Sixteenth week of pregnancy

Future child.

Height – 14-16 cm, weight – 100-110 gr.

The child’s nervous system is growing at full speed, which started at the fifth week of pregnancy. Every second 5000 neurons are formed, which amounts to 100 billion by the end of the sixth month! The legs of the child, finally, have become longer than the handles, the nails have completely formed, the ears have acquired a completely human form.

Up to 250 ml increases the volume of amniotic fluid in which the baby swims. Every 45 minutes a child takes out the wastes of his vital activity into the amniotic fluid, which are decomposed by liquid into chemical elements and re-formed into nutrients.

The child actively stirs in his warm bath and, possibly, the expectant mother is already beginning to feel his movements. Usually women who give birth for the first time, feel the perturbations only by the 20th week of pregnancy. Those who gave birth earlier, feel them by 16-18 weeks. Perhaps this is due to the fact that experienced moms already know what “shaglyushki” are like.

It is impossible to describe this sensation with scientific accuracy, because every woman feels it in her own way. Someone says that a butterfly has settled in the stomach, someone compares with tickling or with bubbles, someone just feels touching the inner surface of the abdomen (uterus). At the same time, and the timing and sensation of the movements of the first and second child in the same woman may not be the same!

Mom, who gives birth for the first time, often waits for quite distinct sensations of stirring something big inside her (as happens in later terms), and she does not pay attention to the weak and almost imperceptible, very quivering and light touch of her baby.

Sometimes she even takes a stir for the processes of her own organism (gases, passage of food, muscle contractions). And only then, when these phenomena are repeated with an enviable regularity, the mother understands who causes new sensations.

In addition to stirring, the kid is busy with swallowing the amniotic fluid, sucking his finger and grabbing everything that comes to his hand: another handle, leg and often the umbilical cord (scientifically, umbilical cord). The umbilical cord, by the way, is the first toy of your baby.

He loves to pull it, to reel and unwind, often flirts even to the cord with the umbilical cord around the neck, which can complicate the delivery somewhat. However, in early terms, you do not need to worry about this. Before giving birth, the baby may have time to wrap around a few more times and unwind back.

The cord is very flexible and sturdy, it can withstand weight up to 5-6 kilograms. Its membrane reliably protects the veins and arteries that go from the placenta to the tummy of the baby. The umbilical cord grows with the baby, which allows him to move freely in the bladder. By the birth of the umbilical cord will reach 40-50 cm in length and 2 cm in diameter!

Another miracle: the child’s fingers have already formed their own unique skin pattern!

Future Mom.

If you weigh about 2.5 – 3 kg, then you belong to those rare women whose body weight is added according to the ideal norm. In fact, you can add 5 and even 7 kg.

Often additional kilograms come because the future mother has an increased appetite. After all, the baby needs so many nutrients! Remember that now is not the time to think about diets. Food should be useful and nutritious. It is better to eat several times a day, snacking a little bit (fruits, vegetables, salads, curds) than as before 2 or 3 times a day.

You must at this or, at most, next week, visit a doctor and take the AFP test (or triple test) and smear for infection. It will not hurt to do a general urine test and a clinical blood test.

Analysis data on AFP signal developmental defects, for example, chromosomal abnormalities such as Down syndrome, or a defect in the development of the spinal cord. Now we are doing a more modern analysis – the so-called triple test. In this case, not only the AFP level is measured, but also the content of hCG and estriol.The test is in addition to the double test done on the 11-12th week of pregnancy.

AFP (alpha-fetoprotein) is a protein that the baby produces in his liver and ventricle, and then passes through the amniotic fluid and the placenta to the mother. Its highest value in the woman’s blood is observed at 32-34 week of pregnancy.

Estriol is a steroid hormone, the proportion of which in the blood increases from the moment of pregnancy (formation of the placenta). Estriol increases blood flow, its values ​​show how well the feto-placental complex functions.

HCG is a specific pregnancy hormone. It provides the synthesis of estrogens and progesterone (on which almost everything is based during pregnancy), is responsible for the formation of testosterone in the event that a boy is expected. HCG begins to be produced in the very first days of pregnancy, the peak values ​​are 10-11 weeks, then its amount gradually decreases.

Which indicators are considered normal?

AFP:

13-15 weeks – 12-60 U / ml
15-19 week – 15-95 U / ml
20-24 weeks – 27-125 U / ml

Estriol:

15-16 week – 5,4-21,0 nmol / l
17-18 week – 6,6-25,0 nmol / l
19-20 week – 7,5-28,0 nmol / l
21-22 week – 12.0-41.0 nmol / l
23-24 weeks – 8.2-51.0 nmol / l

HCG:
14 weeks – 14,000-80,000 mU / ml
15 weeks – 12,000-68 000 mU / ml
16 week – 10 000-58 000 mU / ml
17-18 week – 8 000-57 000 mU / ml
19 week – 7 000-49 000 mU / ml
20-28 week – 1 600 -49 000 mU / ml

As you can see, all indicators are in the range of values. The value is considered anomalous when the discrepancy is not a unit of the norm, but at times.

In addition, it should be remembered that it is necessary to consider the values ​​of the triple test in relation to each other. One marker does not give a general picture. Moreover, even a comprehensive analysis of the three positions should be compared with the data of other clinical studies of a pregnant woman (the same ultrasound, for example).

Increased level of AFP:

– malformations of the spinal cord and brain of the fetus;
– anencephaly;
– open cerebrospinal hernia;
– Child’s liver necrosis due to a viral infection;
– congenital obstruction of the duodenum;
– Meckel syndrome;
– Rh-conflict.

If pregnancy is prolific, then an elevated level of AFP is the norm!

Low AFP level:

– Down’s syndrome and Edwards syndrome;
low-lying placenta;
– death of the fetus;
– miscarriage.

It is also observed if the mother has incorrectly determined the duration of pregnancy, there is obesity, diabetes, hypothyroidism. Scientists say that the level of AFP depends on the race of the person.

Elevated level of ESTRIOL:

– multiple pregnancies;
is a very large one kid;
– liver disease.

Decreased level of estriol (more than 40% of the norm):

– Down’s syndrome;
– threat of miscarriage or premature birth;
– anencephaly;
– feto-placental insufficiency;
– adrenal hypoplasia;
– intrauterine infection;
– the body’s response to antibiotics or glucocorticoids.

Increased hCG level:

– chromosomal pathology (Down syndrome, Edwards syndrome, etc.) against a background of decreased AFP and estriol levels;
– malformations of the fetus;
– reaction to synthetic gestagens.

In addition, it can be observed with improperly established terms of pregnancy, diabetes maternal, severe early toxicosis, multiple pregnancy:

Lowered hCG level (more than 50% of the norm):

– intrauterine fetal death (at 2 and 3 trimesters);
– ectopic pregnancy and threat of miscarriage (in the first trimester);
– placental insufficiency;
is a frozen pregnancy.

A future mother may refuse and do not do a screening to save her nerves, especially if the first double test showed the norm. According to statistics, 5% of the analyzes show abnormal results. In 90% of cases, of these anomalous 5%, women give birth to absolutely healthy children.

This “inaccuracy” of the data can be explained by the fact that the pregnancy period is incorrect and the analysis was not carried out at the time when it is necessary (15-18 weeks from the date of the last menstruation) or pregnancy proves to be prolific.

In any case, the result obtained, even outside the norm, is only an indicator of the degree of risk, and not an accurate diagnosis. Usually, if the analysis shows abnormal results, a woman is sent for repeated blood donation and ultrasound to adjust the timing of pregnancy or determine its multiplicity.

If the results are again unfavorable (probability is only 4%), amniocentesis (amniotic fluid puncture) is performed. Probability of miscarriage after sampling 1: 200.

This analysis resembles a jewelry operation. The sample is taken with simultaneous ultrasound. Through the uterus, a needle is inserted into the fetal bladder and several cubes of amniotic fluid are taken. Then from it will be selected cells that are “thrown off” the child – exfoliated epidermis, urine and so on. On their basis, the karyotype of the baby is formed – a photograph of the chromosomes, on which one can see whether there is an extra chromosome that speaks of an anomaly of development, or not.

We remind you that a normal person has 46 chromosomes (23 pairs). The most common defect is the presence of a third chromosome in 21 pairs (the so-called Down syndrome). The risk of the birth of a child with trisomy 21 increases with the age of the mother (it is interesting that with the age of the father the data does not correlate). In 25 years the risk is 1: 1300, 30 years – 1: 965, 35 years – 1: 365, 40 years – 1: 109, 45 years – 1:32, 50 years – 1:12! There are also trisomy in 18 pairs (Edwards syndrome) and 13 pairs (Patau syndrome).

In addition to chromosomal abnormalities, amniocentesis makes it possible to identify bone diseases, herpes and rubella, anencephaly, hemolytic disease and other blood diseases, congenital metabolic disorders (cystinuria), of the order of 40 diseases out of 400 (10%). But, unfortunately, it is accompanied by a threat of miscarriage. Therefore, resort to puncture now have become less and less, and only in emergency cases.

In any case, if you are really going to do a triple test, try to make it with a time reserve to have time to retake blood before 18 weeks if something is wrong.

15 weeks – 16 weeks – 17 weeks

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