Bloody discharge at 28 weeks pregnant. Bleeding during late pregnancy: possible causes and diagnosis
Most likely, you have already used the calendar and calculated that the 28th week of pregnancy is the end of the second trimester and the beginning of the third.
There is already a little - a third of the period.
Don't worry if doctors give you a different date of pregnancy. It's all about the calculations.
In previous weeks, we have already described in detail how doctors think and what the obstetric week means.
That is, the obstetric month is exactly 4 weeks, therefore, you are now 30 weeks old.
There is also a difference in the calculations for a normal month of 30 days.
If we count from the first day of the last menstruation, the difference will be 2 weeks, since in fact conception occurs during ovulation, 12-15 days after the first day of the last menstruation. Accordingly, with each calculation and approach, you get different terms of pregnancy.
In general, you should feel pretty good, if you do not take into account a number of inconveniences.
Sometimes nausea occurs in the morning. It's not toxic.
The child grows and the uterus also increases in size, pressing on various internal organs, and this causes an unpleasant feeling of nausea.
Frequent indigestion due to disruption of the intestines, as a result of constipation, constant heartburn, hemorrhoids may occur.
With an increase in weight, movement becomes more difficult, constant shortness of breath, which had not been noticed before. In the hot season, swelling and pain in the legs and back.
The chest is enlarged, tense, the nipples are swollen and painful.
There are signs of the first discharge. It's not milk, it's colostrum. A substance that precedes milk and prepares the mammary glands for feeding the child.
The very same milk will appear no earlier than 2-3 days after birth.
There are false contractions. This is a sharp contraction of the uterus, which is preparing for labor.
At 28 weeks pregnant, false contractions are safe and last only a few minutes.
These symptoms may appear several times a day.
You are naturally worried about your weight. That is, how much you gained during pregnancy.
The norm is considered 300-400 grams per week, which is currently about 10 kg.
If you weigh much more, you may need to follow a proper balanced diet. You can make the right diet both on your own and with the help of a nutritionist.
28 weeks pregnant: uterus and belly
The uterus has quite increased in size and continues to grow with the child.
It filled the entire pelvic area and is located 3-5 cm above the navel.
With her condition, she creates a number of inconveniences and pain, with which a woman must come to terms until the end of childbirth.
The abdomen, along with the uterus, increases in size, and now doctors more often measure the circumference and a number of other parameters.
Without internal intervention, doctors can determine the size of the fetus, its position, the predisposition of the uterus, prolapse, the location of the fetus relative to the uterus, the amount of fluid (oligohydramnios, or polyhydramnios).
Proper development and growth of the fetus is extremely important at this stage, otherwise pathological processes associated with developmental delay may be observed.
Unpleasant moments happen, one of them is the appearance of stretch marks on the abdomen and thighs.
Earlier in the previous weeks, we already talked about how to save yourself from this unpleasant moment.
During pregnancy, the skin is so stretched and in constant tension that it does not withstand and stretch marks appear.
Stretch marks are accompanied by burning and itching. For this, there are creams for pregnant women. The use of a cream partially or completely prevents stretch marks, making the skin supple and moist.
The 28th week of pregnancy is accompanied by pain.
They can be divided into 2 types. External and internal.
External and internal pain during pregnancy
Remember, all pain sensations are rather weak and have a aching character.
Sharp pains, especially in the lower abdomen, indicate a violation of the course of pregnancy and lead to premature birth.
Internal pain, as a rule, is associated with the work of the intestines and pressure of the uterus on the internal organs.
With the growth of the child, the uterus also rapidly increases, pressing on the liver, spleen, kidneys, bladder, stomach, rectum, and even partially slows down blood flow.
Sometimes, the baby moves under the liver, or towards the kidney, which is quite painful for a woman. Try to change the position of your body, perhaps the child will also move to the other side.
The bladder is under constant pressure from the uterus and trips to the toilet have become more frequent, although it may be only half full. Sometimes with constant pressure, spontaneous urination occurs.
Discomfort in the rectum. Frequent constipation causes pain and even the appearance of hemorrhoids.
To relieve pain, proper balanced nutrition and gymnastics for pregnant women helps.
External pain is caused by excessive weight, to which the pregnant woman and the body are not accustomed.
With an increase in the abdomen, the gait changes to "goose". The center of weight has now been moved to the back and lower back. At the end of the day, significant pain is felt. To reduce them, a special bandage and underwear for pregnant women, in particular underwear, a bra, outerwear, overalls or pants with a low and free waist, helps.
Legs feel a separate load. In people with a lot of weight, varicose veins appear, blood clots may appear. Legs swell, buzz, cramps are possible. For this, there are special creams to relieve puffiness and fatigue, as well as frequent respite throughout the day. During rest, the legs should be slightly above the pelvis.
Extractions and analyzes
At 28 weeks of pregnancy, the presence of discharge is considered the norm.
But it should be divided: dangerous and permissible.
Permissible are not abundant secretions of an almost transparent color, odorless.
All other species indicate a possible deviation from the norm.
Among them:
- white with a pungent odor
- bloody,
- copious, watery, odorless.
- White discharge - may indicate infection and the appearance of thrush. Often the infection gets during sexual intercourse or non-compliance with basic rules of personal hygiene. By the way, during close relationships, the partner also needs to strictly adhere to hygiene.
- Bloody issues- occur after sexual intercourse with a prolapsed uterus, sudden internal bleeding, cervical erosion or detachment of the walls of the placenta. If you experience these symptoms, contact your doctor immediately.
- Copious watery- we can talk about amniotic fluid leakage, as a result of cracks in the placenta or a significant decrease in wall thickness. Often, doctors tend to induce preterm labor. At 28 weeks pregnant, the baby is able to survive with careful care without further developmental and health consequences.
For any deviations from the norm, doctors prescribe unscheduled tests, including ultrasound, a general blood and urine test, if necessary, a puncture of amniotic fluid.
Scheduled tests for 28 weeks are not provided, except for pregnant women with a negative Rh, it is necessary to take tests for the Rh conflict.
Ultrasound is also not provided according to the plan, but in the presence of pathology, starting from the 28th week of pregnancy, the child takes a stable position with his head down and should remain so until the onset of labor.
fetus at 28 weeks pregnant
The baby begins to grow rapidly.
Its weight is approximately 1.2-1.3 kg.
At this stage of pregnancy, the baby's head rests on the mother's ribs, but before giving birth, he will turn 180 °.
The child has already learned to blink and reacts to bright light. If a lamp beam is directed at the stomach, the baby will instantly close his eyes and turn his head away.
If the child begins to move too actively, try to stroke the stomach and talk to him affectionately - the baby will calm down.
All organs are sufficiently developed for full and independent functioning. The brain is improved, in particular, the convolutions and furrows become deeper.
The lungs do not work yet, but the stage of development allows using the apparatus to inhale and exhale oxygen.
Top 3rd trimester tips you need to know and stick to.
Moderate and calm mode of transportation.
Try to protect yourself from crowded places as much as possible, especially during periods of peak seasonal diseases. Taking medication is still prohibited and can adversely affect the fetus.
At the slightest symptoms of fatigue, try to take a short break, preferably in a horizontal position.
In case of sharp pains in the lower abdomen or lower back, consult a doctor.
Remember, your child's health directly depends on you and your lifestyle.
Shoes should be comfortable, fit well and be flat. Occasionally a small stable heel is allowed.
Comfortable shoes with a bandage for pregnant women will significantly relieve the spinal muscles.
Bad habits should be completely forgotten.
Take care of yourself and the baby will definitely be born healthy.
Nutrition of a pregnant woman at 28 weeks
Considering that at the 28th week of bearing a child, weight gain is accelerating, it is necessary to pay special attention to your diet.
Eat small meals.
Give preference to healthy, wholesome food that will replenish the body with a variety of vitamins, as well as trace elements and other useful substances.
The total number of calories consumed by a pregnant woman at 7 months should not exceed 3000 units.
Most of the calories should be consumed before lunch.
In the afternoon, namely after 19 hours, ideally don’t eat anymore, you can afford milk or kefir, a light vegetable salad or apples.
Limit your salt intake, so you save yourself from puffiness.
You can exclude carbohydrates from your diet, which contribute to rapid weight gain.
These products include confectionery, potatoes, flour, chocolate and white rice.
You can replace such carbohydrates with complex carbohydrates that take a long time to digest, they saturate the body, normalize glucose levels in the body and improve digestion.
Foods that contain complex carbohydrates:
- corn,
- brown rice,
- whole grain,
- wholemeal bread,
Vegetables and fruits are also useful for digestion, they are very rich in fiber.
Do not forget about the use of protein and calcium needed by the baby.
As we grow up, we learn what vaginal discharge is and how to deal with it. Menstruation and leucorrhoea in the intermenstrual period is normal, in case of unusual discharge, you will make an appointment with a gynecologist and receive recommendations. However, if you have entered such a wonderful period as pregnancy, discharge takes on a special meaning.
At each visit to the antenatal clinic, the obstetrician-gynecologist will ask you:
Are there any highlights?
- what color and quantity are they (abundant, scarce, spotting, etc.)?
- Is the discharge accompanied by itching in the perineum, pain in the lower abdomen, changes in fetal movements?
And other clarifying questions. And he may also ask to show the discharge on the lining (pad) or invite him to an examination on the chair.
Pathological discharge during pregnancy
In order for you to have an idea of what should be discussed first of all, we will characterize the most common pathological secretions:
1. Brown
Brown discharge always indicates the threat of abortion before 22 weeks and the threat of premature birth at 22 - 36 weeks 6 days. Brown discharge is clotted blood, and in case of timely treatment and with adequate treatment, the prognosis can be favorable, and the pregnancy can be saved.
2. Bloody
Bloody discharge is a sign of an active pathological condition (a miscarriage that has begun, an abortion in progress, chorionic detachment up to 22 weeks; preterm labor that has begun, detachment of a normally located placenta, bleeding with placenta previa in a period of more than 22 weeks). The prognosis for obvious bleeding is more formidable. The sooner a pregnant woman turns to the nearest obstetric facility, the greater the chance of a favorable outcome for the mother and fetus.
3. Pink, cream
Pinkish, beige discharge may be a precursor to spotting. Therefore, if such secretions appear, immediately contact your obstetrician-gynecologist to clarify the condition (gynecological examination, ultrasound, cardiotocography, Doppler depending on the period).
4. Yellowish, yellow, green, greenish, gray in color. By the nature of the discharge, they are thick (up to discharge in “crumbs” or “pieces”), watery, frothy, may include lumps of mucus, flakes, etc. As a rule, such discharge is a sign of infection.
The discharge can be moderate or copious, have a different smell (sour, putrid, fishy) and be accompanied by complaints (itching, burning in the perineum, swelling, redness of the external genitalia). These are discharges that directly indicate the development of the inflammatory process. In pregnant women, immunity always decreases, this is due to nature and serves to prevent the rejection of the fetus by the mother's body (since the fetus is also a foreign organism to some extent, half of the genetic material is paternal). But in addition to the good, a decrease in immunity entails a greater risk of any inflammatory disease, in particular colpitis (inflammation of the vaginal mucosa).
The cause of the inflammatory process may be:
Coccal flora (excessive reproduction of conditionally pathogenic microflora of the vagina or the introduction of coccal flora from the external genitalia and skin if personal hygiene is not followed)
E. coli (introduced from the anus with improper care)
Trichomonas (protozoa, sexually transmitted)
Gonococci (cause gonorrhea, sexually transmitted)
Chlamydia (intracellular microorganisms, also sexually transmitted)
Ureaplasmas, mycoplasmas (may be present in the conditionally pathogenic microflora of the vagina, can be brought in from outside)
Colpitis during pregnancy is subject to treatment, external treatment (ointments, creams) is allowed from an early date, local treatment (candles, vaginal tablets, creams and gels) is allowed from 12 weeks, a limited range of drugs is allowed.
Also during pregnancy, bacterial vaginosis is often found, which is characterized by an imbalance of beneficial and conditionally pathogenic microflora of the vagina and needs treatment.
It is impossible to select the drug on your own in any case, not all drugs are allowed during pregnancy, there is a dependence on the duration of pregnancy and the type of pathogen, the nature of the smear. The drug and duration of treatment is determined by the obstetrician-gynecologist leading your pregnancy.
5. White, cheesy discharge
Most often, such discharge indicates the development of candidiasis, which is associated with hormonal changes and a decrease in local immunity. Treatment is indicated after 12 weeks, the choice of the drug and the duration of treatment is carried out by your doctor.
6. Thin, watery, copious discharge
They may indicate leakage of amniotic fluid, up to 37 weeks - this is an unfavorable phenomenon, therefore, it needs to clarify the situation and choose the tactics of further treatment (tactics vary significantly at different stages of pregnancy).
The norm and pathology of discharge by week of pregnancy
The obstetric gestational age is considered from the first day of the last menstruation, since while the endometrium is being rejected in the uterus, the same follicle with an egg is already ripening in the ovary, which will give rise to our pregnancy.
1 – 4 weeks
The first weeks of pregnancy are a particularly crucial period, since many influences (an infectious disease with high fever and intoxication, the toxic effects of alcohol and drugs, taking medications, etc.) can lead to undesirable consequences (termination of pregnancy, bleeding). Therefore, we will give the most detailed schedule of possible discharges by week, so that you can figure out where the norm is and where the pathology is. But, of course, you can not do without consulting a doctor.
1 Week
The first week is menstrual bleeding. In one of the ovaries (and occasionally in two at once), the follicle matures and prepares to exit.
2 weeks
Ovulation is a physiological phenomenon, which is the release of a mature egg from the ovary into the abdominal cavity, where it is captured by the fimbriae of the fallopian tubes and carried into the tube.
Ovulation occurs approximately on the 14th day of the cycle, and this event can be manifested by smearing scanty bloody or brown discharge and moderate pulling pains in the lower abdomen and above the womb for 1-2 days (ovulatory syndrome). During this period, more abundant than usual, mucous discharge may appear.
During ovulation, the egg is fertilized by the sperm.
3 week
On the 5th - 7th day after fertilization, the egg is implanted into the prepared endometrium, and "implantation bleeding" can be observed, scanty spotting spotting lasting up to about 40 hours. They are not accompanied by pain and go away on their own.
4 week
At the 4th week of pregnancy, the discharge is transparent or whitish, not abundant, thick, odorless and not accompanied by additional sensations. Such secretions are due to hormonal changes in the body (an increase in the concentration of progesterone) and increased blood circulation in the pelvic organs.
5 - 8 weeks of pregnancy
The secretions have a thick, but "slippery" consistency, they are transparent or slightly whitish. Gynecologists call such discharge "milk". The discharge is practically odorless, or you may experience a subtle sour smell. The whole picture described above is a reflection of the normal secretory function of the female organs and is regulated by the "pregnancy hormone" - progesterone. Allocations at this stage of gestation perform a protective function, as they prevent the penetration of infectious agents to the fetus.
However, any discharge that differs from those described above should alert. Brown or dark, spotty discharge may indicate a miscarriage that has begun and require immediate clarification of the diagnosis. A miscarriage that has not always begun leads to the complete rejection of the fetal egg; timely treatment started often helps to maintain the desired pregnancy.
Bright spotting is a threatening sign, and the more abundant the bleeding, the worse the prognosis for the fetus.
The appearance of fresh bloody discharge is a reason to immediately contact the gynecological department or call an ambulance team.
There is such a phenomenon as “colored pregnancy” or “fetal washing”, which consists in the fact that a woman regularly menstruates on time against the background of a progressing pregnancy. The pregnancy test is positive. But in order to calm down and be sure that the pregnancy continues to develop, it is necessary to consult an obstetrician-gynecologist.
Abundant, yellowish / greenish / gray, frothy discharge, liquid or, conversely, thick and “curdled” with an unusual or pungent odor, accompanied by itching in the perineum, redness of the mucous membranes and skin of the external genital organs (labia) is a sign of an infectious process. Infections require timely diagnosis (specific swabs and cultures for infections) and treatment. Therefore, if disturbing discharge appears, contact your doctor at the antenatal clinic.
Very often, candidiasis (thrush) develops in the early stages, which is associated with a change in the immune status due to hormonal changes in the body. Candidiasis is not a "true" infection, rather it is a manifestation of an imbalance in the vaginal flora. When registering, you will definitely be examined on a chair and take a swab for the flora. But even if signs of thrush are detected, treatment will have to wait up to 12 weeks. The maximum that can be used is external washing of the genital organs with a soft gel for intimate hygiene (without application to the mucous membranes!).
9 – 12 weeks
Discharges from 9 weeks become more liquid, watery and transparent and may resemble egg white in appearance and consistency, have no noticeable smell (or have a barely noticeable sour smell) and do not bring any unpleasant sensations.
Up to 12 weeks, a woman can normally experience subfebrile temperature (up to 37.2 ° C). If the temperature increase is not accompanied by other pathological symptoms (cough, runny nose, back pain, dysuric phenomena, stool disorders, and in our case, pathological secretions that are different from the above picture of the norm), then you should not worry.
However, an increase in body temperature, combined with the appearance of profuse yellowish / greenish / gray discharge, which can be thick or, conversely, watery and frothy (you notice air bubbles in a copious secret), indicates the development of a urogenital infection and requires diagnosis and treatment.
If you were diagnosed with cervical erosion before pregnancy, then during pregnancy a gynecological examination or sexual intercourse can provoke small spotting spotting. Such discharge is observed for several hours and is not accompanied by any subjective complaints (no pulling pains in the lower abdomen). This happens because during gestation, all body tissues are under the influence of progesterone, which loosens all tissues. The mucous membrane of the cervix becomes looser, "juicy" and bleeds more easily upon contact.
13 - 16 weeks
Allocations in this period become more liquid, have a transparent or slightly whitish color, may become slightly more plentiful. This is due to an increase in the level of estrogen in the blood. The smell, as before, should not bother. The discharge is homogeneous and does not have inclusions (lumps of mucus, thick accumulations of white / yellowish color)
In the presence of pathological discharge, it is necessary to pass additional tests (a smear for flora, seeding for infections and, possibly, a blood test from a vein for sexually transmitted infections). After 12 weeks, the use of certain drugs for the treatment of candidiasis and STIs is already allowed.
17 - 21 weeks
The discharge remains neutral in color and odor, but may become more copious and thin. The secretions are more liquid, but homogeneous and quite viscous, do not have foreign inclusions and are not accompanied by complaints (itching and burning in the perineum, swelling and redness of the external genitalia).
The appearance of brown discharge or bright spotting should alert, as it indicates the threat of a late miscarriage. With timely treatment, pregnancy can be saved.
22 - 24 weeks
Normal discharge at this time is also transparent / whitish, homogeneous, liquid, without foreign smell and without complaints of discomfort in the intimate area and pain in the lower abdomen.
From 22 weeks we are no longer talking about the threat of miscarriage (or the threat of miscarriage, which means the same thing), but about the threat of premature birth.
Bloody discharge may indicate the onset of preterm labor or detachment of a portion of the placenta (premature detachment of a normally located placenta). This situation is urgent and you should contact the maternity hospital.
You should also be alerted by too abundant clear liquid discharge (resembling water, may be light or yellowish in color), which appeared suddenly (possibly after a sharp or heavy physical exertion, sexual intercourse or severe stress), the discharge does not stop or comes in portions, wetting the laundry ( mucus secretions are usually viscous enough to soak underwear).
Perhaps here we are talking about leakage of amniotic fluid (PIV or PIOV - premature rupture of amniotic fluid).
This situation is urgent and is subject to urgent diagnosis and, in case of confirmation of amniotic fluid leakage, the development of management tactics depending on the obstetric situation.
The period from 22 weeks is already “maternity hospital” and in case of premature birth, the child is subject to resuscitation and nursing (On approval of the Procedure for the provision of medical care in the profile "obstetrics and gynecology (with the exception of the use of assisted reproductive technologies)" (as amended on January 12, 2016) ).
24 - 28 weeks
The discharge at this stage of pregnancy is whitish (milky) or transparent, rather liquid, homogeneous, does not have a pronounced odor and is not accompanied by any complaints.
Bloody discharge (brown spotting or the appearance of scarlet drops of blood) indicates the threat of premature birth, and you should consult a doctor about this.
If bloody discharge appeared suddenly, it is plentiful (you need more than a daily pad) and / or are accompanied by pulling pains in the lower abdomen and lower back, a change in fetal movements, then you should immediately go to the emergency room of the maternity hospital (on your own or by calling the ambulance team help").
If you have noticed the appearance of smearing brown discharge, your stomach does not hurt, and you do not notice an increased tone of the uterus (the stomach is soft and does not “stiffen” when touched, walking or by itself), you feel the fetal movements well (they are the same as always, not stormy and not lethargic, barely noticeable), then you should go to your obstetrician-gynecologist in the antenatal clinic during reception hours without an appointment.
After the examination, the doctor will choose further management tactics. You must be prepared to be referred to a day or 24-hour hospital.
In the event of the appearance of liquid watery discharge (suspicion of premature rupture of amniotic fluid), you should contact the maternity hospital to clarify the diagnosis and be prepared that you will be offered hospitalization.
Premature birth before 28 weeks is characterized by deep prematurity and extremely low fetal body weight (up to 1000 grams), so you should be very attentive to yourself and not neglect medical care and supervision.
29 - 31 weeks
The secretions retain a milky color, a liquidish but viscous consistency and may acquire a more pronounced sour smell. If there are no other signs of infection (itching, burning, yellow / greenish / gray discharge, flakes), then you should not worry.
At 30 weeks, in a consultation at a scheduled appointment, you will be examined on a chair and take a swab for the flora. In the presence of inflammation, you will be prescribed treatment and a control smear.
Everything that was said above about spotting and suspicion of PIOV is true in this period. Postponing a doctor's consultation in these cases is unacceptable.
Premature births from 28 weeks and 1 day to 30 weeks and 6 days are characterized by severe prematurity and very low fetal weight (up to 1500 grams).
32 - 36 weeks
The secretions retain a neutral color, the same consistency and may have a sour smell.
At 36 weeks, you will take a smear for the flora for the third time (even if there were no pathological changes in previous smears), this is necessary to prevent premature outflow of water (the infection “corrodes” the fetal membranes and provokes PIV), timely sanitation of the genital tract prevents many problems. If you notice a change in the nature of the discharge, tell your doctor about it at your next visit.
Also, if inflammation is detected, it is necessary to have time to sanitize the vagina before childbirth. Childbirth against the background of the inflammatory process can be complicated by infection of the fetus.
The inflamed tissues of the birth canal are loose and vulnerable, they cannot be stretched to the proper size during the birth of the fetus and ruptures occur. Ruptures can also occur with the normal microflora of the vagina, but in the presence of colpitis, this is almost inevitable, and then the healing of the stitches is more difficult.
37 - 41 weeks and 3 days
Pregnancy is full-term and labor can begin at any time.
The secretions gradually become more viscous, transparent and viscous, this is due to the increase in estrogen in the mother's blood.
Estrogens prepare the cervix for childbirth, soften it and contribute to shortening.
The mucus plug, which worries expectant mothers so much, is a clot of transparent or whitish mucus, possibly with streaks of blood, which is separated without any precursors, and may be accompanied by pulling pains in the lower back or lower abdomen. The passage of the mucous plug is not the beginning of labor, on average, the plug departs 2 weeks before the birth. Sometimes a woman does not notice this moment if everything happened in the toilet or while bathing.
After the cork is released, you should not swim in open water bodies (rivers, lakes, etc.), since thick mucus used to block the entrance to the cervical canal and thereby protect the fetus.
The discharge of water is a signal for the onset of labor. If you noted the appearance of copious watery discharge that soaked the linen, and possibly clothes, then you should go to the maternity hospital.
Pay attention to the color of the watery discharge. Normally, they are colorless, light, have a slight specific smell (some compare it with the smell of mother's milk). If you notice greenish or dense green / brown water, then we are talking about fetal hypoxia. Yellow / brown appear with hemolytic disease (increased bilirubin level). Turbid water with flakes that have an unpleasant odor is a sign of infection.
Be sure to tell the doctor in the maternity hospital about the nature of the discharge at home, since tactics in different cases can vary dramatically.
After a gynecological examination, mucous discharge with streaks of blood and brown spotting may appear for several hours, this is normal and indicates a gradual preparation of the cervix for childbirth. Such discharge is not accompanied by a change in the nature of fetal movements.
Abundant scarlet spotting or brown discharge with clots may indicate the onset of premature detachment of a normally located placenta. This is an emergency situation that requires immediate medical attention and intervention. You should contact the nearest maternity hospital.
discharge and pain
Pain in the lower abdomen and lower back, which is accompanied by fresh bloody discharge from the genital tract, is a threatening symptom that may indicate the development of a miscarriage (if up to 22 weeks) or premature detachment of a normally located placenta (in a period of more than 22 weeks). In this case, the prognosis depends on the speed of contacting a maternity facility (better than level III, that is, equipped with resuscitation and able to nurse children).
Drawing pains in the lower abdomen in combination with brown discharge indicates a threat of abortion or a threat of premature birth, this situation is more favorable, but needs treatment in a day or round-the-clock hospital.
Pregnancy is, in a sense, a "work" for a woman, so you need to take a lot more care of yourself during this wonderful period. If you have noted discharge that differs from the norm within the specified period, then you must additionally consult with an obstetrician - gynecologist. Spotting is always a reason to go to the hospital, in other cases, contact your doctor. In all cases, the rule applies that the sooner you start treatment, the more favorable the prognosis for you and the unborn baby. Look after yourself and be healthy!
Obstetrician-gynecologist Petrova A.V.
At week 28, the fetus turns 26 weeks from the moment of fertilization of the egg. He will already be able to survive in case of premature birth with adequate medical support.
Changes in the body of the fetus
The size of the fetus at the 28th week of pregnancy is about 35 cm in length, it already weighs 1000 - 1100 g. The future baby is getting larger, it already kicks quite strongly in the mother's abdomen at the 28th week of pregnancy. On average, a woman fixes about 10 movements per hour of wakefulness of the fetus, the movements become more active before a night's sleep. You can no longer touch the stomach to guess the parts of his body - a handle or a leg, with which the fetus rests against the abdominal wall from the inside.
The child in the abdomen actively changes its position, it happens that in one day it turns over from the breech presentation to the head or even transverse. There is still enough space in the uterus for such movements, although the baby is already getting cramped in the stomach at 28 weeks of gestation.
Under the skin of the future baby, fatty tissue continues to accumulate, he looks more well-fed than before. Because of this, the skin is no longer so transparent to translucent blood vessels, because it is more pink than red. The surface of the skin of the fetus at the 28th week of pregnancy is covered with a cheese-like lubricant - a product of the sebaceous glands in the skin. White lubrication protects the skin from irritation by amniotic fluid in the uterus and from excessive drying out immediately after the baby is born.
The whole body of the baby at this time is still covered with fluffy hair - lanugo. They are longer on the head and completely absent on the feet and palms. Some body hairs may already be falling out, and eyelashes, eyebrows, and scalp hair may become darker and thicker.
The fetus at the 28th week of pregnancy opens its eyes more and more often, the pupillary membrane in the form of a thin film on the surface of the eyeball gradually resolves. The baby already well distinguishes light from darkness.
At a period of 28 weeks of pregnancy, it becomes clear which hemisphere of the brain will be dominant in the child - the left or the right. Depending on this, the fetus already now prefers to move more with one or another hand. If the left hemisphere dominates, then he more actively feels everything around with his right hand, that is, he will be right-handed, and vice versa.
In boys, the testicles from the abdominal cavity continue to descend into the scrotum, at this time they are at the entrance to it. According to ultrasound at the 28th week of pregnancy, the genitals are visible, that is, you can find out who will be born - a boy or a girl.
Changes in the body of a woman at 28 weeks of gestation
The waist of the woman was completely smoothed out, the stomach is impossible not to notice at this stage of pregnancy. The bottom of the uterus is determined 28 cm above the womb or 8 cm above the navel. Ordinary clothes become tight.
Sometimes a woman may be disturbed by pain at the 28th week of pregnancy in the lower abdomen. A periodic increase in tone is the reaction of the uterus to the environment and stress, it can also be training contractions. But there should be no painful sensations in the norm during such training. Pain at the 28th week of pregnancy can be the first symptom of a threatened miscarriage, so a medical consultation is a must.
Increased discharge at the 28th week of pregnancy from the genital tract, their more liquid nature is suspicious for leakage of amniotic fluid. This happens if the integrity of the fetal bladder is broken somewhere on the side. This condition is dangerous with possible infection of the fetus and the onset of premature birth. You can eliminate the leakage of water using a special test.
Examination at 28 weeks of gestation
If a pregnant woman has Rh-negative blood, then another control of anti-Rh antibodies will be required, the concentration of which, if there is a conflict with the fetus, may increase. If an increase in antibodies is detected, the doctor may recommend a course of maintenance preventive treatment.
Planned ultrasound at the 28th week of pregnancy is not performed. If necessary, blood tests can be prescribed - general, for glucose, urine control is required once every 2 weeks.
Video from YouTube on the topic of the article:
Most women experience some sort of vaginal discharge during pregnancy. How to find out when they are safe, and in what cases they can become a threat to the health of the mother and child.
Discharges without a strong odor, clear or with a white tint, are the norm for a pregnant woman. In comparison with "before pregnant" - they are more liquid, more. A woman usually does not complain of irritation, and with a little discomfort, special sanitary pads can be used.
Any changes in the nature of the discharge should alert the woman: for example, a pungent odor, a different color. All this can be a symptom of an infectious or fungal disease, such as candidiasis (thrush) and bacterial vaginosis.
With thrush, the discharge acquires a curdled structure, white or grayish in color with a sharp unpleasant odor. Treatment should be carried out under the supervision of a doctor so that the thrush does not become chronic.
Bacterial vaginosis is characterized by a watery, foul-smelling discharge. This disease is especially dangerous because it significantly increases the risk of premature birth.
Bloody discharge at 28 weeks of gestation and later lines is before birth and can be caused by placental abruption.
Changes in discharge, itching can be a reaction to improperly selected hygiene products or tight, synthetic underwear. But bloody or brownish discharge is an alarming sign that requires an immediate examination by a doctor. If in the first trimester small bleeding associated with the formation and implementation of the placenta is still allowed, then any abnormal discharge at the 28th week of pregnancy and later becomes a threat to the life of the child.
22 Mar 2012 467
Leaking amniotic fluid during pregnancy: causes,…
Brown discharge in early pregnancy: causes and ...