28 weeks of pregnancy heavy discharge with a characteristic pattern. Bleeding during late pregnancy: possible causes and diagnosis

The larger the mother’s belly becomes, and the closer the birth gets, the more often it is quite difficult for a woman to calculate: how many months is 28 weeks of pregnancy? Considering obstetric months, in which a month has 28 days, you can calculate: the 28th week of pregnancy falls on the 7th month of pregnancy. This is the first month of the third trimester, a month that brings a woman even closer to the long-awaited meeting with the baby growing in her tummy.

Ultrasound

Usually an ultrasound is not required at 28 weeks of pregnancy - unless for some special indications. The second planned ultrasound examination is already over, and the time for the third planned ultrasound examination has not yet arrived - it awaits the woman at 32 weeks of pregnancy. Although theoretically, an ultrasound at 28 weeks of pregnancy is still capable of showing the baby, the location and degree of maturity of the placenta, and the umbilical cord. It’s just that the readings displayed on the monitor are very difficult for mommy to make out: it’s impossible to see the baby completely. And how things are going with the development of the child, whether everything in this case corresponds to the norm, can only be determined by a doctor.

Tests at 28 weeks of pregnancy

But tests may be needed at the 28th week of pregnancy - both “traditional” (urinalysis, clinical blood test), and a blood test for sugar, as well as an antibody test. The latter becomes a necessity if the expectant mother has a negative Rh factor: such an analysis will help determine whether a Rh conflict is developing and whether certain complications of pregnancy and childbirth will be associated with this. If necessary, the woman will be given a special drug that will prevent the synthesis of antibodies to the fetal blood in the mother's body.

Starting from the 28th week of pregnancy and until childbirth, a woman will have to see a gynecologist more often: 2 times a month, with each visit taking urine samples for analysis, and, if indicated, blood tests. Now it is extremely important to monitor the level of iron in the body during pregnancy in order to avoid the development of anemia, as well as constant measurements of blood sugar levels, the increase of which indicates the likelihood of developing gestational diabetes.

Stomach

The seventh month is already quite a “solid period”, therefore it is not surprising that at the 28th week of pregnancy the belly is already greatly enlarged, and the mother’s figure is acquiring more and more rounded “shapes”. Due to the constant growth of the abdomen and the tension of the skin on it, the abdomen begins to itch and itch, and if it is overstretched, it becomes covered with purple stripes and stretch marks. Eliminating stretch marks that have already appeared is not an easy task; it is much easier to avoid their appearance. For this purpose, today there are many different cosmetic products in the form of creams and gels for stretch marks for pregnant women. Vegetable oils - olive, almond, citrus - are also excellent as a preventive measure for the appearance of stretch marks.

Uterus

The uterus also increases significantly by this time - the uterus is located 8 cm above the navel and 28 cm above the symphysis pubis. And this is far from the end: the uterus will continue to grow as the baby grows in it - until birth. But now, without “waiting” for the appointed due date, the uterus can periodically contract slightly and with little pain. If from time to time the mother feels the uterus tense easily at the 28th week of pregnancy, there is no need to be alarmed: if contractions of the uterus do not cause severe pain, are not prolonged and irregular, and are not accompanied by discharge, then so-called false or training contractions are taking place. Through such contractions, the uterus at 28 weeks of pregnancy “learns” to contract and prepares for the upcoming birth.

Childbirth at 28 weeks of pregnancy

Starting from the 28th week of pregnancy, if suddenly for some reason the baby decides to leave the mother’s womb early, the fetus is considered viable, and its actual birth is considered premature birth. Childbirth at 28 weeks of pregnancy can result in a very successful outcome for a baby: the likelihood of his survival is very, very high. True, the baby had a chance to survive even if he had been born at an even earlier stage, but only at the 28th week of pregnancy these chances increase even more. Of course, this will require special equipment, equipment, and careful care of the baby.

But for a mother, premature birth at 28 weeks of pregnancy, which is taken as an urgent one, can be overshadowed by very common complications. These include early and premature release of water, cervical ruptures, weak labor, unprepared birth canal, bleeding during the labor and postpartum period.

Fetus

Normally, the fetus at the 28th week of pregnancy continues to improve, every day preparing to meet a new world. The baby's weight already reaches a kilogram, and sometimes more, his height is about 38-38.5 cm. Bone tissue is actively strengthened, pulmonary alveoli are formed, which will give the baby the ability to breathe on his own. The baby’s brain is also developing - grooves and convolutions are gradually formed on it, the formation of which began a little earlier.

The baby gains weight due to the formation of subcutaneous tissue, which also contributes to the gradual smoothing of the baby’s skin. As the fetus grows at the 28th week of pregnancy, it increasingly fills the uterine cavity, leaving less and less room for the baby to move. But his activity is still high: the baby has developed his own sleeping and waking patterns, and during hours of activity he noticeably makes himself known to his mother.

Feelings at 28 weeks of pregnancy

This is expressed in the fact that the woman feels the baby’s movements within herself more and more. It is precisely these sensations at the 28th week of pregnancy - sensations of regular movements and periodic activity of the fetus - that are very important for monitoring the normal condition of the baby.

Doctors recommend carefully monitoring your baby's activity, recording his movements in the morning and evening. True, they warn: in the evening, the baby’s movements can be much more noticeable - during the day he often remains calm, pacified by motion sickness from the movements and movements of his mother. But as soon as a woman sits down or lies down in bed in the evening, preparing for a night's rest, how - rrraz! The baby begins to actively move, tumble and kick in the tummy, preventing the mother from falling asleep.

The baby's movements may also increase in response to the mother's food intake - along with an increase in glucose levels in the pregnant woman's body. The baby also reacts with active movements to an increase in adrenaline in the mother’s blood - due to stress or emotional arousal. In general, the baby makes about 10 movements over 10 minutes. However, this does not mean that all the babies in their mother’s tummy should move with exactly the same activity: each baby is unique, some are more “temperamental”, some less so. So, there is no reason to worry, even if the baby moves up to 10 times within an hour. But if movements are felt even less frequently, you should be concerned. If the baby’s movements are not felt throughout the day, you should consult a doctor immediately.

Pain

The seventh month is a very “tangible” month of pregnancy for a woman. So, due to the increasing changes that the body undergoes as the baby grows and the uterus enlarges, a woman may well experience some pain at 28 weeks of pregnancy. We are talking, first of all, about painful sensations in the lumbar region, back - as a result of softening of the supporting ligaments and joints, a shift in the center of gravity due to the growth of the abdomen.

Pain at the 28th week of pregnancy in the lower back, similar to pain with radiculitis, which spreads along the thigh and even “reaches” the knee and ankle, is explained by the pressure of the growing uterus on the sciatic nerve. Usually such pains arise “spontaneously”, are not particularly strong and quite tolerable, and are increasingly aching in nature. But if you experience sharp and severe, cramping pain in the lower back, you should immediately call a doctor - such symptoms may indicate a high probability of premature birth.

You should also listen to pain that occurs in the abdominal area. So, from time to time there may be a sharp and quickly subsiding pain in the hypochondrium - this is the baby digging. If the pain in the hypochondrium is dull, occurs several hours after eating and is accompanied by a feeling of pulling in the abdomen, nausea, and bitter belching, you should definitely be examined by a doctor for possible gallstone cholecystitis.

A special issue is the development of edema, which becomes a frequent accompaniment of pregnancy. Many expectant mothers begin to “swell” to one degree or another, sometimes noticing that their favorite shoes have become too small, and their faces become puffy. However, if the swelling is significant, you should consult a doctor as soon as possible: severe swelling becomes the first sign of dropsy and the further development of a dangerous complication of pregnancy - late gestosis. When edema appears, you need to be especially careful about weight control, reduce fluid intake to avoid its accumulation in the body, and also adjust your diet. So, the amount of liquid consumed per day should be reduced to 1.5 liters (including soups, milk, fruits). To avoid thirst, you must completely avoid foods that provoke it - smoked meats, fried and spicy foods, concentrated broths, and significantly limit the use of salt. It also becomes necessary to control bladder emptying: according to the norm, the amount of urine released during the day should exceed the amount of fluid consumed during the same time.

Weight

As for weight, it is believed that, starting from the seventh month, mommy should gain about 50 g per day and about 300 g (at most, 500 g) weekly. Normally, weight at 28 weeks of pregnancy can increase from 8 to 10.5 kg. And further weight gain must be monitored very carefully, weighing yourself every morning and strictly adhering to the indicated diet.

Nutrition

Nutrition at the 28th week of pregnancy must be structured in such a way as to provide the small organism growing in the womb with all the necessary nutrients and beneficial substances. Doctors, speaking about nutrition while carrying a baby, unanimously agree on one thing: a special diet tailored to the needs of the pregnant woman and the baby inside her can ease the course of pregnancy and ensure normal childbirth.

An important aspect is diet: given that weight gain accelerates from the 28th week of pregnancy, you should consume food 5-6 times a day in small portions, choosing healthy and high-quality foods. In general, the total number of calories ingested per day for a pregnant woman at week 28 should be about 3 thousand units. Moreover, nutrition at the 28th week of pregnancy should be varied, the main amount of calories consumed should be in the first half of the day. After 19 hours, it is advisable not to eat at all, except for fermented milk products in the form of kefir or milk, apples or light vegetable salads.

In the third trimester of pregnancy, significant salt restriction becomes mandatory. As mentioned above, salt leads to fluid retention in the mother’s body, which, in turn, contributes to the development of edema.

Since rapid weight gain also includes eating simple carbohydrates, it is necessary to reduce the consumption of foods containing them. These include confectionery, candies, potatoes, white rice, chocolate, and products made from refined white flour.

In addition to the fact that quickly digestible carbohydrates lead to rapid weight gain, they also cause an increase in glucose levels in the blood of a pregnant woman. A serious consequence of this may be the development of gestational diabetes in the mother, which can complicate not only the course of pregnancy, but also the process of childbirth.

Instead of foods containing “fast” carbohydrates, it is better to enrich your diet at 28 weeks of pregnancy with foods that contain complex carbohydrates. Complex carbohydrates take a long time to digest, bring a long-lasting feeling of fullness, do not cause a spike in glucose and normalize digestion. Foods such as whole grains, a variety of cereals, brown rice, corn, and wholemeal bread contain complex carbohydrates. Vegetables and fruits, in turn, are rich in fiber - it also promotes better satiety, improves intestinal motility, and has a beneficial effect on digestion.

Discharge at 28 weeks of pregnancy

Discharge at the 28th week of pregnancy retains its previous character: normally, the discharge should be light or milky in color, uniform in consistency and with a slightly sour odor. If suddenly the discharge at the 28th week of pregnancy changes color towards gray, green or yellow, is distinguished by the appearance of cheesy formations, clots of mucus or pus, accompanied by itching and a burning sensation in the genital area, you need to consult a doctor for the presence of infection and decide on its scheme treatment.

If there is bleeding, you should immediately call an ambulance. Thus, spotting at the 28th week of pregnancy most often indicates previa or abruption of a normally located placenta. In this case, bloody discharge can have a different character: be insignificant or abundant, spotting, brown or with a scarlet tint. In addition, spotting at 28 weeks of pregnancy may indicate an increased risk of preterm birth. Almost every situation in which spotting occurs is also accompanied by nagging pain in the abdomen. In any case, medical intervention should follow on an emergency basis: if bloody discharge appears, you need to call an ambulance as soon as possible.

Also, a pregnant woman should be suspicious of the appearance of watery discharge, which indicates leakage of amniotic fluid. Water can flow either noticeably or leak slightly. Be that as it may, in such a situation we will be talking about a violation of the integrity of the fetal bladder, and therefore the amniotic fluid flows out.

Sex

If future parents are concerned about the safety of physical intimacy while carrying a baby, then the answer will most likely please them. After all, according to experts, sex at 28 weeks of pregnancy is not only not prohibited, but is even indicated, being one of the ways to obtain positive emotions, joy and pleasure, and relaxation. Sex at 28 weeks of pregnancy will not harm your baby in any way; the main thing is to choose a comfortable position that will eliminate pressure on the mother’s belly. The only contraindication for having sex at this stage may be a diagnosed threat of premature termination of pregnancy. In all other cases, parents can quite calmly enjoy each other’s closeness.

The birth of a child is considered a huge holiday for the family and in particular for the mother. Only women will be able to understand how difficult it is to carry a fetus for 9 months and then endure the agony of childbirth. But how wonderful it is when a baby is born.

During such a period, many mothers who have already given birth consider it their need to give advice or warn about something. So, the pregnant woman begins to apply all their problems to herself - is there a strong pull in the lower abdomen or how often does the fetus move?

28th week of pregnancy: discharge within normal limits

Most often, pregnant women do not feel very good in the first trimester, although the second and third, and especially the last weeks, also contain certain “wonderful” moments. I propose to analyze the 28th week of pregnancy.

Pregnancy at 28 weeks generally involves the presence of a fetus approximately 35 cm long, weighing just over 1 kilogram, its head having a diameter of about 70.5 mm, the chest in diameter increasing to 71.9 mm, and the tummy - up to 73.5 mm. During this period, the fetus continues to grow rapidly, gain weight and develop.

The outlines of the head and face acquire smooth, soft contours, the cheeks become plump and round, the first signs of constrictions appear on the arms and legs. Due to the presence of closely spaced capillaries to thin skin, it acquires a more reddish tint. The scalp gradually becomes darker in color as pigment begins to accumulate.

The fetus is so actively capable of carrying out the accumulation process that by the time of birth it can be much darker than its parents due to the fact that the amount of pigment has exceeded the genetically transmitted parameters laid down at conception.

So you shouldn’t be surprised if at this time a premature baby born has a much darker hair color than its parents. In addition, the period is 28 weeks of pregnancy, discharge from the pregnant woman’s vagina cannot show whether there are hairs on the fetal head or not.

During this period, intensive development of the cerebral cortex continues, and now it is possible to make small assumptions about the predominance of the hemispheres: right or left. This can be determined quite easily - on an ultrasound you should look at the finger of which hand is in the fetus’s mouth. If it is right, then the baby will be right-handed, but the left hemisphere will be predominant.

If it is the left hand, then everything is the other way around, and the right hemisphere will take a dominant position. As for the respiratory system, all structures should be formed by the 28th week of pregnancy. One of the main components is surfactant, due to which the process of filling the alveoli with air occurs. By this time, its quantity has reached its maximum value. As a result, children born prematurely in this period have the ability for adequate respiratory ventilation.

Also, at 28 weeks, the discharge of the expectant mother cannot show how developed the fetus is. However, in this case, help is needed in the following: maintaining a certain body temperature of the baby and other still underdeveloped functions, since the process of independent thermoregulation has not yet been formed. In this regard, such children are kept in an incubator, which has favorable conditions for continued full development, such as constant optimal temperature and air humidity.

At 28 weeks of pregnancy, a woman already begins to think about childbirth and the process of safely carrying a fetus to term.

However, now you should not worry and observe only your ongoing processes and not listen to most wise women. If you have any questions, you should contact your gynecologist, not your neighbor.

Yellow discharge during pregnancy is considered normal, since when a woman is pregnant, it tends to change color and consistency. Such changes are associated with an increase in the production of progesterone, secreted by the corpus luteum, as well as several other hormones. Normal discharge is considered transparent or milky in color and does not have flakes or additional components. Their consistency is similar to egg white, and there should be no smell, of course, subject to adequate hygiene.

In addition, such discharge should not cause itching, redness, or the appearance of spots and rashes on the genitals. Yellow discharge is considered a pathology when it has a viscous, viscous property, has a strong fetid odor that resembles putrefactive processes, and is accompanied by irritation of the skin with the formation of small ulcers. In addition, there may be pain or cramping when urinating and itching in the genital area. All these signs characterize a fungal or bacterial infection.

Frequent pathogens are gonococci, staphylococci and Escherichia coli. Sometimes a woman could get sick before pregnancy, but the pathogen did not immediately manifest itself, and only became active when the immune system decreased. The yellow color of the discharge is added by pus and waste products of microbes. The dark yellow color combined with the smell of rotten fish indicates trichomoniasis, which is very dangerous during pregnancy.

Light brown discharge during pregnancy in the first trimester is considered normal.

This occurs due to a violation of the structure and integrity of the endometrium of the uterus during implantation of the fertilized egg. A darker-than-brown discharge may appear in later weeks as a result of a mucus plug coming out.

This is the norm only when there are no more than two weeks left before the expected due date. In other cases, dark discharge is assessed as a pathology and requires immediate decision making. This is due to impaired functioning of the genital organs due to cervical erosion or an infectious disease of the reproductive system. In the case of blood traces, the condition is considered urgent, since we are talking about premature detachment of a normally located placenta or ovum. Moreover, if on top of everything there is a pulling, cutting or cramping pain in the lower abdomen.

Liquid discharge during pregnancy appears in the second half and later stages due to an increase in the level of estrogen in the blood. The vaginal mucosa begins to produce so-called leucorrhoea as a result of increased permeability of the vascular wall. Most women begin to worry and panic about this, but in vain.

During such a period, it is advisable to more carefully observe the rules of personal hygiene, since now any infection can easily and quickly occur. In general, all concerns about health should be resolved with a doctor, since advice on forums or on the street differs from a professional opinion.

As for the free time of the expectant mother, she is required to spend more time walking in the fresh air, talking with the baby and promoting its development. This could be reading books, fairy tales and listening to music together. Also, do not forget about the correct water and nutritional regime, including vitamins and beneficial microelements.

The feeling and well-being of the expectant mother is important, and you especially need to monitor the discharge at the 28th week of pregnancy. At this time, the fetus is actively developing, the woman should not worry about anything except possible back pain due to the increase in abdominal weight. However, there is a risk of premature birth, placental abruption, or other complications. Some abnormalities during pregnancy may be indicated by vaginal leucorrhoea, which is not normal.

What happens if there is discharge?

Under normal conditions, discharge in the late stages, namely at 28 weeks of pregnancy, should not change color, consistency or color. They are usually white or transparent, they have virtually no odor and the mucus is uniform without inclusions.

The appearance of earthy-brown discharge with an unpleasant odor indicates the appearance of an infection in the woman’s body, namely in the genitals. Such diseases threaten the life and health of the fetus and require treatment by a gynecologist.

The occurrence of pinkish discharge or leucorrhoea mixed with blood is a more serious symptom - they indicate placental abruption or previa, possibly a sign of early labor. In this case, you should immediately seek medical help.

Yellowish discharged water often indicates loss of amniotic fluid. They significantly increase the level of humidity of the external genital organs; violation of their tightness harms the child.

Any deviation in mucus discharge may indicate the development of pathological processes. The lack of timely treatment harms the unborn child and the woman herself, and treatment of the disease in later stages of development may be unsuccessful.

What discharge is considered normal at 28 weeks of pregnancy?

The formation of mucous leucorrhoea that has no color or has a white tint is considered normal. They must be homogeneous and odorless. Under certain conditions, mucus may turn yellow, this is due to hormonal changes. But normally it should have no odor, and there should be no sores or cracks on the genitals.

A woman should not feel discomfort in the intimate area, leucorrhoea should not cause itching, pain, or irritation of the mucous membrane. Otherwise, these symptoms indicate the development of a fungal or bacterial infection.

To prevent the development of bacteria, you need to carefully monitor intimate hygiene. Of course, in addition to this, there are many other recommendations for pregnant women. It is necessary to monitor your diet, do not forget to take vitamins, and undergo regular examinations if they are needed.

All this is necessary because at 28 weeks of pregnancy there is a risk of premature birth. During this period, the fetus grows rapidly and can provoke early dilatation of the cervix, especially with severe physical exertion, for example, lifting a heavy object.

During such a period, it is necessary to wear a special bandage; it will relieve the load on the spine. However, before buying such a device, you need to consult a gynecologist so as not to harm the fetus.

During pregnancy, especially in the last third of the term, a woman is very vulnerable; she needs to monitor not only her health, but also the well-being of the baby. In this position, serious physical exertion should be avoided, it is recommended to wear loose clothes and comfortable shoes, if you are prone to varicose veins, wear special underwear, the same applies to a bra - the breasts at this stage become larger and more painful, colostrum begins to be released, the bra should not squeeze the chest.

Discharge mucous like snot

If thick mucus comes out, like snot, we can talk about a surge in hormones. In the first trimester, this hormone is progesterone, it affects many changes in the body, thanks to it the formation of a mucus plug occurs, which protects the fetus from infection. During this period, leucorrhoea should have no odor, foreign shades or inclusions, and have a uniform viscous consistency.

At a later stage, namely in the third trimester, the discharge may retain the same appearance as at the beginning of pregnancy, but it may also change. During its normal course, there should be no bloody discharge, as well as leucorrhoea that has an unpleasant odor. The discharged masses should not cause discomfort or make the woman feel pain. If discomfort occurs, you may need to consult a specialist.

You need to very carefully monitor the appearance of discharge in the last weeks of pregnancy - they may indicate the imminent onset of labor. So, the removal of the plug may be accompanied by pinkish or red discharge, this means the beginning of labor.

Pathological causes of discharge during pregnancy

Any change in consistency, smell or color may indicate pathological processes in the body. The most common problem that gynecologists encounter when examining a woman during pregnancy is the presence of infectious diseases in the patient.

The cause of bacterial vaginosis is a violation of the vaginal microflora. The main symptoms are the smell of rotten fish and profuse leucorrhoea. As a preventive measure, it is recommended to avoid wearing tight trousers and synthetic low-quality underwear, as well as stress.

Thrush or candidiasis can appear in a woman with hormonal imbalances, weak immunity, or due to long-term use of antibiotics. The appearance of white, heterogeneous discharge with an unpleasant odor and a feeling of discomfort in the intimate area are the first signs of this fungal disease.

The cause of colpitis is the excessive proliferation of harmful organisms. Symptoms are yellow discharge with purulent patches.

Trichomoniasis is an STD that is characterized by severe itching and discharge of varying consistency and an unpleasant odor.

All infections acquired before or during pregnancy must be treated before labor begins. Your doctor may prescribe antibiotics. Do not avoid taking them, as the harm to the fetus from infections is greater than from medications.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

From the twelfth week, the gestational age is indicated exclusively in obstetric weeks, since various parameters of growth and development, with which the current state of the fetus is compared, are adjusted specifically for the obstetric period.

Fetus

The body weight of the fetus at the 28th week of pregnancy averages 1124 plus or minus 183 g, but can reach up to 1300 g. The length of the fetal body can reach up to 38 cm, and on average is 35.9 plus or minus 1.8 cm It must be remembered that at this stage the body length and weight of the fetus can vary widely among different women, since they are determined by a number of individual characteristics, such as a genetically predetermined constitution, the nature of the expectant mother’s diet, etc.

At the 28th week, the fetus has its own immune system, its lungs are ready for gas exchange - that is, the alveoli can already release carbon dioxide and bind oxygen.

The digestive system functions: the stomach produces hydrochloric acid, the pancreas produces enzymes, the liver produces bile, and the intestines perform peristaltic movements. In other words, the gastrointestinal tract is ready to digest milk, which the baby will eat in the first year after birth.

If the results of cardiotocography and Dopplerography reveal fetal hypoxia or circulatory disorders in the mother-placenta-fetus system (for example, fetoplacental insufficiency), then the woman may be recommended hospitalization for the treatment of these pathologies or even early delivery if the baby suffers too much and may die.

As for tests, at the 28th week, women with a negative Rh factor and the first (0(I)) blood group should definitely take an antibody titer test (test for antibodies to the Rh factor and proteins of the AB0 system). This analysis allows us to assess whether a Rh conflict develops between the organisms of the mother and the fetus, which, if present, leads to hemolytic disease of the newborn.

At the 28th week, a test for antibody titers is mandatory, since at this stage of gestation, in the absence of antibodies to the Rh factor in the blood (absence of Rh conflict), a special anti-Rh (anti-D) immunoglobulin must be administered. This anti-Rhesus immunoglobulin helps prevent the risk of Rh conflict during the remaining period of pregnancy. However, in practice, anti-Rhesus immunoglobulin is not always administered at week 28. As a rule, this is due to the lack of the necessary drug in a medical institution. Also, immunoglobulin is not administered to women with a positive antibody titer.

If a woman was injected with anti-Rhesus immunoglobulin at the 28th week of pregnancy, then an analysis for antibody titers is not performed until delivery, as it will be false positive. But if anti-Rhesus immunoglobulin was not administered at week 28, then antibody titers are determined every two weeks until birth, that is, at 30, 32, 34, 36, 38 and 40 weeks.

Regardless of whether anti-Rhesus immunoglobulin was administered at week 28, within three days after birth, women with negative Rh blood factor who gave birth to babies with positive Rh factor blood must be given immunoglobulin. Thus, women with negative Rh blood still receive an injection of anti-Rh immunoglobulin after childbirth if a baby with positive Rh blood is born.

In addition, at the 28th week of pregnancy it is necessary to take a complete blood count, a complete urine test and a blood sugar test. These tests will need to be taken at every visit to the gynecologist, that is, once every two weeks, namely at 30, 32, 34, 36, 38 and 40 weeks. A general blood test, a general urinalysis and a sugar test are simple laboratory tests that can identify dangerous diseases and pregnancy complications that can lead to pregnancy loss, fetal or maternal death, premature birth, etc.

Thus, a general urine test allows one to assess the risk of preeclampsia based on the presence of protein. And assessing the risk of preeclampsia is very important, since this dangerous complication of pregnancy can lead to the death of both the fetus and the mother. Therefore, doctors assess the risk of preeclampsia, and if it is high, they prescribe preventative treatment.

The risk of preeclampsia is considered high if protein is present in a pregnant woman's urine. In this situation, the doctor prescribes calcium (1 g per day until the 40th week) and Aspirin (75–125 mg per day until the 36th week). If there is no protein in the urine, then the risk of preeclampsia is considered low, and prophylactic intake of calcium and Aspirin is not prescribed.

If, in addition to protein in the urine, a woman has high blood pressure, severe swelling, persistent headaches and visual disturbances such as flies or spots before the eyes, then preeclampsia should be suspected - also a formidable complication of pregnancy. Therefore, if there is a triad of “edema + blood pressure + protein in the urine,” the doctor refers the woman to hospitalization in a maternity hospital.

In addition, a general urine test allows you to assess the condition and functioning of the kidneys, as well as identify hidden diseases of the urinary system. So, if the urine contains leukocytes, red blood cells, casts, mucus, bacteria or epithelial cells in large quantities, then this indicates the presence of diseases of the urinary system that need to be treated.

A general blood test can detect anemia, a well-known pathological syndrome that develops in many pregnant women due to an increased need for iron. And since anemia negatively affects the growth and development of the fetus, creating a state of chronic hypoxia, this syndrome must be cured, and the sooner this is done, the better. Therefore, doctors prescribe a complete blood test, starting from the 28th week, every two weeks, in order to promptly detect anemia and treat it in the early stages.

A blood sugar test can detect diabetes, which can develop in about 2% of pregnant women.

There is no need to take any other tests at week 28 as planned. However, if the doctor suspects the presence of any diseases or complications of pregnancy, he can order any examinations and laboratory tests that he deems necessary.

Visiting an obstetrician-gynecologist

At the 28th week, a period begins for a planned visit to the gynecologist leading the pregnancy. Moreover, doctors always try to set the date of the planned visit precisely for the 28th week, since this is very important for further visits to the doctor, which from this period until the 37th week will occur every two weeks. And so that visits occur on certain dates on which examinations should be carried out, doctors schedule a “starting” visit for the 28th week.

When visiting a doctor, you must take the results of all tests and examinations that the doctor has not yet seen, as well as the exchange card that is in the woman’s hands. The results of tests and examinations will be analyzed by a doctor and on their basis a conclusion will be drawn about the condition of the child, mother and the course of pregnancy.

The doctor always begins the appointment with a conversation, during which he always asks the following questions to find out the woman’s well-being, fetal development and the presence of complications or diseases:
1. Does anything bother the woman, how often do complaints appear, how can they be eliminated, etc.?
2. How often does a woman feel movements and when was the last time she felt them?
3. Have you had any unusual or bloody vaginal discharge?
4. Have you ever had vaginal discharge that causes discomfort, pain, itching or burning?
5. Have you had episodes of vaginal discharge of a relatively large amount of fluid that looks like yellowish, cloudy water?
6. Have there been any episodes of feeling constant wetness or wetness in the perineum?
7. Do you have persistent headaches?
8. Did your face and hands swell a lot?
9. Was there any redness, swelling, redness, or itching in the genital area?
10. Were there episodes of flies, spots and flashes of light before your eyes?
11. What kind of vaginal discharge does a woman have (color, smell, consistency)?
12. Do you experience pain or burning when urinating?
13. Do you have persistent and severe abdominal pain that does not go away over time?

Due to the rapid growth of the uterus, severe stretching of the skin on the abdomen occurs, which can lead to stretch marks and itchy skin. To prevent the appearance of stretch marks, you need to lubricate the skin of the abdomen, sides and thighs with regular nourishing cream, special cosmetics or regular vegetable oil daily. Lubricating the skin with these products when red stretch marks first appear will help make them more invisible. Itching of the skin on the stomach and sides cannot be relieved, since it is caused by stretching of the skin, but there is no need to worry about its presence. However, if the itching spreads from the abdomen to other areas of the skin, you should consult a doctor - this may be a sign of an allergy or skin disease.

Often, pregnant women at the 28th week suffer from cramps in the calf muscles, which can be caused by a deficiency of calcium, vitamin B12, low concentration of glucose in the blood, varicose veins, diabetes mellitus, as well as severe stress on the legs. If a cramp occurs, you need to firmly pull your foot towards you until the pain stops, and then massage your calf. To prevent the occurrence of cramps, you should take calcium supplements, B vitamins and avoid putting heavy strain on your legs.

At the 28th week, the breasts may increase in size, and colostrum may periodically be released from the nipples. When colostrum is released, you just need to wipe your breasts with a dry and soft cloth. Colostrum should not be squeezed out of the breast. It is also recommended to start preparing the breasts for feeding the baby, for which you should wash the mammary glands with cool water and wipe with a rough towel.

Finally, at the 28th week, a woman may periodically feel painless contractions lasting 1 to 2 minutes. Such contractions are called training contractions. They are not dangerous, and only reflect the process of preparing the uterus for childbirth. But if contractions become painful, regular and their number exceeds 5 per hour, then you should immediately be hospitalized in a maternity hospital, as this may indicate the onset of premature labor.

Discharge

Discharge that is normal for the 28th week of pregnancy has a uniform, runny consistency, is whitish or translucent in color, has a slight sour odor, and does not cause discomfort. The discharge contains no impurities of pus, blood, mucus, etc.

If the nature of the discharge changes, its color becomes greenish, yellowish, grayish, earthy, the consistency becomes heterogeneous with lumps, flakes or bubbles, or impurities of pus, blood, mucus appear, then this indicates the development of an infectious and inflammatory disease of the genital organs. Also, the inflammatory process is indicated by itching, swelling, redness or pain in the genital area. Accordingly, if such symptoms appear, you should contact a gynecologist at the clinic.

The appearance of watery discharge is a sign of leakage of amniotic fluid. Moreover, water can leak in different ways: for example, a relatively large amount of cloudy, yellowish water with a sweet taste is possible at once. The sweetness of water is easy to determine - after contact with it, the skin of the perineum and pubis becomes sticky. Or water may leak unnoticed, in small portions, but in this case the woman in the perineum constantly experiences the feeling that she is wet and sticky. If you suspect leakage of amniotic fluid, you should contact a gynecologist at the clinic.

If a large amount of muddy water suddenly leaks out and wets all the woman’s clothes, you should immediately call an ambulance, as this may be a sign of the onset of premature labor.

Bleeding

Bleeding at the 28th week can be of a different nature - heavy, scanty, spotting. The blood released can also be different - scarlet, burgundy, with a reddish tint or even brownish. Almost always, bleeding is combined with nagging pain in the lower abdomen. However, regardless of the nature, bleeding at 28 weeks is always dangerous - it indicates the development of complications that can lead to pregnancy loss (for example, placental abruption, premature birth, etc.). Therefore, if bleeding occurs in any quantity and of any nature, you should call an ambulance and be hospitalized in the maternity hospital.

Uterus and belly

The uterus at the 28th week is large, the height of its fundus is 28 cm. But the height of the fundus of the uterus (UFHR), depending on the individual characteristics of the woman, can vary from 24 to 30 cm, however, on average, it is still 28 cm. Starting from this date, VSDM in centimeters will correspond to the gestational age in weeks. That is, at 30 weeks, the VSDM will be 30 cm, etc.

The uterus is preparing for childbirth, so during the day a woman feels short training Braxton-Hicks contractions (1-2 minutes each) 10-15 times a day. Such contractions are harmless, occur irregularly and are not too painful. However, if contractions suddenly become painful, regular, more than 5 per hour, then you should call an ambulance and be hospitalized in a maternity hospital, since such symptoms indicate the onset of premature labor.

At the 28th week, the abdomen protrudes strongly, its circumference is normally 80–85 cm. In addition, the skin on the abdomen may be very itchy and covered with rashes due to its rapid stretching. Itching and rashes on the skin of the abdomen are completely normal and are associated with its stretching. But if the rash or itching spreads to other areas of the skin, you should visit a doctor, as this could be a sign of an allergic reaction, skin disease, or jaundice.

Pain in the abdomen and other parts of the body

At the 28th week of pregnancy, a woman can experience any pain of any location, because she is, first of all, an ordinary living person. But we will consider only physiological pain caused directly by pregnancy and the changes in the body that have occurred because of it. Such physiological pain is normal because it reflects ongoing changes and the impact of pregnancy.

So, very often women in the 28th week of pregnancy suffer from pain in the abdomen, hypochondrium, back, lower back, sacrum, coccyx, pelvic bones, hips and legs.

Often at the 28th week, women feel pain in the anus, which is usually caused by hemorrhoids, which occur due to compression of the vessels of the lower part of the body by the large uterus.

Sex

The twenty-eighth week of pregnancy is the last one in which a woman has a pronounced libido, she actively desires intimacy and goes for it with pleasure. Over longer periods, starting from the 29th week, libido will decrease and the stomach will increase, which will create natural physiological difficulties for sexual intercourse. Therefore, couples can enjoy the last days in the 28th week, when sexual activity is desired by both, and is not associated with strong physical stress. Of course, sex at 28 weeks is allowed if the woman has no pregnancy complications.

Weight

Normal weight gain at week 28 is 5.4 – 9.8 kg. Moreover, the plumper a woman, the less weight she should add. In other words, initially, overweight women should normally gain between 5.4 and 8.2 kg, and thin women should gain between 8.2 and 9.8 kg. It is advisable not to gain more weight than normal, as this will lead to the appearance of fat deposits, which can provoke a difficult birth and, naturally, worsen the figure after childbirth.

Women can monitor their own weight gain by weighing themselves every day or once a week. With daily weighing, the increase should be no more than 50 - 70 g, and with weekly weighing - 350 - 500 g. If weight gain occurs within the specified limits, then everything is in order. If the weight increases more than normal, then it is advisable to reconsider the diet, excluding from it high-calorie and low-health foods, such as flour, confectionery, chocolate, white

At the 28th week of pregnancy, the length of the fetus is 35 cm, the weight already slightly exceeds 1 kg, the diameter of the head increases to 70.5 mm, the diameter of the chest - to 71.9 mm, and the diameter of the abdomen - to 73.5 mm.

The fetus continues to actively grow and develop. The features of his face become softer, his cheeks are rounded, and the first constrictions are already appearing on his arms and legs. The skin remains slightly reddish due to visible, closely spaced capillaries. The hair on the scalp begins to accumulate pigment and becomes darker. In some children, pigment accumulation occurs so quickly that its amount, as a result, exceeds the underlying genetic parameters. Some premature babies, born at 28 weeks to blond mothers, may well appear before the eyes of their surprised relatives as burning brunettes.

The development of the cerebral cortex continues and now, at the 28th week of pregnancy, it is already possible to guess which hemisphere of the brain will be dominant. In classic right-handers, who are already putting the fingers of their right hand in their mouth, the activity of the left hemisphere of the brain will predominate, and in left-handers, who often use their left hand, the right hemisphere will be more active.

All respiratory structures have already formed in the child’s lungs. At this time, the amount of surfactant, responsible for maintaining the airiness of the alveoli after inhalation, reaches its first maximum. Premature babies born at 28 weeks already have the ability to breathe on their own. However, imperfections in thermoregulation and other body functions necessitate special care. In the case of premature birth, premature babies, 28 weeks of gestation, are nursed in a special incubator, where favorable conditions are created for further development, and constant air composition, temperature and humidity are maintained.

28th week of pregnancy: woman's feelings

At the 28th week of pregnancy, a woman becomes increasingly concerned about how to safely carry the baby to term and not give birth prematurely. Numerous stories from “eyewitnesses” of other people’s premature births are alarming and force you to listen to your feelings: is your stomach tight, is the baby moving normally, is there any suspicious discharge from the genital tract. The more you listen to the “true stories” of well-wishers, the more anxiety you will have personally. Try not to delve into other people's problems in order to maintain your peace of mind and the peace of mind of your unborn child. Think more about a favorable outcome and carefully and accurately follow your doctor's instructions.

The fetus grows very quickly, gradually its movements become less sweeping, it changes its position in the uterus less often, but after being contrived, it is able to turn over from its head to its feet. The baby is most active when the uterus is relaxed, that is, when you are lying down and resting. When you work or the tone of the uterus increases, the child calms down and practically does not move. To assess the condition of the fetus, continue to count its movements. Let us remind you that the calculation can be done within 12 hours, while living a normal life and fulfilling your duties at work or at home, or during 1-2 hours of rest in a lying position. Normally, a child should move at least 10 times in half a day, or at least 4 times if you count within an hour.

Sometimes pregnant women are bothered by lower back pain, which resembles sciatica, spreading throughout the thigh, down to the knee and even the ankle. These symptoms appear as a result of pressure from the growing uterus on the sciatic nerve located nearby in the pelvic cavity.

If, a couple of hours after eating, you feel a tug in the stomach or a dull pain in the right hypochondrium, nausea, bitter belching or vomiting mixed with bile, you need to think about the presence of gallstone cholecystitis, the development of which is promoted by pregnancy.

At the 28th week of pregnancy, women are often bothered by numbness and a crawling sensation on their arms. The accumulation of fluid in the body, compression of sensitive nerve endings by edematous tissues is the cause of such disorders. Along with this, limb cramps may occur due to a lack of calcium in the body.

28th week of pregnancy: vaginal discharge

Discharge from the genital tract of a light milky color, uniform consistency and a slight smell of kefir are considered normal. The most common disease of pregnant women is candidiasis - thrush, accompanied by the appearance of abundant cheesy leucorrhoea and a sharp sour odor, itching and burning in the external genital area. The development of the disease is facilitated by decreased immunity during pregnancy, intestinal dysbiosis, the presence of candidiasis in a sexual partner, and wearing synthetic “non-breathable” underwear, which increases humidity and temperature in the genital area. The presence of mucus and pus in vaginal discharge is a symptom of a sexually transmitted infection and requires additional examination.

Placenta previa may be accompanied by bleeding of varying intensity. Discharge from the genital tract can be slight, spotting, brown or bright, but can also take on life-threatening proportions. Presentation is especially dangerous when the tone of the uterus increases and nagging pain in the abdomen appears - threatening premature birth.

The cause of bloody discharge from the vagina may be abruption of a normally located placenta. Most often in such cases, the woman has a stomach ache, and contractions of the uterus cause further separation of the placenta from the walls of the uterus. The situation requires immediate medical intervention.

In any case, bloody discharge from the genital tract is a reason for immediately calling an ambulance and hospitalization.

28th week of pregnancy: nutrition for pregnant women

Are carbohydrates good for you during pregnancy? It depends on what kind of carbohydrates they are.

Glucose, sucrose, fructose are simple sugars; they are quickly broken down in the human body and are sources of quick energy and a source of nutrition for nervous tissue. However, despite the obvious benefits, such carbohydrates in excess amounts cause the accumulation of excess weight.

Simple sugars are found in confectionery products, premium flour products, chocolate, candies, white rice, and potatoes. Such products are called refined and are poor in nutrients and vitamins, but are extremely high in calories.

Complex sugars (polysaccharides) are, for example, starches and fiber. They are found in whole grains, cereals, wholemeal bread, brown rice, corn and other foods. Complex carbohydrates take a long time to digest and do not cause a sharp increase in glucose levels in a person’s blood; consuming them can improve digestion, normalize it, and compensate for the lack of B vitamins and minerals, such as zinc, magnesium and selenium.

In the third trimester of pregnancy, a woman is recommended to limit her intake of simple sugars, reducing the amount of sugar to 4-5 teaspoons per day. It is even better to replace sugar with honey, provided you are not allergic to this product.

All kinds of sugar substitutes should be avoided, since these substances are not beneficial and can cause harm to the fetus. The exception is cases of diabetes, when substitutes are the only possible way to make food sweet.

The following photo shows very clearly the head of a baby at 28 weeks gestation. The frontal and occipital bones are clearly visible in the form of white arches. By this time, the cerebral cortex has developed convolutions, the brain mass is actively increasing, and quite long hairs are already growing on the head. The bridge of the nose and paired nasal bones are clearly projected. The large nose is clearly visible, even its tip and small nostrils. The baby's ears are now in place and the left ear is very clearly visible in the picture. The cartilages of the nose and ears are still soft. By this time, the child’s eyes are already opening, the baby sees. In the photo you can see the baby’s upper and lower jaws and emerging baby teeth. His face and entire body are covered with a protective lubricant at this time. The shadow of the heart is visible in the chest cavity, and the outline of the spinal column is visible below in the form of a whitish cord. The accumulation of fat continues, the body becomes fuller and rounded, its length approaches 35 cm. The first constrictions on the arms are visible. The baby folded his hands on his chest somewhere in the area of ​​his heart, which now beats at a frequency of 150-180 beats per minute. The forearm and left shoulder are clearly visualized - they are located along the body. The arm is bent at the elbow joint, the outline of which is somewhat shadowed, but the elbow is easily discernible. It looks like the right and left palms meet on the baby’s chest, you can even see small fingers.

Useful tips

Think about the upcoming birth. How do you want them to proceed? Whether your meeting with the child will take place at home or in the maternity hospital, whether you need a pool or a bath, what is your attitude towards pain relief during childbirth - it is better to think about all this in advance. The better you imagine what you want, the more likely it is that everything will go the way you want. But remember that it’s always worth thinking about backup options, because your baby’s plans may not completely coincide with yours.

If you're working, it's time to think about whether you're going to take maternity leave on time.