Sixteenth week of pregnancy


Future child

Height - 14-16 cm, weight - 100-110 g.

The growth of the baby's nervous system, which began at the 5th week of pregnancy, is in full swing. Every second, 5000 neurons are formed, which will amount to 100 billion by the end of the sixth month! The child's legs have finally become longer than the handles, the nails have fully formed, the ears have acquired a completely human shape.

Up to 250 ml, the volume of amniotic fluid in which the baby swims increases. Every 45 minutes, the child removes his waste products into the amniotic fluid, which are decomposed by the liquid into chemical elements and re-formed into nutrients.

The child is actively moving in his warm bath and, perhaps, the expectant mother is already beginning to feel his movements. Usually, women who give birth for the first time do not feel movement until 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 mothers already know what "shawls" are like.

It is impossible to describe this sensation with scientific precision, since every woman feels it differently. Someone says that a butterfly has settled in the stomach, someone compares it to tickling or bubbles, someone just feels touches to the inner surface of the abdomen (uterus). At the same time, the timing and sensations from the movements of the first and second child for the same woman may not be the same!

A mother who gives birth for the first time often expects quite distinct sensations of movement of something big inside her (as happens in later periods), and she does not pay attention to the weak and almost imperceptible, very quivering and light touches of her baby.

Sometimes she even takes perturbations for the processes of her own body (gases, passage of food, muscle contractions). And only later, when these phenomena are repeated with an enviable regularity, the mother understands who is the cause of new sensations.

In addition to perturbations, the baby is busy swallowing amniotic fluid, sucking a finger and grabbing everything that comes under his arm: another handle, a leg and often an umbilical cord (scientifically, an umbilical cord). The umbilical cord, by the way, is your baby's first toy.

He loves to tug, wrap and unwind, often flirts even before the umbilical cord is wrapped around the neck, which can somewhat complicate childbirth. However, there is no need to worry about this in the early stages. Before giving birth, the baby may have time to wind up and unwind back several more times.

The umbilical cord is very flexible and strong, it can withstand a weight of up to 5-6 kilograms. Its shell reliably protects the veins and arteries that go from the placenta to the baby's tummy. The umbilical cord grows with the baby, which allows him to move freely in the fetal bladder. By delivery, 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 are about 2.5 - 3 kg heavier, then you are one of those rare women whose body weight gains in accordance with the ideal rate. In fact, you can add 5 or even 7 kg.

Often the extra pounds come because the expectant mother's appetite is growing. After all, the baby needs so many nutrients! Remember, this is not the time to think about dieting. Food should be healthy and nutritious. In this case, it is better to eat several times a day, snacking on a little bit (fruits, vegetables, salads, curds) than as before 2 or 3 times a day.

You should definitely visit a doctor at this or, in extreme cases, next week and get tested for AFP (or triple test) and smears for infections. It will not hurt to do a general urine test and a clinical blood test.

AFP test data indicate malformations, such as chromosomal abnormalities such as Down syndrome, or a defect in the development of the spinal cord. Now they 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 at 11-12 weeks of gestation.

AFP (alpha-fetoprotein) is a protein that the baby produces in his liver and ventricle, and then passes it on to the mother through the amniotic fluid and placenta. Its greatest value in the blood of a woman is observed at 32-34 weeks 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 correctly the feto-placental complex is functioning.

HCG is a specific pregnancy hormone. It provides the synthesis of estrogen 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 value is 10-11 weeks, then its amount gradually decreases.

What indicators are considered normal?

AFP:

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

Estriol:

15-16 weeks - 5.4-21.0 nmol / l
17-18 weeks - 6.6-25.0 nmol / l
19-20 weeks - 7.5-28.0 nmol / l
21-22 weeks - 12.0-41.0 nmol / l
23-24 weeks - 8.2-51.0 nmol / l

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

As you can see, all indicators are in a range of values. The value is considered abnormal when the discrepancy is not by units from the norm, but by several times.

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

Elevated AFP levels:

- malformations of the spinal cord and brain of the fetus;
- anencephaly;
- open spinal hernia;
- Necrosis of the baby's liver due to a viral infection;
- congenital obstruction of the duodenum;
- Meckel's syndrome;
- Rh-conflict.

If the pregnancy is multiple, then an increased AFP level is the norm!

Reduced AFP level:

- Down syndrome and Edwards syndrome;
- low-lying placenta;
- fetal death;
- miscarriage.

It is also observed if the mother has an incorrectly determined gestational age, obesity, diabetes, hypothyroidism. Scientists say that the level of AFP depends on a person's race.

Elevated levels of ESTRIOL:

- multiple pregnancy;
- very large one kid;
- liver disease.

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

- Down syndrome;
- Threat of miscarriage or premature birth;
- anencephaly;
- fetal-placental insufficiency;
- hypoplasia of the adrenal glands;
- intrauterine infection;
- the body's response to antibiotics or glucocorticoids.

Elevated HCG levels:

- chromosomal pathology (Down syndrome, Edwards, etc.) against the background of lowered AFP and estriol;
- fetal malformations;
- reaction to synthetic gestagens.

In addition, it can be observed with incorrectly set periods of pregnancy, diabetes mellitus in the mother, severe toxicosis in the early stages, multiple pregnancies:

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

- intrauterine fetal death (in the 2nd and 3rd trimesters);
- ectopic pregnancy and the threat of miscarriage (in the first trimester);
- placental insufficiency;
- frozen pregnancy.

The expectant mother may refuse and not do screening in order to save her nerves, especially if the first double test showed the norm. According to statistics, 5% of tests show abnormal results. Moreover, in 90% of these abnormal 5% of cases, women give birth to absolutely healthy children.

This "inaccuracy" of the data can be explained by the fact that the timing of pregnancy is indicated incorrectly and the analysis was carried out at the wrong time (15-18 weeks from the date of the last menstruation), or the pregnancy turns out to be multiple.

In any case, the result obtained, even outside the norm, is only an indicator of the degree of risk, and not an accurately established diagnosis. Usually, if the analysis shows abnormal results, the woman is referred for repeated blood donation and ultrasound in order to correct the timing of pregnancy or to establish its multiple pregnancy.

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

This analysis resembles a jewelry operation. Sampling is carried out with simultaneous ultrasound. A needle is inserted through the uterus into the fetal bladder and several cubes of amniotic fluid are taken. Then from it will be selected the cells that the child "dropped" - exfoliated epidermis, urine and so on. On their basis, the baby's karyotype is compiled - a photograph of chromosomes, which shows whether there is an extra chromosome, which indicates a developmental anomaly or not.

We remind you that a normal person has 46 chromosomes (23 pairs). The most common defect is the presence of the third chromosome in 21 pairs (called Down syndrome). The risk of having a child with trisomy 21 increases with the age of the mother (interestingly, the data do not correlate with the age of the father). At 25 years of age, 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 trisomies 18 pairs (Edwards syndrome) and 13 pairs (Patau syndrome).

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

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

15 weeks - 16 weeks - 17 weeks


Watch the video: Your pregnancy: 16 weeks


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