At the 36th week, the weight of the fetus fluctuates within 2572 plus or minus 235 g, and the body length is 45.3 plus or minus 1.7 cm. On average, the weight is most often 2500-2700 g, and the length of the body is 46- 47 cm .
At the 36th week all the organs and systems of the baby are developed and work smoothly, so his body is almost ready for life outside the womb of the mother. However, some systems continue to evolve, while others are improved. For example, the nervous system is still developing, numerous connections are formed between brain structures, nerve fibers are covered with a protective myelin sheath, and the immune system improves the skills of antibody production and rapid response to the penetration of pathogenic microbes into the body.
The liver continues to accumulate iron stores, which will be spent in the first year of life on the synthesis of hemoglobin and other enzymes. The work of the endocrine system is debugged, all hormones are produced in sufficient quantities. The lungs have completed their development and are ready for breathing.
The fetus trains its urinary and digestive systems by swallowing the amniotic fluid. Sugars and some other substances contained in the waters are digested in the gastrointestinal tract, and from their residues, bile and desquamated cells of the intestinal epithelium, the original feces (meconium) are formed. The kidneys filter the blood and form urine, which removes approximately 0.5 liters per day. The baby pisses directly into the amniotic fluid, but this does not mean that he is in his own urine, as the water is completely updated every 2 hours.
The child intensively gains weight – 250 – 350 g per week, and the weight increases mainly due to the fat deposits that he will need after birth to maintain a constant body temperature. Fat is deposited throughout the body – and on the stomach, and on the back, and on the neck, and on the legs, and on the arms, and even on the cheeks.
Also, the baby trains his sucking skills that he will need in order to well grab and suck the breast or nipple of the bottle with the mixture. For this, he sucks his toes and hands or cam.
The bones of the skeleton harden, but the bones of the skull remain soft and do not fully fuse with each other. Soft bones of the skull are necessary to ensure the safe and low-impact passage of the baby’s head through the birth canal during birth.
Externally, the fetus at the 36th week already has a form in which the mother will see it after birth. The face has acquired individual features, the auricles are straightened, the nails and hair on the head have already grown, the genitals are fully formed and are in their permanent place.
The fetus has grown strongly and occupies all the free space in the womb. He can not stretch his arms and legs as he wants, and therefore is located in the uterus in the fetal position, pulling the legs bent at the knees to the stomach, and arms crossed on his chest. Because of constraint, the baby moves relatively rarely, for a long time is in one pose without movement. The nature of fetal movements has become different: now they are slow, smooth, neat, it does not tumble, does not pull out legs and arms sharply and quickly, but pushes, makes pokes, pokes, moves, or rests various parts of the body against the walls of the uterus.
Although the baby does not move as actively and often as before, his movements are still clearly visible to the mother and still cause her pain and discomfort. Bows and pushes the fruit makes with great force, as its muscles are strengthened. As a rule, the pain of fetal movements is felt by the mother 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.
When a baby rests on the front wall of the uterus with different parts of the body, a woman can see them as prints of hands, legs, butts or heads on the skin of her abdomen. The prints of baby’s body parts are so well visible that some even photograph them.
In addition to calm slow and relatively rare movements, the fetus can make sharp, strong movements, giving the woman pronounced pain and discomfort. Such sudden movements of the baby, as a rule, are provoked. They respond to a variety of external stimuli, such as, for example, too bright light, unpleasant smell, loud sounds, stress, fear or other strong emotions in the mother. Strengthening activity and making sharp movements is a kind of response of the fetus to stimuli that he does not like. Remember that a child can react with increased activity on anything, because he already sees perfectly, hears well, feels odors, feels touches to his mother’s stomach, and also responds to any emotions that a woman experiences.
In addition to responding to external stimuli, the fetus almost always begins to move more actively after the mother eats. This is due to the fact that after a meal in the blood, the level of glucose rises, which the kid uses as energy for his games.
In some cases, the mother may feel an increase in the intensity and frequency of perturbations of the fetus for no reason, against the background of the absence of external stimuli and not after a meal. In this case, active perturbations are usually triggered by hypoxia, and the fetus tries to speed up blood flow in order to eliminate oxygen deficiency. If such situations occur, it is recommended to get on all fours and take a deep breath or perform breathing exercises.
The fetus does not move equally often and unevenly during the day, as it alternates periods of sleep and wakefulness. Accordingly, in periods of wakefulness, he moves more actively, and during sleep, he is practically motionless. It may seem a paradoxical fact that the baby sleeps and moves little at the moments when the woman is active (that is, she does some work, walks, moves, alternately gets up and sits down). And when a woman is resting, the fetus, on the contrary, moves much more actively than at those moments when the mother moves. In fact, there is nothing paradoxical about this fact, because during the movement the woman’s abdomen swings, which lulls the baby, and he sleeps. And when a woman sits motionless or lies, the stomach does not sway, the effect of motion sickness is absent, the baby wakes up and plays, which is manifested by more active movements.
Sometimes a woman feels rhythmic flinches inside the abdomen, which are caused by hiccups in a child.
The movement of the fetus must be felt every day. But perturbations do not have to be in a strictly defined amount hourly. As already mentioned, the baby alternately sleeps and is awake. Therefore, experienced doctors recommend counting perturbations during the day – in 12 hours the fetus should move about 10 times. If within 12 hours the fetus moves 10 times or more, then everything is fine with it. If the baby has never moved at all in 12 hours or has moved less than 10 times, then this indicates that not everything is in order with him. In such a situation, it is necessary to urgently be hospitalized in a maternity hospital so that the doctors have time to carry out the necessary therapy and save the child.
Ultrasound and tests
At week 36, the screening deadlines had already passed, and all planned ultrasounds should have already been done. Therefore, a routine ultrasound study is not appointed at the 36th week. But if a woman was not examined, did not pass the third screening at the 32nd-34th week, then the doctor may prescribe an unscheduled ultrasound at the 36th week to assess the condition of the uterus, cervix, placenta, umbilical cord and fetus, and also to determine , whether the development of the baby is normal.
In addition, unscheduled ultrasound on the 36th week can be assigned to women who have been screened and have passed the third screening. In practice, most often such an ultrasound is assigned for reinsurance, when the doctor simply wants to make sure once again that the fetus is all right. But also unscheduled ultrasound can be prescribed if you suspect any complications of pregnancy, for example, feto-placental insufficiency, early aging of the placenta, entanglement of the neck of the fetal umbilical cord, etc.
Unscheduled ultrasound on the 36th week may be assigned to women in whom the pregnancy proceeded with complications. In this case, an ultrasound scan is performed to assess the condition of the fetus and the woman, so that, based on the results of the examination, choose a method of delivery (vaginal delivery or caesarean section) and decide on which period the woman needs to go to the maternity hospital for antenatal hospitalization.
In addition to ultrasound, a woman can be given a cardiotocography or dopplerography for a period of 36 weeks of pregnancy if fetal hypoxia or other pathologies are suspected due to impaired blood flow in the mother-placenta-fetus system.
As for tests, on the 36th week, in a planned manner, all women need to pass only a complete blood count and a complete urinalysis. A complete blood count is necessary to detect the risk of pre-eclampsia – a dangerous complication of pregnancy that can lead to death of the mother and fetus. If there is protein in the urine, then this indicates a high risk of preeclampsia, and in this case, the woman is given calcium intake to prevent this complication (1 g per day before the 40th week). If there is no protein in the urine, then the risk of preeclampsia is low, and treatment is not indicated.
If, in addition to protein in the urine, the woman has severe edema, visual impairment of the type of flashing of the flies before the eyes, as well as increased blood pressure, this indicates the presence of gestosis – a very terrible complication of pregnancy. With the development of signs of preeclampsia, the doctor sends the woman to the hospital for treatment and selection of the date and method of delivery. If preeclampsia is detected on the 36th week, then the woman is hospitalized and, most likely, is no longer allowed to go home, but will first be treated, after which either they induce natural childbirth or perform a caesarean section before the deadline. With preeclampsia, delivery is carried out before the expiration of the 36th week, since this complication is very dangerous, can lead to death of the mother and fetus, and the only way to treat it is to get rid of pregnancy. Therefore, given that the 36th week of the fetus is already mature and ready for extrauterine life, in the presence of preeclampsia, a woman is given an early delivery in order not to risk the lives of both during the end of pregnancy.
Also, a general urinalysis allows to detect hidden diseases of the urinary organs. If there are urine cells, red blood cells, cylinders, mucus, bacteria or epithelial cells in the urine, this indicates the presence of diseases of the organs of the urinary system.
A general blood test can detect anemia that adversely affects the course of pregnancy, the condition of the fetus and the woman. This syndrome needs to be identified and treated as early as possible.
In addition to the general analysis of blood and urine, women with a negative Rh factor in the blood at the 36th week of pregnancy must pass a test for antibody titers to the Rh factor and AB0 system proteins, if they have not been given anti-D immunoglobulin at the 28-30th week . If immunoglobulin was introduced, then the antibody titer is not necessary to determine, since it will be false positive.
Visit to the obstetrician-gynecologist
At the 36th week, you need to routinely visit the obstetrician-gynecologist who leads the pregnancy. To the doctor you need to take with you the results of all tests and examinations that he has not yet seen. The results of examinations and tests are necessary for the gynecologist to assess the condition of the woman and the fetus, and decide whether it should be sent to antenatal hospitalization, and in what period it should be done.
A doctor’s appointment begins with a survey, during which, in order to identify various diseases, complications of pregnancy and the condition of the fetus, questions about the following are asked:
- What symptoms and complaints bother a woman, how often do they appear, what provoke, how do you manage to stop them?
- How often does a woman feel fetal movement when she felt the movements of the baby for the last time?
- Are there bloody vaginal discharge?
- Did the nature of the discharge change, did something unusual appear, did the discharge cause discomfort, pain, itching or burning?
- What is the nature of discharge from the genital tract (the doctor is interested in color, smell, quantity, consistency)?
- Does a relatively large amount of turbid, yellowish water with a sweet aftertaste and odor occasionally emit from the vagina (sweetness is determined by the fact that the skin becomes sticky)?
- Is there a feeling of moisture in the perineum or periodic causeless wet panties?
- Are there frequent and persistent headaches?
- Are there any visual impairments of the type of flashing of flies, spots, flashes, transparent spirals before the eyes?
- Is there redness, swelling, burning or itching in the genital area?
- Are there pains or burning sensations when urinating and back pain?
- What character are abdominal pain, when there are, how much lasts, from what are they?
- Are there sudden sudden swelling of the hands and face?
After the survey, the midwife or the doctor himself measures the pressure on both hands, weighs the woman and calculates the weight gain. Weight gain and pressure level must be recorded in medical records.
Next, the doctor conducts a general examination. Be sure to examine the breast, assessed her condition, readiness for breastfeeding. In addition, the doctor identifies whether there are signs of mastitis or induration in the mammary glands. Also examined the legs to assess the severity of edema and identify varicose veins. The skin is examined in order to detect any rash, redness or inflammation. Lastly, the anterior abdominal wall is examined, the elasticity of the muscles, the degree of their divergence, the presence of hernias are evaluated.
For severe swelling, fatigue and pain in the legs, the doctor will recommend compression underwear. If there are varicose veins, then such clothes should be worn without fail. The doctor will select the required size and degree of compression, as well as talk about the rules of wearing data for medical devices.
After completing a general examination, the doctor proceeds to an external obstetric examination, which involves listening to fetal heart tones, counting the heart rate, determining the position and presentation of the fetus, measuring the circumference of the abdomen, the height of the uterus and the tone of the uterus.
Calculation of the frequency of heartbeats, the assessment of their rhythm and ringing is performed using an obstetric stethoscope, which is simply attached to the anterior abdominal wall. Listening to the heartbeats allows you to identify fetal hypoxia, entanglement of the neck by the umbilical cord and a number of other pathologies, which are then only confirmed by ultrasound, dopplerometry and cardiotocography. Various parameters relating to the fetal heartbeat are entered in the medical records.
The position and presentation of the fetus gynecologist determines the hands, groping head and ass through the wall of the abdomen. The position of the fetus is transverse, oblique and longitudinal, and only the latter is considered normal, and the first two are abnormal. The transverse position is characterized by the fact that the fetus rests its head on one side and the ass on the other, while the head and ass are on the same level. The oblique position is characterized by the fact that the fruit is located diagonally, resting its head on one side, and the booty – on the other, with the head and the ass located on different levels – one above and the other below. The longitudinal position is characterized by the fact that the fetus sits vertically in the uterus, its head or butt is located in the pelvis, and the second end is in the area of the uterus bottom under the diaphragm.
Presentation is determined by which end of the fetus (head or foot) is in the pelvis. If the head is in the pelvis, the breech is the head and optimal for the upcoming birth, as the baby will be born head forward. If in the small pelvis is the butt, then the breech presentation, and the baby will be born legs forward. Information about the position and presentation of the fetus also necessarily recorded in the medical records.
In the process of groping the head and butt of the fetus, the doctor determines the tone of the uterus. If the uterus in response to the touch of hands in the stomach is moderately reduced, then its tone is normal. But if, after touching, the uterus contracts sharply and strongly, creating the effect "stone belly"then there is hyper tone.
Next, measure the circumference of the abdomen and the height of the standing of the bottom of the uterus (VSDM) normal measuring tape. Belly circumference at the 36th week is 90 – 95 cm, and VSMD on average – 36 cm, but can vary from 32 to 37 cm, depending on the individual characteristics of the woman’s body and the growth of the fetus. VSDM at the 36th week reaches a maximum for the entire pregnancy. Starting with the next, the 37th week, VSDM will begin to decrease due to the fact that the fetus sinks into the small pelvis. The effect of reducing the height of the bottom of the uterus in the last month of pregnancy is called lowering the abdomen, and is completely normal.
After obstetric and external examination, the doctor, if necessary, performs a gynecological examination and takes smears. This is done, for example, if a woman has diseases or abnormalities in the structure of the cervix, vagina, etc. Also, a gynecological examination is performed for women who have a pregnancy with complications and who are recommended for prenatal hospitalization. In such a situation, an examination is made to assess the condition, maturity and degree of openness of the cervix. However, routinely, all women, gynecological examination is not carried out.
Further, having studied all the available examination findings and test results, the gynecologist makes a general conclusion about the condition of the fetus and the woman, the readiness of both for childbirth. Be sure to specify the preferred method of delivery – through the birth canal or by caesarean section. Also at the 36th week, the question of when a woman should be hospitalized in a maternity hospital is decided. If the pregnancy proceeded with serious complications, then they have been sent to antenatal hospitalization since the 36th week, with minor complications – from the 38th week. And women whose pregnancy was uneventful are recommended to continue to visit the consultation every week until the 40th inclusive.
Accordingly, if the doctor does not give the woman a referral for antenatal hospitalization, he sets the date for the next visit in a week, that is, on the 37th week.
Unfortunately, during pregnancy a woman can develop serious illnesses or complications that need to be treated urgently in the hospital, as without therapy they can lead to death of the fetus and mother. Symptoms of such severe conditions are usually called warning signs, when they appear, the woman should immediately call "First aid" and hospitalized in the hospital.
At the 36th week of pregnancy, the following signs of concern include:
- Spotting from the vagina in any quantity and any shade
- Abundant fluid discharge from the vagina (sometimes they are mistaken for involuntary urine, but, unlike urine, the water that has poured out makes the skin sticky due to the sugars they contain)
- Often appearing or persistent 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 that does not subside over time.
- 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 for 12 hours.
Sensations, signs of pregnancy and changes in the state of the body
Thirty-sixth week – one of the most difficult during pregnancy in the truest sense of the word. It is this week that the abdomen reaches its maximum size, it comes forward most strongly and literally props up the diaphragm, flattening the lungs. Therefore, at the 36th week, you need to be patient, treat the inconvenience and discomfort sensations philosophically and simply go through this period of time. After all, from the 37th week of pregnancy, a woman will feel relieved, as the stomach drops a little down due to the fact that the head or ass of the fetus enters the pelvis, as a result of which it becomes easier to breathe, move and perform the usual actions, heartburn subsides a bit, the state of health will improve, etc.
The widest range of discomfort that a woman may experience on the 36th week is actually completely normal, as it is caused by changes in the body that are characteristic of pregnancy. Therefore, despite the discomfort brought, these feelings of pregnancy must be treated calmly – they do not indicate a disease, and therefore will pass after childbirth. We consider the normal (physiological) sensations that a woman may experience at the 36th week of gestation, and their differences from similar pathological symptoms.
Increased volume of blood and fluid in the tissues, high load on the cardiovascular system, accelerated metabolism in a woman cause the following normal manifestations for the 36th week of pregnancy:
- Periodic sensation of heat throughout the body.
- Excessive sweating
- Laying ears
- Bleeding from the gums and nose.
Sensation of heat in the body, excessive sweating, laying of the ears, nasal or gingival bleeding are always normal symptoms of pregnancy. In other words, these manifestations do not indicate pathology. But edema can be both normal and pathological, so you need to be able to distinguish when there is physiological edema, and when there is pathological. Normal edema can be localized on any part of the body, but rapid swelling of the face and hands never appears. Such edemas practically do not increase with time. Pathological swelling increases with time and can be combined with high blood pressure and protein in the urine. In addition, rapid sudden swelling of the face and hands is always considered pathological. If there are normal edema, then nothing needs to be done, but when signs of pathological edema appear, you should immediately consult a doctor.
The pressure of the uterus on the bones, the process of stretching the tendons and ligaments, the protruding abdomen and the divergence of the pelvic bones into the sides are the causes of often disturbing women in the 36th week of pregnancy of pain in the back, lower back, sacrum, coccyx, thighs, pubic and pelvis, and also discomfort when walking. Such pains can appear and disappear, have a different degree of intensity, but in one or another quantity they are present in all pregnant women. To reduce the severity of these pains, it is necessary to reduce the load on the musculoskeletal system, for which you should rest several times a day, lying on your left side, and stand up on all fours for 10-15 minutes.
High physical exertion and edema cause frequent pain in the legs, which affects almost all pregnant women on the 36th week. Such pains can be tried to be reduced by minimizing the load on the musculoskeletal system, for which it is recommended several times during the day to go to bed with a rest upside down, not to wear high heels, not to lift weights, not to sit on chairs without a back, not to stand and not walk a long time. If you have to stand or walk for a long time, you need to relax every 40 minutes while sitting for 10 – 15 minutes.
In addition to physiological pain in the legs, women at the 36th week of pregnancy may suffer from pathological cramps of the calf muscles, which are provoked by a deficiency of calcium, vitamin B12, low concentration of glucose in the blood and a strong load on the legs. When there is such a cramp, you should strongly pull the foot over yourself until the pain is completely relieved, then massage the eggs. And in order to prevent the onset of seizures, it is optimal to take calcium preparations, vitamins of group B and avoid strong load on the legs.
Unfortunately, in the legs there can be not only pain and convulsions, but also a recurring feeling of numbness. Such numbness may appear in the hands. What caused this phenomenon – it is not clear, but it is precisely known that it is harmless.
Headaches, dizziness and fainting often trouble women in the 36th week of gestation. In the overwhelming majority of cases, these symptoms are completely normal, as they are provoked by reduced pressure, anemia, hunger, or a high load on the cerebral vessels, which is characteristic of late pregnancy. To reduce the severity and frequency of headaches, dizziness and fainting, you should take 15 minutes to rest in a cool and dark room several times a day.
However, dizziness, headaches, fainting, and in rare cases seizures and even pain in the whole body can be symptoms of a pathology – compression syndrome of the inferior vena cava. This syndrome develops due to clamping of the inferior vena cava, as a result of which a sufficient amount of blood does not flow to the brain, heart, and lungs, which provokes characteristic manifestations. The compression of the inferior vena cava is easily distinguished from normal headaches, dizziness and fainting. So, if these symptoms diminish or go away after resting in a dark and cool room, then they are normal, and if they do not go away after resting or they get worse after lying on their backs, then the symptoms are pathological. For the prevention of compression of the inferior vena cava should lie only on the side, do not sleep on your back, do not sit with your legs on your leg and do not make any movements capable of transmitting the deep vessels of the legs.
Separately, it is necessary to dwell on a wide range of sensations, which are provoked by the pressure of the heavy and large uterus on the internal organs.
First, the uterus puts pressure on the intestines, which causes constipation. To eliminate constipation, you can take a safe and natural laxative based on lactulose syrup (for example, Duphalac, Portalak, Normase). In addition, for the prevention of constipation, it is necessary to include in the diet products that improve the evacuation of the chair (beet, dried apricots, prunes, etc.), and exclude products that slow down the movement of the food bolus in the intestine and contribute to the consolidation of feces (for example, wheat flour, pastry, fast food, canned food).
Secondly, the uterus strongly presses on the stomach, which provokes heartburn and belching. To make these unpleasant feelings more rare, you need to follow these simple rules:
- There is a little, but often.
- Do not stoop or lie down after eating or drinking.
- Always lie down and sleep with a slightly raised head end, placing a pillow under the shoulders and head.
- Do not eat large amounts of sweets, because sweets in the stomach increase the concentration of hydrochloric acid. But if you feel unbearably sweet, then it is better to eat it in Chinese – before the main course. In this case, the sweets do not acidify the gastric juice so much.
When heartburn occurs, it can be stopped by taking antacids, such as Maalox, Fosfalyugel, Almagel, etc. You can also try to find your nontrivial way to combat heartburn, given that many women are helped by resorption of a piece of chocolate, clicking seeds, etc.
Thirdly, the uterus puts pressure on the bladder and severely limits the free space in the pelvis, as a result of which the bladder can hold only a small amount of urine. The result of this is frequent urination, which are available to all pregnant women without exception. To make trips to the toilet a little more rare, it is necessary to lean forward slightly with each urination, which improves the emptying of the bladder.
Fourthly, the uterus strongly presses on the diaphragm, which literally flattens the lungs. They have no place to turn around, and this provokes breathing problems, such as frequent shortness of breath, inability to take a deep breath, bouts of feeling short of air, etc. These difficulties can be reduced by regular deep breathing several times a day in a pose on all fours. In other words, you just need to get up to the knee-elbow position several times a day and breathe deeply and actively.
Stretching of the skin leads to itching, rashes and stretch marks on the abdomen, thighs and sides. Moreover, stretching is always normal for pregnancy, but itching and rash can be both physiological and pathological. Itching and rashes are considered pathological if they spread beyond the sides, abdomen and thighs, capturing new skin areas. In this case, you need to consult a doctor.
But with normal itching and rashes do not need to fight. But if they cause severe discomfort, they can be reduced by simply lubricating the skin with nourishing cream or vegetable oils (for example, olive, sunflower, grape seed, almond, sesame, flaxseed).
As for stretch marks, it is impossible to cure them with conservative means and it is impossible to prevent their occurrence by 100%. However, you can reduce the likelihood of their occurrence, if you lubricate the skin with special cosmetics, nourishing cream or the above vegetable oils.
From the mammary glands in almost all women, at the 36th week, colostrum is released – a product that is a precursor of normal milk. Synthesizing colostrum, the glands are preparing for the upcoming production of milk to feed the baby. When the colostrum comes out of the nipples, you just need to wipe the skin with a clean, dry and soft cloth. You can not squeeze the colostrum out of your chest with your hands, because it can provoke mastitis.
The uterus prepares for childbirth, as a result, quite often during the day, women feel solitary, irregular, slightly painful and short-term contractions of the uterus, called Braxton Hicks training bouts. But if the contractions become regular, then they are no longer training, but quite real, and in that case you should immediately go to the maternity hospital, since they are a sign of the onset of labor.
In addition to all the above and described sensations, a woman in the 36th week of pregnancy often feels fear of the upcoming birth, suffers from insomnia, irritability, an unusual feeling of inactivity, awkwardness, heavy treading, awkward movements, inability to bend and perform others that are quite simple in the usual state actions. However, all these sensations will have to just go through, maintaining the presence of mind and mental balance. We must remember that all this is temporary and will end soon, so you should not give yourself the opportunity to lose your presence of mind.
Normally, on the 36th week, the discharge is painted in a whitish-milky translucent color, it smells slightly sourish, does not cause itching, burning, swelling or redness of the genitals. The amount of discharge on the 36th week may increase compared to the 35th. The consistency of the secretions may be watery or viscous mucous. The fluid consistency is preserved if the mucus plug from the cervical canal has not yet departed. But the change in the consistency of discharge on the 36th week for viscous and mucous suggests that mucus gradually leaves the cervical canal due to the fact that the latter is softened, preparing for childbirth. Sometimes in the 36th week, a stopper from the cervical canal comes out in the form of a lump of thick mucus with or without blood streaks, which is completely normal. The release of a lump of mucus or a change in the consistency of secretions on the viscous and mucous means that the kind will soon begin, so you need to be ready to go to the hospital at any time.
If the discharge has a character different from the above, they are pathological, and indicate the presence of a disease.
Pathological secretions containing admixture of pus and / or blood in any quantity or mucus in large quantities, painted in yellowish, greenish, grayish or earthy color, emitting an unpleasant pungent odor (rotten fish, beer, etc.) that have a heterogeneous consistency with lumps, flakes, blisters or causing a feeling of itching and burning, as well as swelling and redness in the genital area, indicate the development of an infectious-inflammatory process in the genitals. When such "inflammatory" discharge should be treated by a doctor, since any inflammation in the genital tract must be cured before delivery, so that the baby does not risk getting infected while passing through the birth canal.
In addition, any bleeding is considered pathological, since they are a sign of the development of potentially dangerous conditions. Accordingly, when the appearance of bleeding should be called "First aid" and hospitalized in the maternity hospital.
The third variant of pathological secretions on the 36th week is the amniotic fluid, which may leak in small portions or pour out simultaneously in large quantities.
The leakage of amniotic fluid in small portions is a periodic release of unclear whitish or yellowish fluid, which makes the skin of the perineum, pubis and thighs sticky. Sometimes the leakage of water occurs in such small portions that the woman does not notice the release of fluid from the vagina, but then she feels the causeless wetting of the panties and the fact that the skin of the pubis and perineum becomes sticky. In any case, leakage of amniotic fluid indicates a defect in the membranes, and with the development of this phenomenon should consult a doctor.
Water rupture is the discharge from the vagina of a large amount of liquid at one time, which is difficult not to notice. If such a situation arises, you should immediately be hospitalized in a maternity hospital. After using the water, doctors should evaluate how many of them are left in the uterus, and on the basis of this, make a decision to wear a pregnancy or carry out an early delivery (stimulate natural childbirth or perform a cesarean section). As a rule, during the outpouring of waters at the 36th week, doctors perform early delivery, since the fetus is already mature and will be not prematurely born, but prematurely born. Accordingly, donating it for 2 – 3 weeks with the risk of intrauterine death does not make sense.
More on vaginal discharge
If blood flows from the vagina in any quantity, any color and texture, then it is a bleeding. At the 36th week, any bleeding should be considered as dangerous, for which there is an objective reason. So, theoretically, at the 36th week, there may be non-dangerous bleeding, which are characterized by short duration, little blood is released, they do not cause deterioration of health and are caused by cervical erosion, hematoma of the vagina, uterine myoma, irritation or trauma to the genital tissues during sexual contact or gynecological examination, etc. But, in addition to the safe ones, on the 36th week they can develop very dangerous bleeding, the danger of which is that they are provoked by pathologies leading to the death of the mother or fetus. And since any dangerous bleeding at the very beginning can be disguised as safe, as a result, valuable time will be lost to provide qualified assistance, any discharge of blood from the vagina at the 36th week should be considered dangerous. Indeed, in such situations, as popular wisdom says, it is better to outbid than underclass.
Accordingly, for any bleeding from the vagina you need to call "First aid" and hospitalized in the maternity hospital. After the call "Ambulance" You should take with you a policy, passport, exchange card and telephone, then open the apartment doors, go to bed and wait for the doctors to arrive in a prone position. It is not necessary to go around the house and collect things in the hospital while doctors wait, as any physical activity may increase bleeding. And if the bleeding increases, the woman may lose too much blood before the doctors arrive, and she cannot be saved.
More on bleeding
Uterus and belly
At the 36th week, the height of the uterus floor reaches its maximum and averages 36 cm, but can vary from 32 to 37 cm. The upper part of the uterus is very high, resting on the xiphoid process of the sternum and diaphragm. Due to this position of the uterus, the 36th week is physically very difficult for a woman. But do not get upset – from next week it will become easier: the stomach will fall down, and the bottom of the uterus, too, due to the fact that the head or ass of the fetus enters the pelvis.
In some women, the head or ass of the fetus begins to descend into the small pelvis already at 36 weeks, which causes a feeling of pressure in the lower abdomen. The pressure is felt due to the fact that the fetus began to press on the bones and soft tissues of the pelvis, dropping into it.
In preparation for childbirth, the uterus is periodically reduced, causing irregular, low-painful, short in duration, self-sustaining and not increasing with time, Braxton Hicks training bouts.
On the 36th week of gestation, the belly stands out strongly and stands high, its circumference is 90 – 95 cm. A wide dark strip dividing it into two halves goes from the stretched and protruding navel down to the pubis down the middle of the abdomen. The skin of the abdomen, sides and hips due to stretching itching and itching, it may also appear rashes and stretch marks.
Pain in the abdomen and other parts of the body
Huge physical stress on the body, pressure of the uterus on organs and tissues and changes in the body provoke the appearance of pain of different localization in women at the 36th week of pregnancy, which, however, are completely normal, as they are connected with physiological, and not pathological processes. Consider the normal, typical for the 36th week of pain of different localization, as well as their differences from similar pathological pains of the same localization.
Abdominal pain at the 36th week of pregnancy may have a normal different character. Thus, the pain caused by the tension of the ligaments that hold the uterus, have the character of slanting on the sides or strong, but short in the length of the firing stresses when making sharp movements. The pains, agreed upon by the training fights, are of a pulling-aching nature, localized in the lower abdomen, appear periodically, do not last long, pass quickly and independently, do not increase with time. And the pain resulting from lowering the head or butt of the fetus in the pelvis, felt as pressure in the lower abdomen. Any normal abdominal pains, unlike pathological pains, do not increase with time, decrease or completely disappear after a short rest in a pose lying on one side or standing on all fours.
Pathological abdominal pains indicate the development of severe conditions that can lead to loss of pregnancy, death of the mother and / or fetus, therefore, are considered dangerous. Such pathological pains have their own distinctive signs: they increase with time, they do not decrease after resting on their side, they are localized in any part of the abdomen, they are pulling, cutting or sharp cramping in nature and are combined with lower back pain, elevated body temperature, vaginal discharge blood or large amounts of turbid water or a sharp deterioration in health. When signs of pathological abdominal pain appear "First aid" and be hospitalized in a hospital.
Also, at the 36th week, a woman may feel pathological and normal pain in the hypochondrium and ribs. Normally, the pains of this localization are of the nature of sudden, sharp, short, strong, but quickly passing painful shocks, and are provoked by kicks of the baby in this part of the body. Pathological pains in the hypochondrium are always long, do not pass on their own, are aching in nature, are combined with belching bitter and nausea, and are provoked by diseases of the liver and biliary tract. If you have pathological pain in the hypochondrium, you should consult a doctor.
In addition, almost all women in the 36th week of pregnancy suffer from normal pain in the bones of the pelvis, thighs, pubis and perineum, as well as discomfort when walking, which are caused by the divergence of the pelvic bones in the sides to increase the lumen of the birth canal ( born on the light). In addition, almost all women in the 36th week suffer from pains of varying degrees of intensity in the back, lower back, sacrum, coccyx, pelvic bones, thighs, hip joints and legs, which are caused by a high load on the bones, muscles and joints, as well as ligaments and tendons and a displaced center of gravity due to the protruding abdomen. A distinctive feature of the normal pain of all these localizations is that they diminish or completely disappear after a short rest in a pose lying on one side or on all fours, but they increase with physical exertion.
If the pain in the pubis and perineum is not reduced after rest or is combined with "duck gait"then it is pathological, since it is caused by a symphysitis, an inflammation of the pubic symphysis. If the back pain is combined with pain during urination and / or with increased body temperature, it is pathological and most likely caused by diseases of the urinary system. If the pains in the sacrum are sharp, strong, not subsiding, literally hardly tolerated and give up, then they are also pathological, and are provoked by sciatica (pinching of the sciatic nerve). If signs of symphysitis, sciatica and urinary system diseases appear, consult a doctor.
Leg pain can also be pathological, provoked by preeclampsia – a terrible complication of pregnancy. However, during preeclampsia, in addition to pain in the legs, the woman additionally has any of the following four symptoms: severe swelling of the hands and face + flickering flies and blemishes before the eyes or blurred vision + high blood pressure + protein in the urine. If you suspect that the pain in the legs is pathological, it is necessary to urgently be hospitalized in the maternity hospital.
Very often, pregnant women at the 36th week suffer from pain in the anus, which is always pathological. Such pains are associated with the development of hemorrhoids. If a woman has signs of hemorrhoids, it is necessary to consult a doctor and undergo a course of therapy, since this disease, if left untreated during pregnancy, becomes severe.
There is no consensus among doctors about whether it is possible to have sex on the 36th week. One group of doctors is of the opinion that sex is allowed, because, firstly, uterine contraction during orgasm cannot affect the onset of labor and fetal revolution, and, secondly, sperm has a beneficial effect, softening the cervix, thereby improving her preparation for childbirth. And the second group of doctors, on the contrary, believes that sex at 36 weeks is dangerous, because contractions of the uterus during orgasm can still provoke premature birth or a fetus turn in the wrong position, and the female genital tract can become inflamed even from contact with the normal microflora of the penis or a condom because of its sensitivity.
Thus, each pair will have to think independently what opinion of the doctors is closer to them, and on this basis to decide whether to have sexual intercourse on the 36th week.
Attention! It must be remembered that, regardless of the two polar opinions of doctors, there are conditions in which there is strictly prohibited sex at the 36th week. These contraindications include the following:
- The mucus plug came out
- Poured water
- A woman or man suffers from any genital diseases.
- Bearing twins, triplets, etc.
- There are any complications of pregnancy (water leakage, placenta previa, threatened miscarriage, premature birth in the past and present, etc.).
Regarding the weight that existed at the beginning of pregnancy, the body weight of a woman in the 36th week, normally, should increase by 7.9 – 13.6 kg. It is necessary to know that the fuller the woman, the closer to the lower limit of the norm should be her weight gain.
If the weight has increased beyond the norm, then it may indicate that, firstly, the woman is corpulently stouter, and secondly, that preeclampsia is developing (a terrible complication of pregnancy). In order not to get better during pregnancy and to monitor the development of preeclampsia in the early stages, you need to weigh yourself weekly and monitor weight gain every seven days. In the third trimester, weight gain should be no more than 500 – 700 g per week. If weight gain is more than 0.7 kg per week, then it is necessary to reduce the caloric intake of the diet, limit the intake of fluid, salt and be examined for the presence of preeclampsia.
Food and Alcohol
The menu of a pregnant woman should include healthy and natural products of animal and vegetable origin (cereals, wholemeal bread, meat, fish, seafood, fresh vegetables, fruits, berries, nuts, dried fruits, dairy products, butter and vegetable oil, and t .d.) to provide her body with all the necessary substances. To minimize consumption or eliminate from the diet should be harmful and too high-calorie foods (canned, fried, pickled, salted, smoked, spicy, spicy, fast food, tea, coffee, confectionery, sweets, pastries, etc.), as they contribute weight gain and cause a variety of digestive disorders (flatulence, bloating, heartburn), edema, etc.
Liquid should be ingested in an amount of not more than 1.5 liters per day, including water in soups and second courses. Juices, fruit drinks, fruit drinks and other natural drinks are best for drinking. It is recommended to eat and drink in small portions, but to do it when you want.
Some women are faced on the 36th week with a paradoxical desire to drink, which is caused by a lack of protein in the body, and not the need for alcohol. To eliminate this craving, you just need to include a large amount of protein foods (cheese, meat, fish, nuts, etc.) in the diet.
Drugs that can be used during pregnancy are determined depending on their affiliation to one of the five groups of FDA classification. These groups are allocated based on the effect of drugs on the fetus. The FDA classification divides all drugs into five groups (A, B, C, D, and X). And during pregnancy you can use drugs belonging to those groups for which no harmful effect on the fetus is typical.
So, at the 36th week of pregnancy without fear can be used drugs belonging to groups A and B according to the classification of FDA. The instructions for group A drugs always state that they are approved for use during pregnancy and do not have a harmful effect on the fetus. The instructions for group B drugs may include 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 "animal experiments have not revealed a negative effect on the fetus, but for people the absence of a negative effect on the fetus has not been confirmed, as a result there is a theoretical probability of a negative effect on the fetus, and therefore it is possible to take the drug only as prescribed by the doctor after assessing the risk / benefit ratio".
When a woman’s condition is poor, she has any disease that requires compulsory treatment, in the absence of which the pathology will progress, drugs from group C can be used at the 36th week of pregnancy. For drugs in this group, negative effects on the fetus in animal experiments have been revealed . But since man is not an animal, it is impossible to transfer the results of experiments on animals to people. Therefore, even the presence of a negative effect on the fetus in animals does not necessarily guarantee that the preparation will also have a negative effect on the human fetus. Thus, with the urgent need for therapy during pregnancy, the use of drugs of group C is allowed, because the benefits of them in this case will be invaluable, but the risk is doubtful, because the medicine may not cause any harm to the baby. In the instructions for use for preparations of group C, the following semantic phrase is necessarily present: "negative effects on the fetus were revealed during animal experiments, therefore it is prohibited to use during pregnancy or can be used in critical situations under the supervision of a physician".
With the threat of death at the 36th week of pregnancy, doctors use drugs of group D, which negatively affect the fetus. Moreover, their negative impact on the fetus in humans is confirmed by numerous clinical trials or experience of use. The instructions for group D drugs always state that "the medicine has a negative effect on the fetus, therefore it is forbidden to use during pregnancy".
Preparations of group X are never used during pregnancy, because they cause fetal death. The instructions to the drugs of group X always state that they are strictly contraindicated in pregnancy.
Thus, it is obvious that it is quite simple to understand whether a specific drug can be used during pregnancy – for this you need to read the instructions and extract all the necessary information from it. However, in real life it is not always possible to read the instructions. Below we provide a list of drugs of groups A and B, which can be used during pregnancy at the 36th week and which are most often used in daily life:
- Antipyretic drugs (to reduce body temperature) – Paracetamol-based drugs (Acamol-Teva, Daleron, Ifimol, Kalpol, Panadol, Lupocet, etc.) or acetylsalicylic acid (Aspirin, Acetylsalicylic acid, etc.) are acceptable. It is better to take drugs with paracetamol, since it is generally safer than acetylsalicylic acid. But acetylsalicylic acid can also be drunk during the 36th week of pregnancy, since recent research has shown the complete safety of this drug, although in the past it was thought that Aspirin was dangerous in the third trimester.
- Antitussives (for stopping dry cough without sputum discharge) are preparations with the active substance dextromethorphan (Akodin, Padeviks, Paracetamol DM, Tussin plus).
- Expectorant drugs (to facilitate the removal of sputum from the bronchi and lungs) – means with the active substances guaifenesin or bromhexin (Bronhikum, Bronchipret, Gerbion, Gedeliks, etc.).
- Remedies for nasal congestion and runny nose – only local forms (nasal drops and sprays) with the active substances pseudoephedrine, phenylephrine (Vibrocil, Orinol Plus, Rinopront, etc.), xylometazoline or oxymetazoline (For Nose, Galazolin, etc. ).
- Antiallergic drugs – any antihistamine drugs belonging to the third generation (Allegra, Desloratadine, Norastemizol, Telfast, Ezlor, Erius, etc.).
- Painkillers (to relieve pain of different localization) – you can take drugs with the active substance drotaverin (No-Spa, Drotaverin), papaverine (Papaverine) or magnesia (magnesium sulfate).
- Antacid drugs (for stopping heartburn) – you can take drugs with the active substance magnesium- or aluminum hydroxide (Almagel, Alumage, Gastracid, Maalox, Fosfalyugel).
- Antifungal drugs (for the treatment of candidiasis / thrush) – you can only local forms (suppositories, creams and ointments for vaginal administration): Clotrimazole, Mikogal, Miconazole, Natamycin, Nystatin, Sertaconazole, Econazole.
- Antihemorrhoic drugs – you can only local forms (suppositories, creams and tablets for the introduction into the rectum): Hepatrombin, Dobezilat calcium, Proktoglivenol, Relief, Troxerutin, Eskuzan.
- Laxatives (for constipation) – any syrup with lactulose is allowed (Dufalac, Portalak, Normase, etc.).
- Antidiarrheal drugs (to stop diarrhea) – probiotics (Linex) and sorbents (Smecta).
- Antibiotics are drugs from the penicillin group (Amoxicillin, Amoxiclav, etc.), the group of cephalosporins (Cefuroxime, Cefalexin), as well as Nitrofurantoin, Erythromycin, Polymyxin, Lincomycin, Clindamycin.
- Antihypertensive drugs (to lower blood pressure) – drugs with the active substances methyldopa (Methyldopa, Dopegit), metoprolol (Betalok, Metolol, Metoprolol, Egilok, etc.) or atenolol (Atenol, Atenolol, Betacard, Tenormin, etc. ) as well as nifedipine. In this case, nifedipine is used as a drug for a single, episodic decrease in pressure, when it is critically necessary. And means with metoprolol, atenolol or methyldopa are used by long courses to maintain pressure within normal limits. At the same time, for the course of administration, drugs with methyldopa are prescribed in the first place, and only if they are ineffective do they switch to medication with metoprolol or atenolol. This is due to the fact that methyldopa is safer than atenolol and metoprolol.
- Antivirals (for the treatment of influenza and ARVI) – drugs with the active substances oseltamivir (Tamiflu) or zanamivir (Relenza). Both drugs are recommended by WHO, but remember that they belong to group C, therefore, they can only be used under the supervision of a physician.
- Decongestants (for stopping edema) – you can drink pharmaceutical kidney tea and magnesium preparations (Magne B6, Magnerot, etc.).
Birth on the 36th week
Starting from the 36th week of pregnancy, a woman should be ready for childbirth at any time. Moreover, babies from the 36th week of pregnancy are already considered full-term, and therefore, if necessary, a planned cesarean section (for example, triplet pregnancy, preeclampsia) can be performed from this time of pregnancy. In many maternity hospitals there is a practice of prenatal hospitalization of women with planned cesarean section from 36 weeks, and the operation itself is carried out at 37 – 39 weeks, because in these terms the baby is already full-term, viable, it does not have to be nursed, but to undergo surgery or induced giving birth is easier and safer.
Thus, if the birth takes place at the 36th week, there is no need to worry – the child is already fully prepared for life outside the womb of the mother, and therefore he will not have to be nursed. In other words, a completely normal, healthy baby will be born at 36 weeks.
More about childbirth
36 week of pregnancy: preparing for a trip to the maternity hospital, how to distinguish real contractions from false ones (recommendations of a gynecologist and a neonatologist) – video
Author: Nasedkina A.K. Specialist in conducting research on biomedical problems.