Discharge during pregnancy. Bleeding during late pregnancy: possible causes and diagnosis 28 weeks of gestation yellowish discharge

28 weeks pregnant5.00 /5 (100.00%) Votes: 3

The second trimester of pregnancy is coming to an end - it has come the last week. The baby's senses are well developed by this time, and he is almost ready for birth. If it so happens that the child is born prematurely, from the 28th week of pregnancy, his chances of survival increase significantly compared to previous weeks. However, the time for childbirth has not yet come, and the baby is in no hurry - he needs to grow and develop.

The condition of a woman at 28 weeks of gestation

The pregnant uterus has already risen quite high above the navel, its growth does not stop, which means that the stomach also continues to grow. Usually, the weight of the expectant mother by the 28th week increases by about 10 kg. Fat deposits appear on the hips, abdomen and buttocks, which usually disappear after childbirth with proper nutrition and regular physical activity.

At the 28th week of pregnancy, a woman may have veins in the mammary glands., droplets of colostrum continue to flow from the breast. If there is still no colostrum, do not worry and mistakenly consider this a sign of a complete lack of milk when breastfeeding- it will appear later.

This period is characterized by such mild ailments as stomach cramps, indigestion and heartburn. Often, expectant mothers notice the periodic appearance of a weak pulling pain in the lower abdomen. It is caused by uterine contractions, in other words, these are false contractions.

How does the fetus develop at 28 weeks of gestation?

In the normal course of pregnancy at this time, the baby continues to grow and develop, preparing to get acquainted with a new world for himself and his relatives, who are next to him from the very beginning. Bone tissue becomes stronger every day, the formation of pulmonary alveoli continues, which will allow the baby to breathe on its own. The development of the baby's brain does not stop - at this time, convolutions and grooves appear, the rudiments of which formed a little earlier.

The growth of the fetus at the 28th week of pregnancy approaches 40 cm, and the baby weighs about 1 kg. Due to the formation of subcutaneous tissue, the baby continues to gain weight. In addition, the emerging fat contributes to the gradual smoothing of the skin of the child. As the baby grows, there is no longer enough room in the uterus to move. The child remains active, but he develops his own regime - he sleeps and is awake at certain hours. As a rule, future mothers can easily determine what their baby is doing at the moment.

Tests and ultrasound at 28 weeks of gestation

In addition to the usual general blood and urine tests, this week the pregnant woman will need to donate blood for the presence of antibodies. The fact is that sometimes a situation arises when the mother's blood is Rh-negative. Such an analysis allows you to find out whether there is a Rhesus conflict, as well as timely prevent complications associated with it during pregnancy and childbirth. A blood test for sugar levels becomes necessary at this time, since its increase is a signal of the development of diabetes in the expectant mother. In addition, at week 28, it is important to keep the level of iron in the woman’s body (hemoglobin) under control in order to prevent the development of anemia.

And here an ultrasound at 28 weeks of gestation is usually not necessary if the pregnancy is proceeding normally. Two planned ultrasound examinations are already over, and the third is due only at 32 weeks. Of course, an ultrasound examination at the request of the parents can be performed at 28 weeks. The uzist will tell you about the location of your baby and the state of his health, and will also determine if there are any pathologies in the development of the crumbs.

What happens to the stomach at 28 weeks pregnant

Since the 28th week is a pretty decent period, by this moment the figure of the expectant mother is becoming more and more rounded. The belly grows further, and the skin on it is stretched, as a result of which it itches. As the abdomen enlarges at 28 weeks of gestation, purple stripes appear brighter on it., which then turn into stretch marks. It is very difficult to remove them after they have appeared, but there are ways to help prevent them. The range of various creams, lotions and gels against stretch marks today is quite wide. Regularly rub special products into the skin of the thighs and abdomen - this will help increase its elasticity. Various oils help with stretch marks - almond, olive and others.

What discharge at the 28th week of pregnancy is considered the norm

Normally, the nature of the discharge at this stage of pregnancy should not change. There is no reason for alarm if the discharge has a light milky hue, a slightly sour smell and a uniform consistency. The appearance of greenish, yellow or earthy-gray discharge with an unpleasant odor, as well as foamy or curdled discharge mixed with flakes, is a characteristic feature of the development of an infection in the genital tract. In addition to discharge, frequent companions of infectious diseases are itching and burning in the vaginal area.

A cause for concern for the expectant mother should be spotting at 28 weeks of gestation regardless of their intensity and quantity. Any amount of blood in the discharge is a symptom of placenta previa or abruption, as well as one of the signs of the onset of preterm labor. Remember, if you have blood in your vaginal discharge at this time, you should immediately call a doctor.

A yellowish, watery discharge is most likely amniotic fluid. Remember that amniotic fluid does not always pour out at the same time - they can leak in small portions, and this causes increased humidity in the vulva. But even this situation requires an urgent appeal to the doctor, since the violation of the tightness of the membranes is extremely dangerous for the baby.

Pain at 28 weeks pregnant

Most often at this stage of pregnancy, expectant mothers suffer from pain in the back and lower back. This is due to a shift in the center of gravity and sprain due to a growing belly, as well as softening of the joints - this is how the mother's body prepares for the upcoming birth.

Sciatica-like pains in the lumbar region, which radiate to the thigh, and sometimes reach the knee and ankle, are the result of pressure from the growing uterus on the sciatic nerve. These sensations are quite unpleasant, but should not cause serious concern. Such pains are irregular, they are aching in nature and are not pronounced. However, when a sharp and severe pain resembling spasms appears in the lower back, it is worth calling an ambulance - it is possible that this is provoked by the onset of premature birth.

Since the tummy grows, and with it the body weight of the expectant mother increases, at the 28th week of pregnancy, pain and fatigue in the legs are a common complaint of women. Regular rest, foot massage and baths with cool water will help to avoid pain in the limbs.

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 the 28th week of pregnancy 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

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Already in the midst of the seventh month of pregnancy. This is the third trimester and there is very little left before the birth. At the 28th week, a woman should already begin active preparation for the birth of a baby. Some expectant mothers are still working during this period, but fatigue comes quickly.

In many ways, a woman can still lead a normal life without outside help. But you can no longer do anything that could be potentially dangerous for inducing premature birth: carry weights, hang clothes or curtains. The baby already weighs a little more than a kilogram, and its height is 35 cm. Many organs and systems have been formed, and active external development is underway.

In many sources, the 28th week of pregnancy is called the border of the second and third trimester. The belly is already large enough and it becomes difficult to travel long distances on foot. A woman does not constantly leave the direction in the back, especially in the lumbar region. Swelling of the legs, heartburn and shortness of breath may occur. But the baby feels great and looks more and more like little man. The fetus already weighs more than a kilogram, it leads active life in the womb, shows activity (which is not always pleasant for the mother, but is already noticeable to others).

Internal organs, systems and external development is almost complete. If at this time the child is born, then the doctors have a chance to save his life.

Feelings at 28 weeks pregnant

The movements and pushes of the baby are becoming more and more noticeable, because the fetus is actively growing. The period of wakefulness becomes longer and often occurs at night. Doctors recommend to note at what time of the day the child shows maximum activity. If in the morning or in the afternoon, then a calm and peaceful baby will be born. If at night, then the child will be active and very mobile.

The process of stirring and activity of the crumbs in the womb during this period is largely influenced by the nutrition of the woman. If you give the body a lot of sweets, which means glucose, then the baby shows an active life position, because he has the strength for it. Also, the child reacts strongly to the increase in adrenaline in the blood of the mother. Movements are the main sensations of the mother at the 28th week of pregnancy. They should be active, and if there are very few of them, then you should definitely contact a gynecologist.

Changes in mom's body at 28 weeks pregnant

At the 28th week, the edge of the uterus is already eight centimeters higher, if counted from the navel. As the pregnancy continues, the uterus will continue to grow, from which the sensations of the woman will become even more uncomfortable.
During this period of bearing a baby, women with negative Rh factor receive an injection of RhoGAM. This substance mixes with the blood of the mother and crumbs and protects against a possible Rh conflict if the child has a positive Rh factor. The injection will protect not only during pregnancy and childbirth, but also after the appearance of crumbs.

Signs of preterm labor:

Regular contractions that are accompanied by pain;
Abundant discharge of fluid from the vagina (even bleeding is possible);
Sensation of pressure on the pelvis, as if the baby is pushing down;
Dull pain in the back;
Cramping like pain during menstruation;

Baby at 28 weeks: external and internal development of the fetus

The baby already weighs 1.1 kilograms, and its length is 35 centimeters. He actively blinks his eyes and even cilia can be distinguished on them. Since vision is well developed, the child can react to a strong light source directed at the stomach. There are already billions of neurons in the brain. Until the 28th week, the baby's brain was smooth, and now the first furrows and convolutions are already appearing. The mass of the brain also increases, and the body of the child acquires subcutaneous fat, preparing to be born.

During this period, the formation of the endocrine system occurs. Growth hormones, pancreas and adrenal glands become important. During this period, the pancreas and thyroid gland of the mother will gradually be released from the double load. A specific type of metabolism is formed.

Features of internal and external development:

The skin becomes smooth and tender;
Fingernails and toenails continue to grow actively;
The hairs on the head become longer, have an individual color;
Protective lubricant covers the face, body;
Alveoli develop in the lungs;
The child can distinguish subtle varieties of tastes;
Complete formation of the sucking and grasping reflex;
Muscle formation, due to which the movements of the child become even more active;
Established a clear biological clock;
Bone formation, although they are still flexible and will continue to harden even after birth.

What's new?

Training contractions are actively appearing, which allow the uterus to prepare for childbirth. These contractions should not be regular or painful. If you have any doubts about whether the training bouts have definitely come, you should definitely consult a doctor. When everything is fine, but there are doubts about the tone of the uterus, it is better to lie on your side more often. This helps to relax the muscles and bring the uterus out of tone. You can also drink tea with motherwort and valerian to calm down.

Weight gain at 28 weeks pregnant

Starting from the 28th week of pregnancy, a woman should gain no more than 50 grams per day or 500 grams per week. It is best if weight gain is reduced to 300 grams per week.

Normal weight gain for the entire period of bearing a baby is 8-10.5 kg. If there is already a bust, then it is better to go on a diet. At the same time, it is necessary to reduce not the number useful products, but sweet and starchy.

Signs and symptoms of pregnancy at 28 weeks

The third trimester for pregnant women is quite difficult. Often there is shortness of breath, because the large uterus begins to actively press on the diaphragm. Shortness of breath during pregnancy is normal and nothing to worry about. To alleviate the condition, you can sit and stand straight, raise your arms above your head.

Important! If shortness of breath is very strong and is accompanied by palpitations, dizziness and loss of consciousness, then it is imperative to call an ambulance.

Pain in the lower back - in the lower back - becomes regular. Since by this time about 8 extra pounds had already been gained, the load on the spine increased significantly. A heavy uterus also strains the muscles of the back, plus certain hormonal changes.

Already in the third trimester, there is constant fatigue that every pregnant woman feels. This is associated with high energy costs. If sleep disturbance is added to this condition, then the woman may feel exhausted. It is necessary to rest more often during the day and try not to load yourself with everyday work.

What happens to the stomach at 28 weeks pregnant

The abdomen at the 28th week is already greatly enlarged, because the gestational age is quite long. The figure becomes rounded, and the skin on the abdomen is stretched, from which itching is constantly felt. Crimson stripes may appear on the abdomen, which in the future will turn into stretch marks. If this has not been done yet, it is urgent to buy a cream for stretch marks and start actively using it in the morning and evening.

Uterus

The uterus is large and is located 8 cm above the navel and 28 cm above the pubic joint. It seems to women that the belly is already huge, but the uterus will continue to grow until the very birth, because the baby is also growing. The uterus can often tense up and be afraid of this condition is not worth it if it does not cause pain and discharge. These are training contractions that prepare the body for future childbirth.

pain

On pain The 28th week of pregnancy is a very tangible period. Significant changes occurred in the growth of the child, and this affected the growth of the uterus. Most often, pain is disturbed in the lumbar region and the back as a whole. This is due to softening of the ligaments and joints, a shift in the center of gravity, which contributes to big belly. Such pains are similar to sciatica, often moving from the lower back to the knees and even the ankles. If sharp cramping pains appear in the lumbar region, then you need to call a doctor. Perhaps this is a sign of premature birth.

Particular attention should be paid during this period to pain in the lower abdomen. They may be under the lower ribs. In such a situation, you should not worry, most likely, this is the activity of the crumbs. But, if the pain is dull in nature and often appears, accompanied by nausea and heartburn, then you should consult a doctor. This phenomenon is a symptom of gallstone cholecystitis.

Edema - another important problem pregnant women in the third trimester. Puffiness appears not only on the legs, but even in the face. To make the body swell less, you should drink less, exclude spicy and fatty foods from the diet. No more than one and a half liters of liquid should be consumed per day, this includes soups and cereals.

Discharge at 28 weeks pregnant

Allocations should be the same and in the same amount as during the entire period of bearing the baby. There should be no odor, pronounced color or change in consistency. If the discharge has become thick, pus appears, itching in the groin area, then you should urgently go to the gynecologist. It is possible that an infection has appeared in the body that needs to be treated correctly and promptly.

Bloody discharge requires an ambulance call. They indicate that placental abruption has occurred. Bleeding may be different shades, but they always indicate the threat of preterm birth. This type of discharge is always accompanied by pain in the lower abdomen. Active watery discharge should also be alarming. They indicate flow. amniotic fluid. If water flows out abundantly, then this indicates an incomplete fetal bladder.

Necessary medical observations, tests and examinations

Ultrasound at the 28th week is not prescribed, only if there are some indications for this. In total, three ultrasounds are done during pregnancy, and two of them are already in the past before the 28th week. The third ultrasound is done at the 32nd week of pregnancy. But, if you want to see the baby, then ultrasound will help with this.

Tests are still required. In addition to the traditional general blood and urine analysis, blood is additionally donated for sugar and antibodies. If the mother has a negative Rh factor, and the child may have a chance of a positive Rh factor, then a situation of conflict is likely, which is fraught with complications in childbirth. If there is a Rh conflict, then a special drug is injected into the blood, which eliminates complications. In the third trimester, you will have to meet with a gynecologist up to two times a month. It is important to control the level of iron in the blood so that anemia does not develop.

Sex

You should not be afraid of intimacy at the 28th week of pregnancy, if there are no contraindications to this. It is important to choose the right position, and positive emotions from sex will benefit both mother and child.

Nutrition

If severe swelling appears, it is necessary to reduce the amount of fluid consumed. In general, you should adhere to the usual diet, reduce salt intake to a minimum.

You also do not need to eat marinades, seamings and spicy salads. Stewed vegetables, cereals, more beef and dairy products are welcome.

What to do this week

Maternity leave falls at this time, so it's time to relax a lot and take care of your condition. If there is only one crumb in the stomach, you can start collecting documents and certificates for vacation. If a woman is expecting twins or more, she will already be released on vacation.

Dangers and Complications

A woman begins to actively experience ailments, which may be associated with the development of anemia. Also often at the 28th week there is a lack of iron in the body, which causes anemia. To exclude such conditions, it is necessary to constantly take tests and monitor yourself. Iron-rich foods should be included in the diet: prunes, walnuts, legumes and bran, honey and cranberries.

To make sure that everything is in order with the crumbs, you need to count how many times per hour he pushes. The standard number is 10 times. If it differs up or down, this should be reported to the doctor;
With dizziness, weakness and pallor, it is necessary to take blood tests for iron;
It's time to sign up for prenatal courses that will help get rid of the fears of childbirth.

The third trimester or final stage begins. It is quite heavy because the baby is now big and continues to grow. The best thing a woman can do during this period is to provide herself with peace, plenty of rest and a good emotional state.

The 28th obstetric week of pregnancy begins, and already from this period your baby has a high chance of life in case of premature birth and subsequent proper care.

However, the time of delivery in the normal course of pregnancy has not yet arrived, so now your child continues to actively grow and develop.

How does the fetus develop at 28 weeks of gestation?

Your baby at the 28th week of pregnancy is improving and developing, becoming like a little man.
The unique features of his face began to emerge clearly.
The lively and funny facial expressions of the child are touching: either he blinks, then squints and squints, and then yawns and makes faces - this can be seen on ultrasound
At this stage of pregnancy, the subcutaneous fat layer of the baby is actively formed. Now his skin will gradually smooth out.
You know it's already beating little heart your baby can be listened to with a regular phonendoscope.
The pulmonary alveoli of the baby continue to actively form.
The bone tissue of the fetus is strengthened, and the child himself at 28 weeks of pregnancy continues to gain weight significantly.
The child's brain is also actively developing. At this stage of pregnancy, the first grooves and convolutions appeared, which had just begun to form before.
In the mother's belly, there is less and less room for the baby to free somersaults.

It is already difficult for him to spin freely, but so far the child can easily change his presentation. The expectant mother should not worry if at 28 weeks of pregnancy the position of the fetus is not upside down - now it can still change.

Movement, height and weight of the unborn baby

The main task facing a woman in the third trimester is to constantly control the movements of the crumbs. It is necessary to determine the time of activity of your child and be sure to control his movements twice a day (in the morning and in the evening).

Normally, the number of movements, pushes and perturbations that the fetus makes at the 28th week of pregnancy for one hour reaches 10.

A cause for concern is a decrease in movement or lack of activity for a long time. In this case expectant mother need to rush to the doctor.

At 28 weeks of pregnancy, the weight of the child can reach and even slightly exceed 1 kilogram, and its height reaches 38.5 cm or more.

Feelings and well-being of the expectant mother

At this stage of pregnancy, the expectant mother will have to undergo a series of mandatory examinations and be ready for frequent meetings with her gynecologist.
The next check of the level of hemoglobin and glucose in the blood is carried out.
If a woman has a negative Rh factor, it is necessary to periodically test for antibodies.
Consult a gynecologist if you are allowed to have sex at the 28th week of pregnancy, and if there are no contraindications, you can indulge in pleasure.
For the normal course of your pregnancy, a balanced and proper diet is also important, daily walks on fresh air, lack of stressful situations, good rest.

We suggest you take a picture of your own tummy for memory at this time. Such pictures bring mothers extremely positive emotions. And your photo of the belly, along with the photo of the baby taken at 28 weeks of pregnancy, can be placed in a separate album, the pictures of which will become the beginning of the story of your child's life.

Now you are in the twenty-eighth week of pregnancy, the uterus is growing more and more, and for this reason, a woman may experience various uncomfortable sensations more often.

Pain in the spine and lower back, characteristic of expectant mothers in the second trimester of pregnancy, appear due to a shift in the center of gravity, stretching of the ligaments and softening of the joints. Spontaneous aching lumbar pain, radiating to the thigh, knee and ankle, are the result of compression of the sciatic nerve by an enlarged uterus.

Sharp and severe spasmodic lumbar pain requires an immediate call for an ambulance.

Such sensations indicate that you may begin premature birth at 28 weeks pregnant.

Do not worry if minor swelling of the legs, arms, face appears. You just need to review the diet, reduce salt intake, control fluid intake. But sometimes swelling can be a symptom of preeclampsia - a serious complication of pregnancy.

Can the stomach hurt

If your stomach hurts at 28 weeks of pregnancy, you need to learn to recognize the nature and causes of such pain. Sometimes they indicate problems during pregnancy, and sometimes they are quite normal.

Periodically appearing stabbing and pulling pain in the abdomen may be due to softening of the ligaments that hold the uterus and are not dangerous for pregnancy.
Disturbed work of the digestive system leads to constipation, flatulence, swelling, colitis and can also provoke the appearance of aching pain in the lower abdomen.
Rapidly passing sharp pain in the hypochondrium can be caused by the activity of a growing baby, his jolts and movements.
Aching and dull pain in the hypochondrium, which occurs after eating and is accompanied by bitter belching and nausea, may indicate the development of cholelithiasis cholecystitis. In this situation, you need to consult a doctor.
Severe and acute pain in the lower abdomen may be the result of premature detachment of the placenta. In this case, bleeding is usually also present. In this case, bleeding can be both external and internal, and a woman has a sharp decrease in blood pressure. A woman with similar symptoms should hurry to the doctor to further maintain her pregnancy.

preterm birth

Premature birth at 28 weeks of gestation is characterized at first by aching pains in the lower abdomen, radiating to the lower back, which later become regular, sharp and cramping. Further, the discharge of amniotic fluid is observed.

Preterm births are more common:

in women suffering from gynecological diseases,
in women with uterine malformations,
in women with various internal diseases,
in women prone to severe toxicosis in late pregnancy.

What happens if there are discharges

Vaginal discharge of a homogeneous consistency, light milky in color with a slight sour smell is considered normal for this stage of pregnancy. Any changes in the nature of the discharge require the close attention of the expectant mother!

Yellow, greenish, gray, frothy, mixed with flakes or curdled vaginal discharge, accompanied by burning and itching in the genital tract and having a sharp unpleasant odor, indicate the development of an infectious disease. You should hurry to the doctor and be sure to treat this infection in order to prevent intrauterine infection of the baby.

Any amount and intensity of bloody vaginal discharge, accompanied by aching and pulling pains in the lower abdomen, at this stage of pregnancy is a reason for an immediate call for an ambulance.

Such a picture may be a sign:

placenta previa or abruption,
incipient preterm labor.

The appearance of a small amount of watery liquid yellowish discharge may indicate leakage of amniotic fluid. Contact your doctor immediately, because such a picture indicates a violation of the integrity of the membranes and the risk of infection for your baby.

The onset of preterm labor is characterized by a simultaneous discharge of amniotic fluid. It is extremely necessary in this case to have time to call medical care, after all, such childbirth proceeds rapidly.

Why is an ultrasound done?

At this stage of pregnancy, an ultrasound scan may be prescribed by a doctor to clarify the indicators of the development of the child and the condition of the uterus of the expectant mother. The doctor will examine the ultrasound internal organs baby, will assess the size of the uterus and its location, determine the position and maturity of the umbilical cord and placenta. When conducting an ultrasound examination, the specialist determines the location (presentation) of the child in the uterus: pelvic, head or transverse.

By the way, you also have the opportunity to ask the doctor to take a photo of the fetus at 28 weeks of pregnancy. Keep in mind that the baby is growing rapidly, and later it will be almost impossible to get a high-quality photo of him on an ultrasound. Now there is still a chance to take a picture of the baby at 28 weeks of gestation - ultrasound photo.

Thank you

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

From the twelfth week, the gestational age is indicated exclusively in obstetric weeks, since various parameters of growth and development, with which the current state of the fetus is compared, are verified specifically for the obstetric period.

Fetus

The body weight of the fetus at the 28th week of pregnancy averages 1124 plus or minus 183 g, but can reach up to 1300 g. The body length of the fetus can reach up to 38 cm, and averages 35.9 plus or minus 1.8 cm It must be remembered that at this time the body length and weight of the fetus may vary different women over a wide range, since they are due to a number of individual features such as the genetically predetermined constitution, the nature of the nutrition of the expectant mother, etc.

At the 28th week, the fetus has its own the immune system, his lungs are ready for gas exchange - that is, the alveoli can already release carbon dioxide and bind oxygen.

The digestive system functions: the stomach produces hydrochloric acid, the pancreas produces enzymes, the liver produces bile, and the intestines perform peristaltic movements. In other words, the gastrointestinal tract is ready to digest milk, which the baby will eat in the first year after birth.

If the results of cardiotocography and dopplerography revealed fetal hypoxia or circulatory disorders in the mother-placenta-fetus system (for example, fetoplacental insufficiency), then a woman may be recommended hospitalization for the treatment of these pathologies or even early delivery if the baby suffers too much and may die.

As for the tests, at the 28th week, women with a negative Rh factor and the first (0 (I)) blood group should definitely pass a test for antibody titers (an analysis for antibodies to the Rh factor and proteins of the AB0 system). This analysis allows you to assess whether the Rhesus conflict develops between the organisms of the mother and the fetus, which, if present, leads to hemolytic disease of the newborn.

At the 28th week, a test for antibody titers is mandatory, since at this gestational age, in the absence of antibodies to the Rh factor in the blood (no Rh conflict), a special anti-Rhesus (anti-D) immunoglobulin must be administered. Such an anti-Rh immunoglobulin helps prevent the risk of Rhesus conflict for the remainder of the pregnancy. However, in practice, at the 28th week, anti-Rhesus immunoglobulin is not always administered. As a rule, this is due to the lack of the necessary drug in medical institution. Also, immunoglobulin is not administered to women with a positive antibody titer.

If a woman was injected with anti-Rhesus immunoglobulin at the 28th week of pregnancy, then in the future, until the very birth, an analysis for antibody titers is not performed, since it will be false positive. But if anti-Rhesus immunoglobulin was not introduced at the 28th week, then until the very birth, antibody titers are determined every two weeks, that is, at 30, 32, 34, 36, 38 and 40 weeks.

Regardless of whether anti-Rhesus immunoglobulin was administered at week 28, within three days after birth, women with a negative Rh factor of blood who gave birth to babies with a positive Rh factor of blood must be injected with immunoglobulin. Thus, Rh-negative women still receive an injection of anti-Rh immunoglobulin after childbirth if an Rh-positive baby is born.

In addition, at the 28th week of pregnancy, it is necessary to pass a complete blood count, a general urinalysis and a blood sugar test. These tests will need to be taken at each visit to the gynecologist, that is, once every two weeks, namely at 30, 32, 34, 36, 38 and 40 weeks. A complete blood count, a complete urinalysis and a sugar test are simple laboratory teststhat allow you to identify dangerous diseases and pregnancy complications that are fraught with pregnancy loss, fetal or maternal death, premature birth, etc.

So, a general urine test allows you to assess the risk of preeclampsia by the presence of protein. And assessing the risk of preeclampsia is very important, since this formidable complication of pregnancy can lead to the death of both the fetus and the mother. Therefore, doctors evaluate the risk of preeclampsia, and if it is high, prescribe preventive treatment.

The risk of preeclampsia is considered high if protein is present in the urine of a pregnant woman. In such a situation, the doctor prescribes calcium (1 g per day until the 40th week) and Aspirin (75-125 mg per day until the 36th week). If there is no protein in the urine, then the risk of preeclampsia is considered low, and prophylactic calcium and Aspirin are not prescribed.

If, in addition to protein in the urine, a woman has high blood pressure, severe edema, persistent headaches and visual disturbances such as flashing flies or spots before her eyes, then gestosis should be suspected - also a formidable complication of pregnancy. Therefore, in the presence of the triad "edema + blood pressure + protein in the urine", the doctor sends the woman for hospitalization in the maternity hospital.

In addition, a general urine test allows you to assess the condition and functioning of the kidneys, as well as to identify hidden diseases of the urinary system. So, if there are leukocytes, erythrocytes, cylinders, mucus, bacteria or epithelial cells in large quantities in the urine, then this indicates the presence of diseases of the urinary system organs that need to be treated.

A complete blood count can detect anemia, a well-known pathological syndrome that develops in many pregnant women due to an increased need for iron. And since anemia negatively affects the growth and development of the fetus, creating a state of chronic hypoxia, this syndrome must be cured, and the sooner this is done, the better. Therefore, doctors prescribe a complete blood count, starting from the 28th week, every two weeks, in order to timely detect anemia and cure it in the early stages.

A blood sugar test can detect diabetes, which can develop in about 2% of pregnant women.

No other tests are scheduled for the 28th week. However, if the doctor has suspicions about the presence of any diseases or complications of pregnancy, then he can prescribe any examinations and laboratory tests that he considers necessary.

Visiting an obstetrician-gynecologist

At the 28th week, the period of scheduled visits to the gynecologist leading the pregnancy begins. Moreover, doctors always try to set the date of the planned visit exactly for the 28th week, since this is very important for further visits to the doctor, which this period and until the 37th week will occur every two weeks. And so that the visits fall on certain dates on which examinations should be carried out, doctors appoint a "starting" visit for the 28th week.

At the appointment with the doctor, you must take the results of all tests and examinations that the doctor has not yet seen, as well as an exchange card that is in the hands of a woman. The results of tests and examinations will be analyzed by the doctor and, based on them, a conclusion will be made about the condition of the child, the mother and the course of pregnancy.

The doctor always begins the appointment with a conversation, during which he asks the following questions to find out the woman's well-being, the development of the fetus and the presence of complications or diseases:
1. Does the woman worry about anything, how often do complaints appear, how can they be eliminated, etc.?
2. How often does a woman feel movements and when did she last feel them?
3. Has there been any unusual or bloody discharge from the vagina?
4. Have you had vaginal discharge that causes discomfort, pain, itching, or burning?
5. Were there episodes of vaginal discharge with relatively large amounts of fluid, according to appearance reminiscent of yellowish muddy water?
6. Have there been episodes of constant wetness or wetness in the perineum?
7. Are there persistent headaches?
8. Did your face and hands swell?
9. Was there redness, swelling, redness, itching in the genital area?
10. Were there episodes of flies, spots and flashes of light before the eyes?
11. What kind of vaginal discharge does a woman have (color, smell, texture)?
12. Do you have pain or burning when urinating?
13. Is there persistent and severe pain in the abdomen that does not go away with time?

Due to the rapid growth of the uterus, there is a strong stretching of the skin on the abdomen, which can lead to stretch marks and itchy skin. To prevent the appearance of stretch marks, you need to lubricate the skin of the abdomen, sides and thighs with regular nourishing cream, special cosmetics or conventional vegetable oil daily. Lubricating the skin with these products when red stretch marks have just appeared on it will help make them more invisible. Itching of the skin on the abdomen and sides cannot be relieved, since it is caused by stretching of the skin, but there is no need to worry about its presence. However, if itching spreads from the abdomen and to other areas of the skin, you should consult a doctor - this may be a sign of an allergy or skin disease.

Often, pregnant women at the 28th week suffer from cramps in the calf muscles, which can be caused by a deficiency of calcium, vitamin B 12, low blood glucose, varicose veins, diabetes, as well as a strong load on the legs. If a cramp occurs, you need to strongly pull the foot towards you until the pain stops, and then massage the caviar. To prevent the occurrence of seizures, you should take calcium supplements, B vitamins and avoid heavy stress on the legs.

The breast at the 28th week may increase, and colostrum is periodically secreted from the nipples. When colostrum is released, you just need to wipe the breast with a dry and soft cloth. You can not squeeze colostrum from the breast. It is also recommended to start preparing the breast for feeding the baby, for which you should wash the mammary glands with cool water and wipe with a rough towel.

Finally, at the 28th week, a woman can periodically feel painless contractions lasting 1 to 2 minutes. Such fights are called training. They are not dangerous, and only reflect the process of preparing the uterus for childbirth. But if the contractions become painful, regular and their number exceeded 5 per hour, then you should immediately be hospitalized in the maternity hospital, as this may indicate the onset of premature birth.

Allocations

Discharges that are normal for the 28th week of pregnancy have a homogeneous, liquid consistency, are whitish or translucent in color, have a slight sour smell, and do not cause discomfort. There are no impurities of pus, blood, mucus, etc. in the secretions.

If the nature of the secretions changes, their color becomes greenish, yellowish, grayish, earthy, the consistency becomes heterogeneous with lumps, flakes or bubbles, or impurities of pus, blood, mucus appear, then this indicates the development of an infectious and inflammatory disease of the genital organs. Also, the inflammatory process is indicated by itching, swelling, redness or pain in the genital area. Accordingly, if such symptoms appear, you should consult a gynecologist at the clinic.

The appearance of watery discharge is a sign of amniotic fluid leakage. Moreover, water can leak in different ways: for example, a relatively large amount of cloudy, yellowish water with a sweet aftertaste is possible at one time. The sweetness of water is easy to determine - after contact with it, the skin of the perineum and pubis becomes sticky. Or water can leak imperceptibly, in small portions, but in this case the woman constantly feels in the crotch that she is wet and sticky. If you suspect a leak of amniotic fluid, you should contact a gynecologist at the clinic.

If suddenly there was an outpouring of a large amount of muddy water that wetted all the woman's clothes, then you should immediately call an ambulance, as this may be a sign of the onset of premature birth.

Bleeding

Bleeding at the 28th week can be of a different nature - be plentiful, scanty, spotting. The released blood can also be different - scarlet, burgundy, with a reddish tinge or completely brownish. Almost always, bleeding is combined with pulling and aching pains in the lower abdomen. However, regardless of the nature, bleeding at 28 weeks is always dangerous - it indicates the development of complications that can lead to pregnancy loss (for example, placental abruption, premature birth, etc.). Therefore, when bleeding occurs in any amount and of any nature, you should call an ambulance and be hospitalized in a maternity hospital.

uterus and belly

The uterus at the 28th week is large, the height of its fundus is 28 cm. But the height of the fundus of the uterus (VFH), depending on the individual characteristics of the woman, can vary from 24 to 30 cm, however, on average, it is still 28 cm. From this date on, the ARHD in centimeters will correspond to the gestational age in weeks. That is, at 30 weeks, the ARHD will be 30 cm, and so on.

The uterus is preparing for childbirth, so during the day, 10-15 times a woman feels short training contractions of Braxton Hicks (1-2 minutes each). Such contractions are not dangerous, occur irregularly and are not too painful. However, if suddenly the contractions become painful, regular, there are more than 5 of them per hour, then you should call an ambulance and be hospitalized in a maternity hospital, since such symptoms indicate the onset of premature birth.

The abdomen at the 28th week strongly protrudes forward, its circumference is normally 80 - 85 cm. In addition, the skin on the abdomen can itch and become covered with rashes due to its rapid stretching. Itching and rashes on the skin of the abdomen are completely normal, and are associated with its stretching. But if the rash or itching spreads to other areas of the skin, then you should visit a doctor, as this may be a sign of an allergic reaction, skin disease or jaundice.

Pain in the abdomen and other parts of the body

At the 28th week of pregnancy, a woman can experience any pain of any localization, because she is, first of all, an ordinary living person. But we will consider only the physiological pains provoked directly by pregnancy and the changes in the body that have occurred because of it. Such physiological pains are normal, as they reflect the ongoing changes and the impact of pregnancy.

So, very often women at the 28th week of pregnancy suffer from pain in the abdomen, hypochondrium, back, lower back, sacrum, coccyx, pelvic bones, hips and legs.

Often on the 28th week, women feel pain in the anus, which, as a rule, is caused by hemorrhoids, which occurs due to compression of the vessels of the lower body by a large uterus.

Sex

The twenty-eighth week of pregnancy is the last in which a woman has a pronounced libido, she actively desires intimacy and goes to her with pleasure. For long periods, starting from the 29th week, libido will decrease, the stomach will increase, which will create natural physiological difficulties for sexual intercourse. Therefore, couples can enjoy the last days in the 28th week when sexual activity is desired by both, and is not associated with strong physical exertion. Of course, sex at the 28th week is allowed if the woman does not have pregnancy complications.

Weight

Weight gain at week 28 is normally 5.4 - 9.8 kg. Moreover, the fuller the woman, the less weight she should add. In other words, initially plump women Normally, they should add within 5.4 - 8.2 kg, and thin ones - 8.2 - 9.8 kg. It is advisable not to allow excess weight gain, as this will lead to the appearance of fatty deposits, which can provoke difficult childbirth and, of course, worsen the figure after childbirth.

Women can control their own weight gain by weighing themselves every day or once a week. With daily weighing, the increase should be no more than 50 - 70 g, and with weekly - 350 - 500 g. If weight gain occurs within the specified limits, then everything is in order. If the mass increases more than the norm, then it is advisable to reconsider the diet, excluding high-calorie and low-nutrient foods from it, such as flour, confectionery, chocolate, white