Day 151 baby development and maternal changes

A: Itching as the abdominal skin stretches with the enlarging uterus is common, and moisturising can ease it. But watch out: if you itch all over, especially the palms and soles, worsening at night and with no rash, seek care immediately to check liver function and bile acids to rule out intrahepatic cholestasis of pregnancy (ICP) — it can affect the fetus and must be handled early.

A: Apply moisturising oil or stretch-mark cream (olive oil, cocoa butter, a dedicated care cream) 1-2 times a day to keep it moist; keep shower water not too hot and showers short; wear breathable cotton underwear; and avoid hard scratching. Steady weight gain also helps reduce stretch marks.

A: About 50-90% of pregnant women get stretch marks, mainly related to genetics and the speed of weight gain; they cannot be fully avoided. Steady weight gain, consistent moisturising massage and moderate exercise can reduce their extent; most gradually fade to silvery-white fine lines after delivery.

A: In the second trimester blood volume rises and the enlarged uterus presses the inferior vena cava, so mild oedema after long standing/sitting or in hot weather is common. Raise your legs, lie on your left side, walk to promote return flow, and moderately limit salt. If the swelling suddenly worsens, spreads to the face and hands, or comes with headache/vision changes, check blood pressure to rule out preeclampsia.

A: The best window for the anomaly scan is weeks 20-24; week 22 is still within the window, so book it and complete it as soon as possible — don’t let it drag past week 24. Popular hospitals have tight slots; once booked, go on time; if the baby’s position is poor, you may need to move and re-check or reschedule.

A: The three measurements at 22 weeks: BPD (biparietal diameter) about 52.3mm, AC (abdominal circumference) about 172.4mm, and FL (femur length) about 36.5mm, reflecting head, abdomen and leg development respectively. If the three are in step, growth is good; a single slight deviation isn’t necessarily abnormal — go by your obstetrician’s overall assessment.

A: For a standard BMI, about 0.4-0.5kg a week in the second trimester, with a cumulative gain of roughly 5-7kg by week 22 being common. Watch the overall trend — use a weight-gain calculator to manage by BMI — and discuss with the doctor if it’s too fast or too slow.

A: B12 is important for red-cell production and the nervous system; it is usually covered by fish, eggs, milk, lean meat and animal liver (≤50g a week) and generally doesn’t need extra supplementation. Strict vegans lack dietary B12 and need a supplement under a doctor’s guidance to avoid anaemia and nerve damage.

A: ACOG advises women without complications about 150 minutes of moderate-intensity exercise accumulated weekly (walking, prenatal yoga, swimming), split over 5 days at about 30 minutes a day. Avoid intense exercise and pressure on the abdomen; stop and seek care for pain or bleeding.

A: It’s recommended. The CDC and ACOG recommend that pregnant women receive the inactivated flu vaccine: pregnant women are at higher risk of severe flu, the vaccine protects mother and baby, and it is safe at every stage. During flu season (September to April) you can get vaccinated; tell them you’re pregnant.

A: If there’s no placenta praevia, bleeding, cervical insufficiency or threatened preterm labour, gentle sex is fine using positions that don’t press on the belly and with gentle movements. Pause if you feel unwell or the doctor advises against it; see a doctor for post-sex bleeding or pain.

A: Practise sleeping on your left side to increase uterine-placental blood flow, using a pregnancy pillow to support the waist, abdomen and legs; you don’t need to stay that way all night — comfort and good sleep matter; avoid prolonged lying on your back and face-down on the belly.

A: Pregnancy hormone slows digestion and the uterus presses into the stomach, so heartburn and bloating are common. Eat small frequent meals, chew slowly, stay sitting 30 minutes after a meal before lying down, don’t eat within 2-3 hours before bed, and avoid spicy, greasy, overly sweet food and fizzy drinks. In severe cases, use a pregnancy-safe antacid under a doctor’s guidance.

A: Avoid raw or undercooked meat, fish and eggs, high-mercury large fish, unpasteurised dairy, alcohol, caffeine over 200mg a day, and excess animal liver (vitamin A excess). Fully cooked, well-heated food is safer.

A: Flying is more comfortable in the second trimester; most airlines don’t require a certificate before 32 weeks and need one after 32 weeks (most prohibit flying after 36 weeks). Choose an aisle seat, stay hydrated, and wear compression stockings to prevent clots; ask your doctor first if you have bleeding, pain or placenta problems.

A: This week movement is steady and regular; you can feel various movements like kicks, turning and bulging, mostly obvious after meals and in the quiet at night. Start getting familiar with the baby’s active times to prepare for formal counting after week 28; if the movement suddenly drops clearly, seek care any time.

A: Higher oestrogen increases white discharge; milky-white or clear and odourless is normal. Watch out for turning yellow-green, foul-smelling, with itching (infection), or a sudden large amount of watery leakage (rupture of membranes) — seek care the moment these appear. Wear cotton underwear and don’t douche.

A: Eat more coarse grains, fruit and vegetables for dietary fiber, drink 1.5-2L of water daily, walk after meals, and toilet on a regular schedule without squatting long. In serious cases consult a doctor for a pregnancy-safe laxative rather than buying a stimulant laxative yourself.