41 weeks of pregnancy: perenashivanie, programmed delivery
May 24, 2018
The estimated date of delivery( PDD) is over, and the birth activity has not started - this is one of the most frequent thoughts of expectant mothers at 41 weeks of pregnancy. If the fetus is all right, there is no reason for concern - the birth is considered the norm, occurring at both 41 and 42 weeks.Table of contents: State of health of a woman Condition and dimensions of a baby Status and dimensions of a baby What is programmed delivery?Advice to prospective mothers
Feeling of a woman
At 41 weeks of expectation of a baby, the expectant mother is overcome not only by emotions, but also by severe physical discomfort associated with large size of the stomach and fetal pressure on organs, venous and arterial vessels, and pelvic nerve formation. This is manifested by the following symptoms:
- Various pain sensations.The back, a loin, legs, a stomach, a perineum hurts.The nature of pain can be aching, shooting, pressing, cramping.
- Frequent urination and leakage of urine in any straining.
- Swelling of the lower extremities.Disorder of the chair.Some pregnant women have a tendency to diarrhea, others have constipation.
- Numbness of hands and feet.
- Itching of the skin of the anterior abdominal wall.
To improve your well-being, the expectant mother should rest as much as possible and engage in pleasurable things for the soul.Now is not the time for cleaning, washing, shopping.
The state and dimensions of the baby
At 41 weeks, the fruit continues to gain weight and grow, but is not as active as before, the therefore the average weight and height of the children at this time does not differ much from the previous week.If the baby is born now, its mass will be about 3.5 kg, and height - 52 cm.
Internal organs of the fetus at 41 weeks are fully ready to function outside the uterus . The lungs synthesized enough surfactant, they are waiting for the signal from the respiratory center to open and for the first time to let in the air .In the large intestine, meconium accumulated, which will come out within the first 24 hours after birth.The kidneys have long been performing their function - they filter blood and form urine, which is a constituent part of the amniotic fluid.That's just the nervous system has yet to mature and how this process will occur, largely depends on the course of labor and features of the baby's newborn period.
Appearance of the fetus at 41 weeks of intrauterine life is very easy to imagine - it does not differ much from the appearance of a newborn baby. His hair and nails grow, so before his mother he can first appear with a hair on his head and long nails on his fingers.
With regard to the health of the crumbs, then during normal pregnancy at 41 weeks there are no threats to his health. That is, the kid in principle should just be enough.The only thing that he definitely does not have is the place in the uterus.For this reason, the fetus becomes less active, but its kicks and tremors mom should still feel every day.
Migrating Pregnancy: Causes and Risks
Future mothers, reaching the age of 41 weeks, are usually very much afraid that complications may occur due to "pacing" in them or the fetus.Is it so?We'll figure it out.
Migrating is a pregnancy that lasts more than 42 weeks.A child born after 42 weeks, in most cases, has signs of being overripe.These include:
- Virtually no cheese-like grease on the body of the baby.
- Special changes in the skin - wrinkling, decrease in turgor, "bath" foot and hand.
- Reduces the amount of subcutaneous fat.
- Sealing of the bones of the skull.
- Large size of the fruit.
- Long marigolds on the fingers of the hands.
However, it should be noted that "portability" is not always identical to "overripe". The children, who were born on weeks 41 or 42, have signs of being overripe.Similarly, a postponed baby may not be overripe. That is, "portability" is more a concept of calendar, and "overripe" is a clinical one. These features are displayed in the classification of pregnancy masturbation.So, if childbirth occurs after 42 weeks and as a result an overripe baby appears, doctors say is the true persistent , but if there are no signs of overriding the fetus, is false.
Why are doctors very wary of a delayed pregnancy? The fact is that the longer a baby is in the mother's body after 40 weeks of pregnancy, the more he risks his health.Occurrence of complications can be connected with the following factors:
- The placenta gradually becomes functionally untenable, that is, the baby remains without oxygen and nutrients, which affects its cardiac activity, and in the most neglected cases leads to disastrous consequences.
- The bones of the skull of the fetus harden, so they can not fully adapt to the birth canal, - this is a great risk of injury to both the baby and mom.
- Adaptation of the transferred newborn to extrauterine life is much more difficult.
Important! In order not to lead to the development of complications, doctors always try to "unfold" their patient patients before the end of 42 weeks of pregnancy.Depending on the situation, births are either stimulated or carried out in an operative way.
What are the reasons for delaying the pregnancy?Most often these are various pathological conditions from the future mother:
- Endocrine diseases.
- Obesity.Dysfunction of the nervous system.
- Pathological changes in the uterine wall, resulting in the receptors of myometrium cells becoming less sensitive to hormones.This occurs after abortion and inflammatory diseases.
Well, the fact that the pregnancy does not end exactly in the time set by the gynecologist( not in 40 weeks) can be explained for several reasons:
- Unequal duration of the menstrual cycle.If the cycle is more than 30 days, the probability of prolonging pregnancy is significantly increased.
- The displacement of ovulation, which can be associated with hormonal outbursts, stresses, severe illnesses, a sharp climate change, peculiarities of the woman's intimate life.
- The delayed development of the fetus - some babies, in order to fully mature, are required for 1-2 weeks more than the rest of the mass of babies.
What is programmed delivery?
Quite often in the 41-42 week, doctors resort to programmed births - births caused by artificial means.Indications for such a variant of delivery are:
- True perenashivanie.
- Deterioration of well-being of the future mother( exacerbation of chronic ailments, progression of diabetes, late toxicosis).
- Unsatisfactory condition of the baby - first of all, the appearance of signs of chronic hypoxia.
Prepare for programmed births in advance .If the cervix is immature, the woman is prescribed special medicines - suppositories with antispasmodics, gels with prostaglandins, preparations containing female sex hormones.After the cervix matures( its maturity is determined on the gynecological chair), the date and time of delivery is appointed, usually a weekday, the morning hours, when the medical institution has all the necessary specialists( anesthesiologist, surgical team, neonatologist).
On the day of delivery, the patient is exposed to a fetal bladder.This procedure stimulates the onset of labor.If the birth does not start within a few hours, begin to drip intravenously oxytocin - a hormone that causes contractions.
The programmed delivery is usually more painful, therefore the mother is anesthetized. In addition, she must be given drugs that prevent hypoxia of the fetus.To monitor the baby's condition during childbirth, women are placed on the abdomen of the cardiotocograph( a device that registers the child's heartbeat). If complications occur during the program delivery, the pregnant woman is immediately transferred to the operating room and an emergency cesarean section is performed.
Of course, the programmed births are not without minuses and risks - it's still a serious intervention in the natural process.However, if a woman has a testimony to this type of delivery, in her particular case, spontaneous labor can have much more lamentable consequences.
Advice for prospective mothers
The main advice this week: do not ignore the march in the women's consultation and if the doctor says that it is better to be hospitalized, collect things and go to the hospital. To wait for the birth of the house, of course, it is more pleasant, but now, when the situation can change at any time and there is a tendency to overstay pregnancy, it is better to be under round-the-clock supervision of medical personnel.
At this time, it is desirable for a future mother to undergo cardiotocography( CTG) daily, which allows to assess the baby's condition with great accuracy, to be examined regularly with the help of an ultrasound machine, and also to take blood and urine tests.All this is much more convenient to do in a hospital.
Zubkova Olga Sergeevna, medical reviewer, epidemiologist doctor