On the 38th week, the body weight of the fetus fluctuates within 3145 plus or minus 441 g, on average, most often 3000 g. The length of the baby’s body varies between 49.6 plus or minus 2 cm, and averages 50 cm. In principle , during the remaining weeks of pregnancy, the baby will not grow as much and gain weight, and its size will increase slightly until the 40th week, and in some cases will remain the same as at the 38th week. That is, the size of the fetus at the 38th week can be considered final, with about the same weight and body length, it will be born very soon.
In general, at this time, the weight and length of the baby’s body fluctuate significantly, since they are due to the individual characteristics of the child’s constitution and the nature of the mother’s diet. For example, if there are two women with a completely identical diet, but having a different constitution, then the size of the children they are carrying will be different. Thus, a large, tall, and wide-boned mother will have a child more than a short, thin, and thin-boned mother.
At the 38th week, the baby is already considered mature, and therefore in the case of birth at this time it will be considered full-term. And this means that all the major organs, tissues and systems of the fetus are fully formed, functioning and ready for life outside the womb. And in the last weeks of pregnancy, their functioning is simply being debugged, so to speak, preliminary tests before "by launching".
The baby’s skin has completely smoothed out, now it has a characteristic delicate pink look, like a newborn baby. Gun hair (lanugo) from the skin disappeared, but hair on the head, eyebrows, eyelashes, nails grew.
A sufficient amount of meconium (original feces) has already formed in the intestine, which has formed over the course of long weeks of exfoliated cells of the intestinal mucosa and bile. Meconium will stand out from the intestines of the baby after his birth. However, sometimes the fetus secretes meconium in the amniotic fluid, while still in the womb, and in this case, the water is painted in a greenish tint, and the baby is born covered with greenish mucus.
If a woman bears a boy, then on the 38th week his testicles finally descend into the scrotum.
The fetus moves relatively little – firstly, it protects the forces for childbirth, and secondly, it is very crowded in the uterus, as it has already reached large, impressive sizes, which do not allow free movement in tight spaces.
Since, on the one hand, the fetus already occupies all the free space in the uterus and is very crowded, and on the other hand, it limits its movements, resting and accumulating strength to the birth (during which it will also work), the baby at the 38th week moves slowly, smoothly, gently, relatively rarely, for a long time is in one pose without movement at all. The movements of the fetus are in the nature of neat slow butting, popping, moving, or stops by various parts of the body into the walls of the uterus. He no longer tumbles, does not make sharp, jerky and high-amplitude movements.
If the child rests on any part of the body in the anterior wall of the uterus, then its imprint will be visible on the stomach. For example, if the baby rests on it manually, then the print of his palm will be visible on the stomach. Such prints are so well visible that some couples even photograph them.
Despite the fact that the frequency of perturbations and their sharpness significantly decreased on the 38th week, the expectant mother still feels well and clearly all the movements of her child. After all, he makes them with sufficient force, which his muscles have already gained. Stirring of the fetus can still give the mother noticeable discomfort and pain in the ribs, stomach, liver and intestines, since it is in these parts of the body that the baby most often pushes, kicks, and rests.
In addition to the typical, calm and slow movements, the baby can make sudden movements that cause a strong, but short-term pain to the woman. Such abrupt, atypical for the 38th week movements are always provoked by various external factors to which the child reacts. And since the baby at the 38th week already perfectly sees the outlines of the surrounding world through the stretched skin of the abdomen, perfectly hears sounds, distinguishes the voices of loved ones, smells, touches the mother’s stomach, and also feels the mother’s mood and feelings, he can react with sharp movements practically on any external factor that he does not like. This means that when sudden movements of the baby appear, you need to calm down and try to eliminate external stimuli: bright light, unpleasant smell, loud sounds, stress, fear or other strong emotions from the mother.
Sometimes the fetus begins to move actively and abruptly for no apparent reason, and in such situations its sharp movements are not isolated, but systemic and continue for some time. This situation indicates that the fetus lacks oxygen, and with active movements it tries to speed up blood flow, thereby increasing the amount of oxygen delivered to the tissues. If you suspect that the baby suffers from hypoxia, you need to perform breathing exercises or stand on all fours for 10 – 15 minutes to eliminate the clamping of blood vessels and restore blood flow to the placenta.
The baby during the day moves unevenly and nonconstantly, without a clear pattern, due to the presence of its own sleep and wakefulness regime. In other words, the baby alternately sleeps and is awake, and, accordingly, moves when it does not rest. It is almost impossible to predict the moments when the fetus is asleep, and when it is awake, since it determines its mode itself. Therefore, in some moments, the baby is motionless, while in others, on the contrary, it makes several movements within an hour.
Although there are two main points in which the baby moves and sleeps. So, more often than not, the fetus does not move when a woman moves, that is, she goes down the street, does housework, etc. During these periods of movement of the mother’s body, a swaying of the abdomen, which seems to rock the baby, as in a wheelchair on springs, is caused. Because of this effect of motion sickness, the baby just falls asleep and does not move while the mother is actively moving. But it is worth it for the mother to sit down or lie down to rest, as the effect of motion sickness disappears, the baby wakes up and begins to move, which is very well felt by the woman. Therefore, many pregnant women note a paradox – while they walk, the baby is calm and does not move, but it is worth sitting down to relax, as the fetus begins to move actively.
It should be noted that the fetus begins to actively move after eating the mother. In this case, the reason is simple – the blood glucose level rises, and the fetus uses it to generate energy for their games.
In addition to perturbations, a woman may feel periodic rhythmic flinches inside the abdomen, which are caused by hiccups in the fetus. Hiccup is not dangerous and passes quickly, so you should not be afraid of such jerks.
The woman must feel the movement of the fetus every day. But since the baby is alternately sleeping and awake, you should not count them every hour – this only leads to excessive anxiety. It is enough just to record the amount of movement within 12 hours – normally there should be at least 10. If the kid moved 10 or more times in 12 hours, then everything is fine. If the fetus moved for 12 hours less than 10 times or did not move at all, then this indicates that it is not all right, and in such cases it should be immediately called "First aid", to be hospitalized in the maternity hospital so that the doctors could take the necessary steps to save the child.
Ultrasound and tests
Women who were followed up in the consultation and underwent the necessary examinations are not routinely prescribed an ultrasound scan at week 38. In general, at this time of pregnancy, ultrasounds are performed solely for specific purposes, for example, when the umbilical cord is entangled in the fetal neck or to clarify the position and position of the baby before birth. In a word, ultrasound on the 38th week is carried out only according to indications, when there are specific symptoms that make one suspect that not everything is in order with the fetus.
The only situation where an ultrasound scan can be scheduled on the 38th week is the upcoming prenatal hospitalization, when you need to clarify at the time of admission to the maternity hospital the condition of the fetus, uterus, umbilical cord, amniotic fluid, cervix, etc. Also, a planned ultrasound scan at the 38th week can be given to women who have not been seen by a gynecologist before, and for the first time came to a consultation with a doctor.
At the 38th week, cardiotocography (CTG) is more often prescribed, which allows to detect hypoxia in the fetus, and based on this, decide whether it is necessary to carry out early delivery without waiting for the natural onset of labor. Indications for cardiotocography are the following situations:
- Suspected cord fetal neck
- Abnormal heart rate (frequent or rare) in a baby
- Oblique or transverse location of the fetus in the uterus
- Suspicion of heart or CNS malformations in a child
- Suspicion or pathology of the placenta (for example, early aging, small thickness, placenta previa)
- One umbilical artery
- Malovodie or polyhydramnios that were previously diagnosed
- Fetal growth according to fetometry
- Diabetes or hypertension in a pregnant woman
- Rhesus conflict in women with Rh negative blood, detected on the basis of the determination of antibody titer.
At the 38th week, women need to pass a small set of tests, namely, a complete blood and urine test for all expectant mothers, and an analysis for antibody titers to women with Rh negative blood (if they were not given anti- D-immunoglobulin).
Urinalysis is given to determine the risk of pre-eclampsia and identify hidden diseases of the urinary system. So, if there is protein in the urine, this indicates a high risk of preeclampsia, which is a terrible complication of pregnancy that can lead to the death of the mother and fetus. At high risk of pre-eclampsia, prophylactic treatment is prescribed to reduce this risk, which consists in taking calcium (1 g per day up to the 40th week). But if there is no protein in the urine, then the risk of pre-eclampsia is low, and in this case, prophylactic treatment is not carried out, since it is not necessary.
If leukocytes, erythrocytes, cylinders, mucus, bacteria or epithelial cells are found in the urinary sediment, this is a sign of diseases of the organs of the urinary system. In such cases, the necessary treatment is prescribed.
Complete blood count is done to detect anemia and other diseases that occur with unobtrusive symptoms.
But the analysis of antibody titers is given in order to identify Rh-conflict, which can develop between the body of a woman with a negative Rh factor of the blood, and the body of the fetus, in which the blood is Rh-positive. Rhesus conflict is a serious complication of pregnancy that can cause hemolytic disease of the newborn. Therefore, it is trying to identify as early as possible. If antibody titers turn out to be high, then this indicates the presence of Rh-conflict, in which case the doctors will carry out an early delivery in order to reduce the severity and strength of the lesions of the baby’s organs with hemolytic disease.
It is not necessary to pass any other tests in the 38th week of pregnancy. But if a woman has complications, the doctor can prescribe any other additional tests and examinations that, in his opinion, are necessary.
Visit to the obstetrician-gynecologist
At the 38th week, it is necessary to routinely visit an obstetrician-gynecologist if a woman does not need to go to the maternity hospital for antenatal hospitalization. A consultation visit must be scheduled for such a day of the 38th week, so that 7 – 8 days pass from the last visit to the gynecologist. It is necessary to take with you all the results of tests and examinations that have not yet been seen by the doctor, as well as documents, given that, if necessary, the gynecologist can send to the maternity hospital directly from the consultation. First of all, a pregnant woman should have all the documents with herself, and things can be brought by her relatives a little later.
Reception at the gynecologist usually begins with a survey, during which the doctor tries to comprehensively assess the condition of the woman, the fetus, the course of pregnancy, and identify possible complications. To do this, during the conversation the doctor or midwife ask questions of the following content:
- What symptoms and complaints do women have, how often do they appear, what provokes them, what can they stop?
- How often does a woman feel fetal movements during the day when she felt the movements of the baby for the last time?
- Are there bloody vaginal discharge?
- Did the nature of the discharge change in the last 1 to 2 weeks, what specifically changed, did anything unusual appear, were there discharges that caused discomfort, pain, itching, or burning?
- What is the nature of discharge from the genital tract (color, smell, quantity, texture, impurities, etc.)?
- Does a vaginal discharge have a relatively large amount of unclear, yellowish water with a sweet aftertaste and smell (sweetness is easily determined by the fact that the skin of the perineum and thighs becomes sticky and shiny)?
- Is there a feeling of moisture in the crotch or periodic causeless wetting of underwear?
- Are there persistent headaches?
- Are there any visual impairment of the type of flashing flies, spots, flashes, transparent spiral before his eyes?
- Is there or was redness, swelling, burning or itching in the genital area?
- Are there pains or burning sensations when urinating and back pain?
- What character have abdominal pain, when they arise, what provokes, how long do they last, what do they pass from?
- Are there sudden sudden swelling of the hands and face?
After completing the survey, the doctor or midwife produce a general and external obstetric examination. General inspection consists in weighing, measuring blood pressure, calculating weight gain. Examination of the skin, mammary glands, legs and anterior abdominal wall is also performed. The skin is examined to identify lesions, redness, or inflammation. The abdominal wall is examined to assess its viability, elasticity and muscle strength, the presence of discrepancies in muscle fibers and hernias. Legs are examined for varicose veins. And the mammary glands are examined to assess their condition, the degree of readiness for breastfeeding of the infant, as well as to identify mastitis, lumps, etc. All results of the general examination must be recorded in the medical records.
If a woman has varicose veins, the doctor will recommend that she wear compression knitwear (stockings or socks) without fail. These medical devices reduce the severity of swelling, pain and fatigue in the legs and reduce the risk of thrombosis, which is significantly increased in case of varicose veins. If the woman’s legs just simply swell up and get tired, then the doctor will also recommend her to wear compression underwear, but in this case it is not necessary, since the risk of thrombosis is not significantly increased.
After an external doctor or midwife, an external obstetric examination is performed, which consists of listening to fetal heart tones, counting the heart rate, determining the position and position of the fetus, measuring the circumference of the abdomen, the height of the uterus and the uterine tone.
Listening to the tones of the heart, determining their sonority and rhythm, counting the heart rate of the fetus is performed by an obstetric stethoscope, which the doctor simply puts on the anterior abdominal wall in the area where the baby’s heart is located. This simple method allows to suspect a number of different complications, such as, for example, fetal hypoxia, entanglement of the umbilical cord neck. If, as a result of listening to the heartbeat, the doctor suspected the presence of pathology, he sends the woman to other examinations that will accurately determine the cause of the abnormality of heart sounds.
The position, presentation of the fetus and the assessment of the tone of the uterus is made by hand, by simply probing the anterior abdominal wall. Under the position of the fetus understand how it is located in the uterus – vertically, horizontally or obliquely. If the head / butt of the fetus rests against the small pelvis, and the buttock / head against the diaphragm, then the position is considered longitudinal and correct. From it, the baby can be born into the world through natural paths.
If the fetal head rests on one side, and the butt rests on the other, then the position is called transverse and is considered wrong. If the baby does not turn into a longitudinal position, then it will not be able to be born by natural childbirth, and the mother will have to perform a caesarean section. The oblique position of the fetus differs from the transverse one only in that the head and ass of the fetus, resting against the sides, are located at different levels, as a result of which the baby lies diagonally in the uterus. This oblique position of the fetus is also incorrect, and if it does not turn over vertically, then you will have to perform a caesarean section, since the baby cannot be born from this position independently.
Under previa imply what part of the body (head or butt) the fetus is in the pelvis. If the baby is in the small pelvis ass, then the presentation is the buttock, and in this case he will have to be born legs forward. If the baby is head in the pelvis, then the previa is the head, and in this case the fetus in labor will go headfirst.
Then, the abdominal circumference and the height of standing of the bottom of the uterus (VSDM) are measured using a standard tape. At the 38th week, the abdominal circumference is approximately 92 – 98 cm, and the WSRM is on average 35 cm, but it can vary depending on the characteristics of the woman’s body from 32 to 38 cm. Usually, at the 38th week, the stomach goes down and becomes due to This is a little less than it was at 36 – 37th weeks. This is due to the fact that the fetus head or ass is lowered into the pelvis and pressed against the pelvic bones, preparing for childbirth. However, in some women whose pelvis is narrow and it is impossible for the baby to be in the close bone perimeter, the stomach does not descend, but remains as large as on the 36th week.
After completing obstetric and general examination, the doctor performs a gynecological examination and takes smears. This is necessary to assess the state of the cervix, the degree of its readiness for childbirth, the presence of cervical dilatation, and also to identify inflammatory diseases of the genital tract, which must be treated before birth, so that the baby does not become infected during the passage through the birth canal. In addition, if a woman goes to prenatal hospitalization, the doctor can reorganize the vagina – treat it with an antiseptic solution to destroy pathogenic bacteria and create optimal conditions for the passage of the fetus through the birth canal.
After completing the examination, the doctor examines the results of tests and examinations, and then, based on them, concludes whether the woman needs to go to the maternity hospital for antenatal hospitalization or she can wear the pregnancy at home, and go to the hospital only with the onset of labor. As a rule, women who have a pregnancy with complications have been referred to prenatal hospitalization, or if in the past there have been cases of the birth of a dead child, or if there is a scar on the uterus or any other diseases (for example, diabetes, hypertension, myopia), which may complicate the upcoming delivery.
If a woman does not show prenatal hospitalization, the doctor sets a date for the next visit after 7 days, that is, at the 39th week.
Nowadays, it is accepted to call the group of various symptoms warning signs that indicate the development of severe complications of pregnancy leading to the death of the fetus or mother, if they are not urgently treated in a hospital. Therefore, it is obvious that every woman should know such alarming signs, and when they appear, immediately call "First aid"in order to be hospitalized in a hospital and receive the necessary qualified assistance that will save both the mother and the child.
The warning signs on the 38th week of pregnancy include the following:
- Bleeding from the vagina of any nature
- Abundant fluid discharge from the vagina (they may be similar to involuntary urine, but, unlike her, make the skin sticky due to the sugar content)
- Constantly present or frequently occurring headache, which is combined with visual impairment of the type of flickering spots, flashes and flies before the eyes
- Vomiting, especially repeated
- Sudden swelling of face or hands
- Increase in body temperature above 38.0 o С
- Itching and / or burning in the vagina or perineum
- Burning and / or pain when urinating
- Severe abdominal pain, not subsiding at rest
- A strong blow to the stomach (for example, a fall on the stomach, a blow to the stomach with a hand or an object)
- The appearance of more than 4 – 5 contractions in an hour
- No movement or less than 10 movements of the fetus during the last 12 hours.
Sensations, signs of pregnancy, changes in the mother’s body
At the 38th week of pregnancy, a woman experiences a whole range of sensations from various organs and systems, which are caused by physiological changes in the body, and therefore are perfectly normal, not dangerous, do not indicate pathology, although they cause significant discomfort. Consider just the normal, inherent feelings of pregnancy, as well as their differences from similar pathological ones, which indicate the presence of the disease.
At the 38th week, the woman is no longer as hard as at 34 – 36 weeks, as her stomach dropped down a bit, due to which the uterus does not squeeze the lungs, stomach, liver or other internal organs that are located above the navel. Abdominal ptosis occurs due to the fact that the head or ass of the fetus enters the small pelvis and presses against the pelvic bones, preparing for childbirth. Reducing the pressure of the uterus on the lungs and stomach leads to the fact that the woman stops suffering from heartburn, belching, digestive disorders and respiratory disorders (frequent shortness of breath, inability to take a deep breath, bouts of feeling short of breath, etc.). However, not always belching, heartburn, digestive disorders and respiratory disorders completely disappear, for some women these sensations remain, but their severity and frequency of occurrence significantly decrease.
In turn, all other sensations resulting from changes in the body during pregnancy remain, and some even increase. A large amount of blood and fluid in the tissues, a high load on the cardiovascular system, an intense metabolism cause a periodic sensation of heat throughout the body, increased sweating, laying the ears, swelling, bleeding from the nose and gums. In addition to edema, all these sensations are physiological, normal, not indicating the presence of diseases and not requiring treatment. Edema can be both normal and pathological (signs of disease).
Normal edema usually disappears 1 to 2 weeks before childbirth, can be localized in any part of the body, never appear suddenly on the arms and legs and, most importantly, practically does not increase over time. A pathological edema can suddenly appear on the face and hands, combined with protein in the urine and always increase with time. In the presence of normal edema, you do not need to do anything, but when the pathological edema appears, you should be hospitalized as soon as possible for a course of treatment.
The protrusion of the abdomen forward, pressure on the bones of the pelvis, thighs and legs, sprains and tendons provoke pains in the back, lower back, sacrum, coccyx, thighs, pubic and pelvis, and discomfort when walking. Pain localization can be normal and pathological, and to distinguish them simply. Normal pains always pass or diminish after rest, but pathological pains do not. Normally, every woman suffers from back or back pain, sacrum, coccyx, thighs, pubic and pelvis on the 38th week to varying degrees, and to reduce their severity, it is recommended to rest several times a day while lying on the left side and get up on all fours for 10 – 15 minutes. But if the pain after a rest does not decrease, then you need to consult a doctor, as they are a symptom of the disease.
Normally, at the 38th week, a woman may suffer from persistent pain in the sacrum and the back of the leg to the knee, which is unpleasant, does not pass after rest. However, this pain is normal, as it is caused by the uterus squeezing the femoral nerve.
Exercise and swelling lead to pain in the legs, which are both pathological and normal. Any normal pain in the legs decreases or disappears after rest, therefore, in order to minimize them, no special treatment is needed, but rather simply to reduce the load on the musculoskeletal system. To do this, several times a day should go to bed with a raised upside down, do not wear high heels, do not lift weights, do not sit on chairs without a back, do not stand or walk for long periods. When a woman has to stand or walk for a long time, you need to relax every 40 minutes in a sitting position for 10 – 15 minutes.
Pathological pains in the legs are convulsions of the gastrocnemius muscles caused by a deficiency of calcium, vitamin B12, low concentration of glucose in the blood and a strong load on the legs. When cramps develop, you should pull the foot over and hold it in this position until the relief of pain, and then massage the calf. To prevent convulsions, it is necessary to take calcium supplements, vitamins of group B for prophylaxis and to avoid strong load on the legs.
In addition, for unknown reasons, many women at the 38th week experience a periodic, self-transient feeling of numbness in their arms and legs. This sensation is not dangerous, although the reasons why it is caused are not clear. Therefore, it can be conditionally attributed to normal.
Very often, at the 38th week, women suffer from dizziness, headaches and fainting, which can be normal and pathological. Normal indicated symptoms are provoked by low blood pressure, characteristic of pregnant women for long periods, as well as anemia, hunger and a high load on the vessels. To reduce the severity of such normal sensations, you should just relax more often in a dark and cool room.
Pathological headaches, dizziness, fainting, and sometimes seizures are symptoms and manifestations of the compression process of the inferior vena cava. This syndrome is a dangerous disease. During its development, the blood does not flow in sufficient quantity to the heart, lungs and brain because it accumulates in the inferior vena cava, transmitted by the uterus and other organs. When the syndrome of compression of the inferior vena cava appears, an urgent need to consult a doctor and begin treatment. It is easy to distinguish the compression syndrome of the inferior vena cava from normal dizziness, headaches and fainting – normally, these symptoms disappear after a rest, but when the disease is not present. Moreover, with this syndrome in a supine posture, the symptoms only get worse.
To prevent the development of the compression syndrome of the inferior vena cava, you should only lie on your side, do not lie on your back, do not sit with your legs on the leg and avoid any postures in which the vessels of the legs can be squeezed.
The pressure of the uterus on the internal organs causes a number of sensations on their part. And due to the fact that the head or ass of the fetus fell into the pelvis, now the uterus is much stronger pressure on all the internal organs located below the navel. This means that their feelings on the 38th week may increase.
Thus, the pressure of the uterus on the intestines at the 38th week causes no longer constipation, but, on the contrary, frequent emptying of the intestine. This is because the head of the baby is in the pelvis and does not allow the colon to accumulate a large amount of feces due to lack of free space. Sometimes an emptying of the intestines is so frequent, and the stool is unformed and mushy, that it seems the woman suffers from an upset stomach. In fact, everything is within the normal range.
The pressure of the uterus on the bladder on the 38th week only increases due to the fact that the head or ass of the fetus is now located in the pelvis, that is, in the same place as the bladder. Thus, even less space remains in the pelvis, which provokes frequent urination. Unfortunately, this problem will not be resolved, but you can try to make trips to the toilet more rare, if every time you urinate, lean a little forward – this contributes to a more complete emptying of the bladder.
Finding the head or ass of the fetus in the pelvis provokes completely normal, but rather unpleasant sensations, including:
- Lower abdominal pain
- Feeling of heaviness in the lower abdomen
- Drawing feeling down abdomen
- Feeling of heaviness and pain in the perineum.
All of the above feelings are normal, although unpleasant. Moreover, their appearance indicates that the birth is soon.
Stretching of the skin provokes the appearance of itching, rashes, stretch marks on the abdomen, thighs and sides, as well as a strong inversion of the navel or its stretching. Moreover, stretching and eversion of the navel are always normal, but itching and rash, unfortunately, can be both normal and pathological. There is no need to fight with normal itching, stretch marks, rashes and inversion of the navel. But you can reduce the degree and severity, if you regularly lubricate the skin of the abdomen, sides and thighs with a nourishing cream, special cosmetics or vegetable oils (for example, olive, sunflower, grape seed, almond, sesame, flaxseed, etc.).
If itching and rash are pathological, then you should consult a doctor and undergo a course of treatment. It is easy to distinguish pathological itching and rash from normal. So, in normal itching and rashes do not spread to other areas of the skin and do not increase, but if itching and rashes are a sign of pathology, then they move to other parts of the body and increase with time.
The mammary glands are ready for breastfeeding, they produce colostrum (milk precursor), which is periodically released from the nipples. When this happens, you just need to wipe the chest with a dry, clean and soft cloth. It is impossible to squeeze the colostrum out of the breast, because it can provoke mastitis.
The uterus prepares for childbirth very actively, and therefore on the 38th week, women feel false contractions. Contractions are irregular, but already painful, appear often, can intensify in the process of passage. They are distinguished from true ones by the fact that false contractions take place if a woman resembles or changes her position a little. However, if the contractions become regular and rhythmic, do not go away after a change of posture or walking, this indicates that childbirth has begun, and it is time to call "First aid".
In addition to purely physical sensations, a woman in the 38th week of pregnancy is already in her position, she painfully awaits the onset of labor and exhausts her heavy stomach. Naturally, women experience fear of childbirth, irritability, tiredness from heavy weight, awkwardness, etc. In some cases, on the 38th week, pregnant women are sluggish, apathetic, eager only to bring the moment of birth closer, while other women, on the contrary, feel a surge of strength and strenuously clean the apartment, prepare it for the baby to appear. The desire to equip an apartment to the appearance of a child in the last weeks of pregnancy is called "nesting syndrome".
Normally, on the 38th week of discharge, they are rather abundant, with a light sourish odor, are painted in a whitish-milky translucent color and may have a slight admixture of mucus. The consistency of the discharge may be watery or viscous. Liquid consistency occurs when the tube in the cervical canal remains intact. And if the cork comes out in parts, the consistency of the discharge becomes viscous and mucous.
Cork from the cervical canal can go out not only in parts, but entirely. In this case, it is a large lump of thick mucus (approximately two tablespoons in volume), painted in white, yellowish, creamy or pinkish. Cork can be streaked with blood, which is completely normal. Once the stopper has moved away from the cervical canal, you cannot have sex and swim in stagnant water, because the uterus is no longer protected from the entry of pathogenic bacteria.
Pathological secretions are those that contain impurities of pus and / or blood, have a yellowish, greenish, grayish or sallow coloration, have any unpleasant odor (rotten fish, beer, etc.), contain lumps, flakes, bubbles, or the appearance is normal, but causes itching, burning, swelling and redness in the genital area. Similar pathological secretions indicate the presence of an infectious-inflammatory process in the genitals. In this case, you need as soon as possible to consult a doctor to have time to cure an infectious disease before childbirth, because if this is not done, then the baby can become infected during the passage through the birth canal.
In addition, bleeding is pathological, with the appearance of which you must immediately call "First aid", as they indicate the development of diseases that can lead to the death of the fetus and mother.
In addition to normal and pathological secretions, at the 38th week, amniotic fluid may be released from the vagina in the form of leakage or effusion. When water leaks, a woman notices an episodic discharge of a small amount of yellowish / whitish turbid liquid, which leaves sticky and shiny traces on the skin of the pubis, perineum and thighs. Sometimes when a woman leaks water, she does not notice the discharge of fluid, but she feels that her panties are constantly wet, and the skin of the pubis and perineum is sticky and shiny. When water is poured out, a relatively large amount of liquid (no less than a glass) is released from the vagina, which is impossible not to notice. When water leaks, it is necessary to hospitalize in the maternity hospital in the coming days, so that the doctor can decide whether to wait for the natural onset of labor or to stimulate labor activity for the purpose of immediate delivery. If water is poured out, it should be immediately hospitalized in the maternity hospital, since such a phenomenon is a sign of the onset of labor.
More on vaginal discharge
Excretion of blood from the genital tract in any quantity at the 38th week should be considered dangerous bleeding. Of course, theoretically, bleeding can be non-dangerous, for example, due to cervical erosion. But at any moment it can develop into a dangerous one, leading in the short term to the death of the fetus and mother. Therefore, it is rational to regard any bleeding at the 38th week as dangerous.
Based on the foregoing, it is obvious that when bleeding on the 38th week of pregnancy, it is urgent to call "First aid". After calling the doctors, you should take only the documents, phone, open the door and go to bed in anticipation of the arrival of physicians. You can not actively move around the apartment in anticipation of the doctors, trying to collect things, because any physical activity can increase bleeding. Therefore, in order not to increase bleeding and not to increase blood loss, you need to wait for the doctors lying in bed with documents in their hands, and things can be brought by relatives later.
More on bleeding
Uterus and belly
The height of the uterus on the 38th week of gestation is on average 35 cm, but depending on the individual characteristics of the woman can vary from 33 to 38 cm. The upper edge of the uterus on the 38th week is lower than on the 36th, since the head of the fetus fell into the pelvis.
The abdominal circumference at the 38th week of gestation ranges from 92 to 98 cm. The abdominal shape becomes more rounded as the uterus deviates anteriorly due to relaxation of the abdominal muscles.
On the skin of the abdomen can be peeling, rashes, itching and stretch marks (stretch marks), arising from the strong stretching of the skin. From the navel to the pubis there is a wide dark band dividing the abdomen into two halves, and the navel takes on the form of a stretched shapeless circle or is turned inside out. All these phenomena after childbirth will pass, and everything will return to its usual form.
The uterus is trained before childbirth by frequent but irregular contractions, which the woman feels like false contractions. False contractions – not rhythmic, painful, occur occasionally during the day, are similar in nature to pain during menstruation, only stronger.
Pain in the abdomen and other parts of the body
The load on the musculoskeletal system, on the internal organs, the significantly increased body weight and the pressure of the heavy uterus on the tissues cause unpleasant painful sensations in various parts of the body in all women at the 38th week. Moreover, pain is normal, as caused by natural processes occurring in the body during pregnancy, and do not indicate the presence of the disease, and therefore do not require treatment. Below we give just such normal pains in various parts of the body for the 38th week of pregnancy, and also briefly describe the pathological pains of the same location similar to them.
Lowering the head of the fetus into the small pelvis leads to the fact that, compared with the 36-37th week, the frequency and severity of pain in the hypochondrium and ribs of a woman decreases, since the baby no longer gets their legs with its movements.
Abdominal pain is normal due to a number of factors. Depending on the cause of a painful episode, it may be of a different nature and last longer or shorter. Thus, the pressure of the uterus on the abdomen and the lowering of the fetal head into the small pelvis cause almost constantly present tingling aching pains in the lower abdomen of varying intensity. Sometimes pain for short periods of time becomes pricking or shooting (especially when changing posture or rising from a sitting or lying position). Such a aching pain in the abdomen is perfect normal.
The movements of the baby cause short-term, strong, sharp, stitching pains in any part of the abdomen. These pains, though strong, but quickly passing. False contractions are felt like bouts of severe, aching pain in the abdomen and sometimes in the lower back. Such false labor pains are like pain during menstruation, only stronger. The fight itself does not last long, but it is painful. False contractions occur quite often during the day, but irregularly.
Thus, it is obvious that normal abdominal pain can be caused by pressure of the uterus on the internal organs, false contractions and movements of the baby. Such normal pains are not dangerous and do not require any treatment. But you can try to calm down normal abdominal pains with a few simple tricks: get on all fours for 10 to 15 minutes, lie on your side for 10 to 15 minutes, or walk for a few minutes around the room or down the street. These simple techniques can reduce the severity of normal abdominal pain.
At the 38th week, abdominal pains are not only normal, but also pathological, that is, caused by various diseases. Pathological pains are characterized by the following symptoms: they increase with time, they do not decrease after rest, they can be localized in any part of the abdomen, wear and tear, sharp or cramping, and combine with back pain, fever, vaginal discharge, large amounts of muddy water or a sharp deterioration in health. When signs of pathological abdominal pain appear, it is necessary to cause "First aid" and be hospitalized in a hospital, as they may reflect the development of serious diseases that can lead to the death of the fetus and mother in the absence of medical care.
Due to the fact that the head or butt of the fetus fell into the small pelvis, on the 38th week they strongly press on the pelvic bones, as a result of which the woman feels pain, pressure, heaviness and a pain in the perineum, pubic, sacrum and lower back . In some cases, a woman may even feel the head of the fetus between the thighs, which puts a lot of pressure on the perineum. Pain in the perineum and pubis can give to the legs in the form of sharp piercing lumbago. Considering that the pains, heaviness and spreading in the pubis, perineum, sacrum and lower back are caused by the physiological process, they are completely normal, and therefore do not require treatment. However, you can try to reduce the severity of these unpleasant feelings, if several times during the day for 10 – 15 minutes to get up on all fours.
Strong load on bones, joints and muscles, pelvic bones disagreement, softening of ligaments and tendons, displacement of the center of gravity due to the protruding abdomen cause pain in the bones of the pelvis, hips, back, lower back, sacrum, coccyx, hip joints, legs , pubis and perineum, as well as discomfort when walking. Such pain is normal, so they do not need to be treated. But you can try to reduce their severity, to feel better, which should be several times a day to rest lying on your side or standing on all fours – the pain disappears while reducing the load.
But pain in the pubic, sacrum, lower back and legs may be pathological, that is, due to various diseases. And since for pathological pains, it is necessary to consult a doctor for treatment, you should be able to distinguish between normal and pathological pains. In particular, pubic pain is pathological if it is combined with "duck gait" and does not decrease after rest. In this case, it is a manifestation of symphysitis (inflammation of the pubic symphysis). Pain in the sacrum piercing-cutting nature, extending to the leg, does not subside with time, is pathological and may be a manifestation of pinching of the sciatic nerve (sciatica) or compression of the femoral nerve. Low back pain is pathological, if combined with pain during urination and / or with increased body temperature, as it indicates a disease of the urinary system. Leg pain is considered pathological if it is combined with any of the following symptoms: severe swelling of the hands and face, flashing flies and spots before the eyes or blurred vision, high blood pressure, protein in the urine. In this case, pain in the legs is a sign of gestosis (a terrible complication of pregnancy). When signs of pathological pain of these localizations appear, you should immediately consult a doctor.
Sexual intercourse on the 38th week is absolutely contraindicated in the following cases:
- The mucus plug has come off
- Leaked or leaking water
- A woman or man suffers from any genital diseases.
- Bearing twins, triplets, etc.
- There are any complications of pregnancy (for example, placenta previa, preeclampsia, the threat of miscarriage or premature birth in the past and present).
In the absence of contraindications a clear answer to the question of whether you can have sex on the 38th week, no. Some doctors believe that sexual intercourse is acceptable in the later periods, while other doctors believe that sex is prohibited. Therefore, each couple should decide for themselves whether to have sex at the 38th week or abstain.
At the 38th week, weight gain should vary between 8.6 – 14.5 kg relative to the body weight that existed before pregnancy. Moreover, the fuller the woman, the closer to the lower limit of the norm should be her weight gain. You should strive to ensure that the weight gain is within the normal range, since with too much increase the delivery will be much harder.
Drugs that can or cannot be used during pregnancy are determined by their belonging to one of the five groups allocated FDA classification on the basis of their actions on the fetus. Depending on the specific effect of the drugs on the fetus, all drugs are divided into five groups – A, B, C, D and X. Accordingly, during pregnancy, you can use drugs of those groups that do not adversely affect the fetus.
At the 38th week of pregnancy, safe for the fetus, and therefore acceptable for use without fear of drugs are drugs belonging to groups A and B. The official instructions for drugs of group A indicate that they are safe for the fetus and can be used throughout pregnancy and, therefore, on the 38th week as well. Instructions for group B drugs may contain any of the following three phrases: "the drug is approved for use in the second and third trimesters", or "the drug is banned in the first trimester", or "In experiments on animals, no negative effect on the fetus was detected, but clinical studies have not confirmed the absence of a negative effect on the fetus in humans, therefore there is a theoretical probability of a negative effect on the human fetus, as a result of which the drug can be taken only by doctor’s prescription after evaluating the risk / benefit ratio".
If there is any serious disease that will progress steadily without treatment, worsening the condition of the woman and, of course, the fetus, the use of drugs of group C is allowed for the purpose and under the supervision of a physician. Thus, the drugs of group C are used only when, without their use, the condition of the woman and the fetus will definitely worsen. These drugs have a high risk of negative effects on the fetus, as in experiments on animals such a negative effect on the fetus was revealed. But since man is not an animal, it is impossible to spread the results of experiments on rats and other laboratory animals to him. After all, sometimes for animals the drug is safe, but for humans, on the contrary, dangerous. Therefore, the negative effect on the fetus revealed in animal experiments does not necessarily mean that the drug in humans will have exactly the same effect. Based on this, at the risk of deterioration in the absence of treatment, doctors use drugs of group C, because they may not be harmful for the fetus, but the benefits from the fact that the expectant mother will recover is obvious. The instructions for group C drugs indicate that "during experiments on animals revealed a negative impact on the fetus, so the drug is contraindicated for use during pregnancy or can be used in critical situations under the supervision of a physician".
If the condition of the woman is the hardest, and she is threatened with death, then doctors use drugs of group D, which have a negative effect on the human fetus, which was confirmed by practical experience of their use. The instructions for group D drugs always state that they are "contraindicated during pregnancy, since they have a negative effect on the fetus".
Drugs from group X are never used during pregnancy – they cause fetal death. Instructions for preparations of group X contain an indication that they are contraindicated during pregnancy and are detrimental to the fetus.
Given the above, it is obvious that each person can independently determine whether it is possible to use any particular drug during pregnancy, after reading its official instructions and understanding which group the medicine belongs to. But, unfortunately, in practice it is not always possible to study the instructions, therefore, below we provide a list of the most frequently used in everyday life drugs of groups A and B, which can be used during the 38th week of pregnancy:
- Antipyretic drugs to reduce body temperature – containing as active ingredients paracetamol (Akamol-Teva, Daleron, Ifimol, Calpol, Panadol, Lupocet, etc.) or acetylsalicylic acid (Aspirin, Acetylsalicylic acid, etc.). In the past, it was believed that acetylsalicylic acid should not be taken on the 38th week. However, the results of recent studies have shown its complete safety, and therefore the preparations containing it are acceptable for use at the 38th week.
- Means for stopping dry cough – containing dextromethorphan (Akodin, Padevix, Paracetamol DM, Tussin plus) as an active ingredient.
- Expectorant drugs (for removing sputum from the bronchi and lungs) – containing the active ingredients guaifenesin or bromhexin (Bronhikum, Bronchipret, Gerbion, Gadelix, etc.).
- Remedies for nasal congestion and runny nose – you can use only local forms (nasal drops and sprays) containing pseudoephedrine, phenylephrine (Vibrocil, Orinol Plus, Rinopront, etc.), xylometazoline or oxymetazoline (For Nose, Galazolin etc.).
- Antiallergic drugs – antihistamines with any active substances, but belonging to the third generation (Allegra, Desloratadine, Norastemizol, Telfast, Ezlor, Erius, etc.).
- Painkillers (for relieving pain of any localization) – containing as active ingredients drotaverin (No-Spa, Drotaverin), papaverine (Papaverine) or magnesia (magnesium sulfate).
- Antacid preparations (for stopping heartburn) – hydroxide containing as active components of magnesium-aluminum (Almagel, Alumag, Gastracid, Maalox, Fosfalyugel).
- Antifungal drugs (for the treatment of candidiasis / thrush) – use exclusively local forms (suppositories, creams and ointments for vaginal administration): Clotrimazole, Mikogal, Miconazole, Natamycin, Nystatin, Serconconazole, Econazole.
- Antihemorrhoidal drugs – use local forms (suppositories, creams and tablets for the introduction into the rectum) of Hepatrombin, Calcium Dobesilate, Procto-Glivenell, Relif, Troxerutin, Escuzan.
- Laxatives (for constipation) – various syrups with lactulose (Duphalac, Portalak, Normase, etc.).
- Antidiarrheal drugs (to stop diarrhea) – probiotics (Linex) and sorbents (Smecta).
- Antibiotics – for ingestion and injection use drugs from the group of penicillins (Amoxicillin, Amoxiclav, etc.), groups of cephalosporins (Cefuroxime, Cefalexin), as well as Nitrofurantoin, Erythromycin, Polimixin, Lincomycin, Clindamycin.
- Antihypertensives (to lower blood pressure) – containing as active ingredients methyldopa (Methyldopa, Dopegit), metoprolol (Betalok, Metolol, Metoprolol, Egilok, etc.) or atenolol (Atenol, Atenolol, Betacard, Tenormin, etc. .), as well as Nifedipine. Note that Nifedipine is a tool for occasional, one-time use, when you need to quickly reduce blood pressure to normal. And drugs with methyldopa, metoprolol and atenolol are the means for a long course of use in order to maintain pressure within normal limits. For long-term use is always primarily prescribed drugs with methyldopa, as it is the safest during pregnancy. And only if methyldopa is ineffective, then for the course of a long-term administration, a drug with atenolol or metoprolol is selected.
- Antivirals (for the treatment of influenza and ARVI) – containing as active ingredients oseltamivir (Tamiflu) or zanamivir (Relenza). Both drugs belong to the group C, so they can only be used under the supervision of a physician.
- Decongestants (for stopping edema) – any pharmacy renal tea and magnesium preparations (Magne B6, Magnerot, etc.).
Births at the 38th week
If a woman gives birth to a baby on the 38th week of pregnancy, then this is perfectly normal, since the child is already mature and considered full-term. This means that there is no difference between a baby born on the 38th week and the 40th week — they are both full-term, mature, viable and do not need nursing or special care for premature babies.
Moreover, at the 38th week, women should be prepared for the fact that childbirth can begin at any time. Therefore, documents and a pre-assembled bag with things to the maternity hospital should always be in readiness so that when there are contractions, take all you need "First aid".
Most often in the 38th week, women give birth to a second, third or more child. In addition, obstetricians note a curious feature – girls are born on the 38th – 39th week more often, but the boys, on the contrary, try to live in the womb until the end of the 40th week. Therefore, when a girl is born, the likelihood of childbirth at the 38th week is higher than during pregnancy as a boy.
More about childbirth
38 week of pregnancy: how to breastfeed correctly (recommendations of a breastfeeding specialist) – video
Author: Nasedkina A.K. Specialist in conducting research on biomedical problems.