Eyebrows, eyelashes, hair begin to grow, the body is covered with guns. Nails were formed, a pattern of fingerprints was outlined.

Depending on whether the child is blonde or brunette, the follicles produce the appropriate pigment.

Physical activity

The fetus begins to move at the age of 7-8 weeks. But a woman can feel the first signs of this only at the 4th month of pregnancy, sometimes later. But it should be noted that the absence of tremors after the 20th week is not a sign of deviations. Especially if this is your first pregnancy. In women who gave birth before these women, the abdominal muscles are more stretched and sensitive.

It feels like flatulence. But some compare, as if small bubbles burst in the stomach or butterflies flutter.

The activity of the child in the womb depends primarily on his mood and movements of the expectant mother. If a woman walks a lot, it is lulling. During rest, the child, on the contrary, is energetic. But it must be borne in mind that when a person is busy or passionate, he listens less to his feelings.

Woman's well-being

The fourth month of pregnancy is considered the easiest period. The body began to adapt to the new state:

Toxicosis is significantly reduced or disappears without a trace. Appetite increases.
Irritability and increased fatigue go away, there is a surge of strength, self-confidence, complacency. Anxiety about the unborn child does not go anywhere, but it becomes less than in the first trimester. As a rule, it is now that most people understand that pregnancy can be pleasurable.
The expectant mother continues to gain weight. On average, since the last menstruation, this is plus 5-6 kg. But a lot depends on height and physique. If the indicator is significantly different from the norm, a consultation with a gynecologist is necessary.
After four months of pregnancy, the woman notices that her hair has become unusually dense, and her nails have become stronger and grow faster. As a result of hormonal changes, progesterone produced by the body reduces natural hair loss and prevents delamination of the nail plate.
The temperature returns to normal, due to which the state of health improves.
The amount of whitish vaginal discharge increases.

Many women experience a burst of creativity. They feel an unexpected craving for knitting booties, sewing cute toys, creating culinary masterpieces in the kitchen. New hobbies emerge. Some begin to write stories, draw. Information is easy to digest. There may be an idea to learn a foreign language or get a second education. True, this period lasts several weeks, so it is better not to build long-term plans.

Stomach

The size of the uterus is actively increasing, and by the end of the 4th month of pregnancy, it rises from the small pelvis, where there is no longer room for it. Its bottom reaches the navel, as a result, the stomach is noticeably rounded. But if desired, an interesting position can still be hidden with skillfully selected clothes. The main thing is not to wear tight clothes and tight belts.

If you stand in front of a mirror and look closely, you will see a dark, vertical line, passing through the center of the abdomen and descending to the pubis. It appears due to the deposition of melanin pigment. During pregnancy, the strip may darken, but after childbirth it will disappear without a trace.

Sex

Intimacy has a beneficial effect on the baby and the expectant mother. But only on condition that the child develops normally, and there is no threat of miscarriage.

There are no significant restrictions in postures. The belly at 4 months of pregnancy is still small and will not interfere. Only need to avoid increased stress or pressure on the uterus.

Your doctor may limit your sex life if you have:

Bleeding from the vagina.
Tone.
Low location of the placenta.
Sexual infection.

In other cases, you should not deprive yourself and your spouse of pleasure. But abuse is not recommended. You can make love 2-3 times a week.

A woman is unlikely to be comfortable when her husband lies on top of her. The optimal position is the wife on the left side, the husband is attached behind.

Surveys

In addition to passing a general blood and urine test, it is necessary to undergo an examination by a gynecologist. The doctor will check:

Woman's weight.
Pressure.
The size of the uterus, with the help of palpation and a centimeter tape.
Fetal heartbeat.
Status of the cervix during vaginal examination.

In addition, the following examinations are required:

First ultrasound. If you haven't already, hurry up. According to the norms, it must be carried out up to 14 weeks.
A triple test is preferably carried out at 15-16 weeks. It detects the level of hormones AFP, hCG, E3 in the blood. As a result, it is possible to determine the risk of a child developing chromosomal diseases: Down syndrome, neural tube defects, Edwards syndrome.

But this study only identifies an increased risk. And with a poor test result, an additional examination of amniotic fluid is performed.

Possible problems

Although the second trimester is considered one of the easiest periods, a woman may face certain difficulties:

Areolas of nipples, freckles become darker. Perhaps the appearance of age spots, moles, including on the face. To avoid this, try to be less in the sun.
Heartburn. It occurs as a result of the fact that the uterus presses on the internal organs and gastric juice partially enters the esophagus. Raw carrots and potato juice work well for her.
Bleeding gums, caries. Maintain good oral hygiene and rinse your teeth with clean water after eating. It is advisable to visit a dentist.
Slight nasal congestion, possibly nosebleeds. As a result of an increase in blood volume, thin vessels can be damaged.
The formation of spider veins (varicose veins), exacerbation of hemorrhoids. Under the influence of hormones, vascular tone decreases. To prevent the occurrence of unpleasant diseases, it is recommended to walk more and add fiber-containing foods to the diet.
Falling iron levels in the blood.
Oily or brittle hair.
Increased sweating.
Dizziness.
Constipation.

There are pulling pains in the lower abdomen as a result of the growth of the uterus and sprains. This condition is considered normal and does not require treatment. But it is necessary to consult a gynecologist to exclude the possibility of a miscarriage.

Nutrition

After toxicosis, the appetite of the pregnant woman increases. To avoid problems with excessive weight gain, meet the body's nutritional needs and prevent constipation, it is necessary to balance the diet. It must contain the required amount of fats, carbohydrates and proteins.

Some tips for proper nutrition:

You need to eat fractionally, avoiding the feeling of hunger.
Breakfast should be nutritious. It would be nice to cook porridge with a side dish.
For dinner, leave easily digestible foods.
Between main meals, snack on fruits and vegetables.
It is useful to use lean fish and meat.
Dairy products and cottage cheese must be included in the daily diet. They will help to fill the lack of calcium, and improve intestinal motility.

Pomegranate, beef liver, green apples, dried apricots will reduce the manifestation of anemia, which is usually detected in the 4th month of pregnancy.
Drink plenty of fluids. Drink the main amount of water, juice, tea or compote before 5 pm.
Avoid potatoes, fresh cabbage, grapes.
If you are prone to edema, reduce your salt intake.
Limit sweets, cakes, chocolate. It is better to replace them with marshmallows, marshmallows, honey, jam. And it is desirable to eat in the morning, little by little.

Smoked, overcooked, fast food, sweet soda, alcohol and other harmful products should not be consumed. Coffee is allowed, but not strong and in limited quantities.

It is necessary to monitor the quality of food - it should be as natural and healthy as possible.

In the second trimester, the well-being of the expectant mother improves. And the risk of complications in the fetus is minimal. Now is the time to do what you've been putting off:

If you were planning to move, then the 4th month or a little later is the best time. Pregnant women are even allowed to fly.
Surveys by narrow specialists. If additional treatment or medication is needed, a developed placenta will be able to protect the baby from most drugs.
Repair in the apartment. It is necessary to make a plan so that all work is completed before the start of the 3rd trimester, when the woman can no longer cope with her usual workload.

In case of doubt, whether it is possible to perform certain actions, it would be useful to consult a gynecologist. You should also seek help if you feel unwell.

Behind the difficulties and anxieties of the first trimester, early toxicosis of pregnancy is gone, you have visited many doctors, passed tests. Embryogenesis has almost ended - the development of the embryo and the formation of the placenta. Harmful factors the environment is no longer so scary. It's time to breathe and enjoy, especially since you feel more energetic.

What happens in the body of a future mother at 4 months of pregnancy?

From this month, the uterus extends beyond the small pelvis and grows quite quickly in the abdominal cavity. At the beginning of the month, the bottom of the uterus barely shows above the pubic joint, and by its end it is almost at the level of the navel. To help the placenta in nourishing the growing fetus, your body increases the volume of circulating blood. An increase in blood volume by 30-40% adds work to the heart. If the heart is healthy, then such a load will be invisible to you. Many specific skin and hair changes occur during pregnancy. Moles and freckles darken, hyper- and hypopigmented spots appear on the skin, as well as a dark line running from the navel to the pubic bone. All of these phenomena are associated with another "trick" of hormones - the deposition of a special pigment substance called melanin. After giving birth, they go away on their own. In order to reduce the likelihood of such troubles, use sunscreen for the face (at any time of the year) and body (when you plan to stay in the sun). To slightly lighten existing spots, you can use whitening masks based on fermented milk products and lemon juice.

The increase in the mammary glands continues, especially the areolas - dark areola.

Future baby at 4 months pregnant

By the end of the fourth month, the fetus is fully supplied with everything necessary thanks to the already formed placenta. There is a relatively quiet period for you. The placenta not only transfers food and oxygen from the mother to the fetus - it also performs the function of removing harmful substances, waste products of the fetus with the venous blood flow, protects the fetus from the penetration of viruses, bacteria, harmful chemical compounds, and is also a chemical laboratory that synthesizes proteins and hormones necessary for the fetus.

The child has the first reflexes - sucking and swallowing. His arms bend at the elbows and wrists, he is able to clench his palms into fists and grab something. He becomes very flexible, can swim, suck his thumb. The baby moves a lot, but the vast majority of expectant mothers will feel the first movements only in the next month of pregnancy.

This month, the embryonic fluff - lanugo - appears on the skin of the baby. It performs a protective function - it delays the waxy substance secreted by the skin. Even during pregnancy, lanugo will be replaced by thicker and longer vellus hair. Already in this month, hair on the head begins to grow, eyebrows and eyelashes appear, nails form.

The baby produces urine and releases it into the amniotic fluid every 40-45 minutes. However, the baby's urine is not the main component of amniotic fluid. The origin of the waters is still a mystery to scientists; it is assumed that their main producer is the cells of the fetal bladder. Amniotic fluid is completely renewed every 2-3 hours, which maintains their sterility and constant chemical composition. This is the first "habitat" of the child, and it performs many functions, including protection from mechanical damage, provides freedom of movement, and is involved in metabolism. In addition, by drawing amniotic fluid into the lungs and pushing it back, the baby trains in breathing.

This month, boys-to-be develop a prostate, and girls' ovaries, containing millions of eggs, descend from the abdomen to the hips. It is already possible to recognize the sex by the external genital organs, although this is not always possible with an ultrasound examination at this time.

Your child's face continues to take shape. The ears from the side of the neck rise to the right place. Although the ear is not yet fully formed, the child may respond to external noises with changes in motor activity.

By the end of the month, the baby's eyes open, the retina becomes sensitive. During this month, the baby grows from 12 to 20 cm, its weight reaches 200 g by the end of the month.

Feelings of the expectant mother at 4 months of pregnancy

Your stomach gradually begins to slightly round and the waist is smoothed out. Feeling better, appetite increased. It is better if the weight gain for 4 months of pregnancy is from 1 to 4 kg. Tight clothes can become tight, but you can still get by with the usual “non-pregnant” wardrobe.

A rapid increase in the uterus causes stretching of its ligamentous apparatus, which many pregnant women perceive as a sharp pain in the lower abdomen and in the inguinal regions. Such pains come on suddenly and pass quickly.

More fluid in the body causes increased sweating and vaginal discharge. These phenomena are safe, although they require additional hygiene procedures. Sometimes small blood vessels do not withstand the additional load, so nosebleeds are frequent in pregnant women and bruises are easily formed. For recurring nosebleeds, make sure that the air in the apartment is humidified, besides, be sure to tell your doctor about bleeding.

There is also an unpleasant surprise that a “calm” month is preparing for you. Just at this time, constipation may appear. Hormonal changes in the body and the growing uterus slow down intestinal motility, which causes a delay and compaction of food masses in it. Constipation in itself is unpleasant, besides, they can provoke the development of hemorrhoids - varicose veins of the rectum. Hemorrhoids appear in the form of nodules of veins located in the anus or inside the rectum. With constant tension during constipation, such nodules often become inflamed, swell, and bleed. If constipation can be dealt with, then such complications do not happen.

By the end of the fourth month, multiparous or thin women may feel the movement of the fetus.

Psychology 4 months of pregnancy

Many women claim that they realized their impending motherhood just at the border of the third or fourth month of pregnancy, when the first difficulties of the “interesting situation” receded. This is not surprising: during this period, you increasingly begin to experience joyful excitement, enjoy and take care of it. This amazing feeling will help to cope with any difficulties better than any medicine.

Possible deviations from the norm at 4 months of pregnancy

Now one of the main causes of miscarriage can be isthmic-cervical insufficiency (ICI). The bulk of the muscle bundles of the cervix is located around the internal opening (pharynx) of the cervical canal. These muscle fibers normally tightly compress the internal os, holding the fetus inside the uterus. With unsuccessful births, miscarriages, abortions, hormonal disorders, muscle fibers are destroyed, scar tissue comes in their place, which cannot play the role of a “lock”. Then, as the pregnancy grows, the fetal bladder protrudes into the cervical canal, its membranes become infected, and a miscarriage occurs. The doctor can suggest the presence of ICI with a manual examination, but the final diagnosis is made by ultrasound. Treatment may include surgical suturing of the cervix or/and placement of a special plastic ring around the cervix. With such a diagnosis, you should be very careful, lie more and give up homework.

As mentioned above, at this time the placenta completes its formation, so right now it is possible to form primary placental insufficiency - a condition in which the placenta does not provide the fetus with oxygen and nutrients properly. Primary (early) insufficiency occurs during the formation of the placenta during implantation, early embryogenesis and the formation of the placenta under the influence of genetic, endocrine, infectious and other factors up to 16 weeks of pregnancy. It is manifested by a picture of a threatening abortion (the appearance of pain in the lower abdomen, in the lower back, bloody discharge from the genital tract), the development of congenital malformations of the fetus. For early diagnosis, the determination of the level of placental hormones in the amniotic fluid, blood and urine of pregnant women is used. The change in these levels occurs long before the first symptoms, which allows timely treatment. Such a course may include antispasmodics (NO-SHPA, PAPAVERIN), vitamins, herbal sedatives, COCARBOXYLASE, TRENTAL, METIONIN, ACTOVEGIN.

In addition to taking medication, a woman should eat well, sleep a lot and walk in the fresh air (3-4 hours a day).

Necessary medical measures at 4 months of pregnancy

In this month of pregnancy, in its normal course, you will visit the doctor once. The doctor will talk about the results of the tests, explain the parameters of the ultrasound examination. Perhaps he will prescribe an additional examination for infections.

If any of the sexually transmitted infections that adversely affect the development of the fetus are detected during the initial examination, it is now advisable to conduct a full course of treatment, including antibacterial drugs. After treatment, be sure to undergo a follow-up examination.

Between 15 and 20 weeks of pregnancy, a test is done for alpha-fetoprotein (AFP), human chorionic gonadotropin (CG), and unconjugated estriol (NE). In some congenital anomalies (for example, Down's syndrome, craniocerebral hernia, splitting of the anterior abdominal wall of the fetus), the levels of these substances in the blood of pregnant women may deviate from the norm. If the risk of such anomalies is high, it is advisable to do an analysis at the 15-16th week of pregnancy in order to have time to repeat it if necessary. Risk factors for congenital anomalies include: age over 35 years, the presence of children with malformations in the family, recurrent miscarriage, exposure to radiation, harmful production factors, and certain medications.

If, according to the results of a double test, which a pregnant woman takes at 10-12 weeks (we talked about it last month), and a triple test, there is reason to assume the presence of some kind of pathology, then the pregnant woman will be offered to undergo additional studies.

Women who are at risk of giving birth to a child with malformations are offered to do an amniocentesis at this time - in this case, a needle is passed through the uterine wall under ultrasound control and the required amount of amniotic fluid is taken for examination. They determine the genotype, including sex, fetus, AFP level (an indicator by which one can assume the presence of malformations of the central nervous system), bilirubin (a marker of hemolytic disease), hormones, and proteins. This study allows you to exclude many diseases, accurately diagnose, in the fourth month it is the safest.

From about 13-14 weeks of pregnancy, if the fetus is in a position convenient for examination, ultrasound can determine its gender. However, it is not worth doing an ultrasound only for this reason, especially since at such a time the results may be erroneous. It is better to keep your curiosity until next month, when the second scheduled ultrasound will be performed.

Visit the dentist in the fourth month. Tell him about your pregnancy. The fourth to fifth month is the optimal time for dental treatment, if necessary. At this time, you can already use some anesthetics - the doctor will select the safest for you and the baby. X-rays are also acceptable if needed.

Under the influence of hormones, your gums become sensitive and may bleed. Brush your teeth regularly, rinse your mouth with a decoction of chamomile. An infection in the oral cavity is as dangerous for the unborn baby as any other.

Behavior rules

It's time to rethink your vitamin preparations. If until the fourth month folic acid, vitamin E and iodine were the main ones, now it is necessary to take B vitamins, macroelements (calcium, phosphorus, magnesium) and microelements (iron, zinc). At this time, it is best to take special "prenatal" vitamin complexes. Prenatal vitamins in composition differ from conventional multivitamins in the increased content of iron, zinc and folic acid. Their composition is optimal for a pregnant woman.

Vitamins are usually well absorbed when taken with food or at bedtime. Multivitamins, like other drugs and foods, can cause an allergic reaction, in which case you can try to replace the drug with another one. If, for some reason, you cannot take a multivitamin complex, then iron supplements must be added to the list of monopreparations for this period to prevent anemia in pregnant women. Anemia is a decrease in the concentration of hemoglobin in the blood (a substance that carries oxygen) below 110 g / l. Iron is one of the constituents of the hemoglobin molecule. The daily requirement for iron at this time is 2-4 mg per day. However, iron is very poorly absorbed from both food and medicines. If iron is taken in tablet form, the recommended prophylactic dose is 60 mg per day. The same amount of iron is found in pre-natal vitamins. A lot of natural iron is found in buckwheat, beef, liver, green sour apples, dried apricots, cherries, pomegranates.

At this time, it is permissible to increase the number of calories consumed with food by about 300 per day. These "extra" calories will be spent on the growth of tissues of the mother and baby. If there are not enough calories, then the necessary proteins will be processed in the metabolic process as a source of energy, instead of being spent on growth and development. Expand your diet with protein foods (meat, cottage cheese, fish, poultry, cereals). In addition, the diet of the fourth month must necessarily include fresh vegetables, herbs, vegetable oil, cereals (all cereals are useful, except for semolina - it contains a lot of easily digestible carbohydrates and few useful substances), dried fruits, sour-milk products.

If 10 years ago, pregnant women were advised to move less and rest more, now sports are considered very useful for both mother and unborn baby. Check with your doctor before hitting the gym, especially if you're at risk or have had a miscarriage. You should not engage on an equal footing with your non-pregnant girlfriends. Even if you have an ideal pregnancy, you have become much heavier, you get tired faster, and besides, you have to “breathe for two”, supplying yourself and the baby with oxygen. Best Views sports for pregnant women - walking, swimming. The "forbidden" include extreme and game sports, skiing, cycling.

Household chores at 4 months pregnant

Use the temporary lull of the fourth month to resolve accumulated domestic issues. And if you have Personal car, then it helps in many ways to do everything quickly. However, decide whether it is really necessary now to drive a car on your own. Remember that pregnancy affects concentration, you get tired faster, and most often the cause of an unpleasant accident on the road is fatigue. If you continue to use the car, it is important to buckle up correctly: to do this, place the lower section of the belt under the abdomen across the hips, and the upper one above the abdomen, you can also purchase a special seat belt designed for pregnant women.

Many women are worried about whether it is possible to dye their hair and nails. Of course, paint and solvents are not very useful for inhalation. However, if the refusal of cosmetic procedures causes fear of looking in the mirror, then it is better not to refuse them. In the end, the harm from constant dissatisfaction with oneself can be equated with chronic stress. Alternatively, you can dye your hair once in your natural tone - and solve the problem until the very birth. You can use tinted shampoos or coloring balms: they are safe.

You may already feel tight in your trousers and skirt, so it's time to think about special clothing. Comfortable, comfortable maternity clothes are what you need right now. It's also time to buy a couple of pillows. From the fourth month, the most comfortable and safe sleeping position is on the left side with one leg bent and a thin pillow between the legs. Recommendations to sleep on the left side are due to the fact that in this position the pregnant uterus does not put pressure on large vessels, does not interfere with blood circulation in the placenta. You can attach another pillow to the lower back so as not to “roll” onto your back. This position helps the blood supply to the placenta and improves kidney function.

How to deal with constipation during pregnancy?

Drink more clean non-carbonated water, at least 1-1.5 liters per day. Drink a glass of water in the morning before breakfast. You can replace morning water with a glass of kefir.

The fourth month opens the second trimester - the most calm and comfortable period of pregnancy. By this time, the manifestations had almost disappeared, the woman underwent an initial examination at the antenatal clinic, the recently formed placenta reliably protects the fetus from the negative effects of the external environment. The unborn child has already formed all the organs, and the baby's life support system has begun to function.

During the fourth month of pregnancy, the uterus grows very rapidly in size. If by the beginning of the first week of this month it barely rises above the pubic joint, then by the end of the fourth month the bottom of the uterus approaches the level of the navel. Another significant change is an increase in blood volume by 30-40%. This increase in circulating blood volume puts more stress on the heart muscle. A healthy heart copes with it, and in case of pathology of cardiovascular activity, these changes can affect the work of the heart in a bad way.

An increase in the level of melanin in the blood affects the condition of the skin and hair - moles darken, age spots appear on the skin, the strip of skin between the navel and the pubic bone, the skin of the perineum darkens. These changes will disappear some time after childbirth. To reduce the intensity of the appearance of spots, you need to actively use sunscreen for the face.

The stomach at 4 months of pregnancy may be completely absent, and most pregnant women still use the usual clothing models. However, an increase in waist volume is already noticeable, and in some women, a rounding of the abdomen. Since the uterus is growing rapidly, severe pain in the groin and lower abdomen may appear due to sprain. They pass as quickly as they appear.

Due to the increase in the total volume of fluid in the body, a woman feels. The volume of vaginal discharge also increases. The load on the circulatory system causes a violation of the integrity of small vessels, bruises and nosebleeds. They may appear less frequently if the air is intensively humidified in the dwelling.

Due to frequent constipation, prerequisites for - varicose veins of the rectum may appear. Outside and inside the anus, venous nodules appear, which bleed when straining, become inflamed and swell.

A pleasant sensation for women undergoing a second and subsequent pregnancies, and for slender thin women, is the feeling of the first movements of the unborn child.

The placenta is a universal organ - it protects the fetus from pathogenic bacteria and viruses, synthesizes the necessary proteins and hormones, removes the waste products of the unborn child with venous blood, filters out harmful substances, delivers oxygen and nutrients from the mother's body. Thanks to her, a woman manages to avoid accidents and not be afraid of abortion due to the negative impact of the external environment.

The baby's waste products are urine, which the fetus releases every 40-45 minutes into the amniotic fluid. The amniotic fluid is renewed every 2-3 hours, it is sterile and has a constant chemical composition. Amniotic fluid protects the fetus from damage, stimulates the baby's metabolism, and allows him to move freely. At the 4th month of pregnancy, the fetus imitates respiratory movements, drawing water into the lungs, training the respiratory system.

The weight of the fetus by the end of 4 months, and its height increases from 12 to 20 cm.

The unborn child has already formed a swallowing and sucking reflex - from time to time he sucks his finger. The arms are bent at the elbows, the palms and fingers can fold into a fist, the fetus can grab the umbilical cord, touch its face. Despite the fact that the baby moves a lot and willingly in the uterine cavity, these gentle movements are not yet fully felt by the woman, they can easily be mistaken for sensations from intestinal motility.

A light and thin fluff appeared on the skin of the child - lanugo. It covers the entire body of the fetus, and will disappear only after childbirth. The fluff helps to keep the original lubricant on the body, which protects the skin from the action of amniotic fluid. Eyebrows, hair, eyelashes are outlined on the head and face of the fetus. On the fingers, the formation of nails begins.

The genitals of the child are in the process of formation, but its gender can already be determined. When conducting an ultrasound, it is still very difficult to distinguish a boy from a girl. In the male fetus, the prostate begins its development, in future girls, the ovaries already contain eggs, and have descended into the small pelvis from the abdominal cavity.

The baby's ears gradually take their permanent place, rising from the side of the neck to where they should be. The formation of the inner ear is not yet complete, but the baby is already reacting to strong noise. The sensitivity of the retina increased, and the fetus was able to raise and lower the eyelids.

The psychological state of the pregnant woman

Women undergoing their first pregnancy, at the fourth month, finally realize that expecting a baby can bring positive emotions. They begin to feel that they have an extremely important mission to perform, and they anxiously await the first movements of the fetus. Those who already have children know that in the second trimester of pregnancy they will enjoy the joyful excitement during a kind of communication with an unborn child, from his first gentle, and then more and more tangible movements and movements.

During the fourth month of pregnancy, if there are no deviations from the normal course, the woman visits her doctor once. The obstetrician-gynecologist will evaluate the results of previously passed tests, ultrasound data. If the results of a smear test for urogenital infections are unfavorable, a course of treatment with antibacterial drugs should be completed within the fourth month. After a course of therapy, a control examination of a smear from the vagina is prescribed.

At the end of the fourth month, the doctor may order tests related to screening for the second trimester of pregnancy. It is carried out from 15 to 20 weeks of the gestational period. This screening includes a blood test, or “triple test,” and another ultrasound.

Analysis of the concentration in the blood of the hormone hCG, or chorionic gonadotorpin;

Analysis for ?-fetoprotein (AFP);

Analysis for unconjugated (free) estriol.

If the level of these markers deviates significantly from the norm, the risk of having a child with congenital pathologies is high:

craniocerebral hernia;

Cleavage of the anterior abdominal wall of the fetus.

Risk factors:

The woman's age is over 35;

Radiation impact;

Harmful working conditions;

Side effects drugs;

The presence in the family of children with pathologies;

History of habitual miscarriage.

An increased content of markers indicating a high risk of anomalies in the results of screening of the first and second trimester is a reason for amniocentesis. This study is voluntary, it consists of a puncture of the uterus under ultrasound control to collect amniotic fluid. This is an extremely informative analysis, which is performed only with significant indications for it. One procedure out of 200 ends with spontaneous abortion.

According to the results of the study of amniotic fluid determine:

Genotype and sex of the fetus;

The level of ?-fetoprotein, indicating malformations of the central nervous system;

Since nausea no longer accompanies meals, a pregnant woman's appetite increases. You should not thoughtlessly eat various dishes, because there is a danger of weight gain in excess of the permissible norm. If you count from the initial weight before pregnancy, at this time the increase should be no more than 2-2.5 kg.

The optimal diet is to eat often, but little by little, without overeating. Most of the diet is consumed in the morning, during lunch and breakfast. In the morning they mainly eat cereals, dairy products, at lunch - hearty meals, and in the evening it is better to leave easily digestible foods. For snacks, it is better to use not cookies and sandwiches, but fruits and vegetables.

The use of salty foods is limited, it is better not to salt food in order to avoid edema. Smoked meats, fatty and fried foods, semi-finished products are banned. Sweets, rich pastries can lead to an increase in excess weight.

Very helpful products. containing protein - meat, fish, cottage cheese, cheese. Dairy products will not only make up for the lack of calcium in the body, but also help to improve digestion and bowel function. Recommended for the use of beef, liver, apples, dried apricots. In practice, the doctor will recommend supplementing such a diet with iron supplements.
Problems 4 months - the threat of miscarriage and constipation

Despite the fact that the threat of miscarriage is no longer as great as in the first trimester, it still exists. The main reason is cervical insufficiency. It occurs due to the weakness of the muscle bundle, which normally holds the internal os of the cervix tightly compressed. The pharynx of the cervix does not hold the fetal bladder for the following reasons:
The diagnosis of "istvico-cervical insufficiency" threatens with infection of the membranes and death of the fetus. It is put on palpation, confirmed by ultrasound. Treatment is a surgical suture on the cervix or a ring on the cervix. A woman with such a diagnosis is categorically not recommended to strain, do housework.

Primary placental insufficiency is another risk factor for maintaining pregnancy. In this condition, the fetus does not receive the right amount of oxygen and nutrients due to endocrine disorders, the action of an infection, or due to a genetic factor that manifests its effect before the 16th week of pregnancy.

Symptoms of placental insufficiency are similar to those of a miscarriage:
Due to insufficient supply of nutrients to the fetus, congenital malformations may occur. Diagnosis - a study of the level of placental hormones in the urine, blood and amniotic fluid.

Treatment of placental insufficiency:
- Methionine;
  
  Soothing herbal preparations.
Bleeding

The appearance of bloody discharge, accompanied by pain in the abdomen and lower back, is a very dangerous symptom that indicates the onset of spontaneous abortion. The discharge is bright red and may contain blood clots. If these symptoms appear, you should immediately seek emergency help. If timely measures are taken, miscarriage can be prevented.

Minor painless discharge that appeared after an intimate relationship may be a sign of cervical erosion. This condition should be treated after childbirth.
intimate relationship

The well-being of a pregnant woman at 4 months improves significantly, she becomes more active and energetic. If the doctor sees no contraindications for intimate relationships, you should not refrain from them.

Possible contraindications:
In addition, for many women, under the influence of hormones, libido only increases, and positive emotional experiences will benefit them.

Video about the rules of conduct and features of the course of the fourth month, mandatory examinations:

Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.