Day 158 baby development and maternal changes

A: The abdomen suddenly tightens and hardens, lasts seconds to 30 seconds, then loosens on its own; it is painless and irregular and disappears with movement or a change of position — the uterus "warming up" for delivery. Drinking water, resting and changing position can ease it, and it is a common phenomenon.

A: False contractions: irregular, not growing stronger, disappear with rest or a change of position, usually painless. True contractions/preterm-labour signals: regular (e.g. once every 10 minutes or more often), growing stronger and more frequent, not eased by rest, possibly with lumbar heaviness/pressure, vaginal bleeding or fluid leakage. If the latter appears, seek care immediately.

A: The best window for the anomaly scan is weeks 20-24; week 23 is near the last-call window, so complete it as soon as possible and don’t let it pass week 24. After week 24 the fetus grows and calcifies more, and some structures may be obscured by its body or the placenta, affecting interpretation.

A: The OGTT (glucose-tolerance test) is usually done at weeks 24-28. Keep a normal diet for the 3 days before (no deliberate dieting or carb-loading), fast for 8-12 hours the night before (a little plain water is fine), and arrive at the hospital fasting. The whole process takes about 2-3 hours with several blood draws; you can bring a healthy small snack to refuel afterwards.

A: The three measurements at 23 weeks: BPD (biparietal diameter) about 55.5mm, AC (abdominal circumference) about 183.4mm, and FL (femur length) about 39.1mm, reflecting head, abdomen and leg development. 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 5-8kg by week 23 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: Blood volume rises in pregnancy; drink about 1.5-2L of water daily as recommended (little and often). Potassium-rich foods in the everyday diet such as banana, potato, red beans, spinach and orange are usually enough, so you don’t need a potassium supplement. Supplementing water and potassium helps relieve oedema and leg cramps.

A: When a cramp hits, flex the foot and massage the calf. Prevention: supplement calcium and magnesium, drink water, stretch before bed, wear support stockings, and avoid long standing or sitting. If cramps are frequent with weakness and numbness, check blood calcium, magnesium and electrolytes at a prenatal visit.

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 for support; 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: Mild oedema after long standing or sitting is common; raise your legs, lie on your left side, walk to promote return flow, and moderately limit salt. If the swelling spreads from the ankle up the calf and won’t ease with rest, or comes with headache/vision changes, check blood pressure to rule out preeclampsia.

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. 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: In the second trimester blood volume rises and the heart works harder, so a slightly faster heartbeat and easy fatigue on activity are common. Slow your pace, rest more, and don’t take on too much at once. If you develop obvious palpitations, chest tightness, shortness of breath, dizziness or fainting, seek care to rule out anaemia and heart-rhythm problems.

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.