Week 21 of pregnancy has begun - what month is it? What is pregnancy-induced hypertension and what consequences could it have for mom and baby? Is the low weight of a baby at 21 weeks of pregnancy a cause for concern and how much should a pregnant woman gain weight during this period? Is it possible to start antenatal education already in the twenty-first week of pregnancy? How is the fetus developing at this time and should a woman in the 21st week of pregnancy already sense the baby's movements? Pregnancy is a time when a future mother and her relatives have many questions - in this post we present the most important information about the course of the 21st week of pregnancy.
We are starting the 21st week - which month of pregnancy is this? Is this a good time to start antenatal education?
A woman in her 21st week (20.1-21 weeks) is in her 5th month and 2nd trimester, entering the second half of her pregnancy. Her abdomen at 21 weeks becomes noticeably rounded, and the fundus of the uterus is at the navel line. Many expectant mothers experience a surge of energy now, making it a great time to begin prenatal education.
According to the regulations, from 21 weeks of age each pregnant woman is entitled to free educational meetings with the midwife. If the pregnant woman has contacted her midwife sporadically, it is a great time for closer acquaintance - an experienced midwife is invaluable support, both during the preparation for the birth and counseling in the field of newborn care.
In the 21st week of pregnancy, you can also opt to attend a childbirth class, where expectant parents can receive prenatal education with other expecting couples. Many of these classes offer free classes, reimbursed by the National Health Fund. Paid childbirth classes, on the other hand, often operate very flexibly (including online), adapting the dates and detailed program to the busy work schedules of expectant parents. From the 21st week of pregnancy, it's definitely worth investing time in thorough preparation for the birth itself and the care of the newborn.
Symptoms of the 21st week of pregnancy: the abdomen is clearly visible, there may be discoloration on the skin and calf cramps that do not let you sleep at night
Pregnancy symptoms may vary slightly from woman to woman, and some pregnant women experience none at all. The common denominator for most women at this stage of pregnancy is a growing belly , which is difficult to conceal, especially under tighter clothing. Many women in the 21st week of pregnancy share photos of their growing bellies and questions about their weight gain on online forums.
A pregnant woman should gain around 300-500 grams per month during this time. However, at 21 weeks of pregnancy, a mother's weight is a very individual matter, depending on factors such as her pre-pregnancy weight and lifestyle. Therefore, it's best not to overly compare yourself to other women, and it's a good idea to discuss any concerns about weight gain or discomfort during the 21st week of pregnancy with your doctor.
Pregnancy chloasma
During this time, many expectant mothers notice discoloration on their skin, most often on the face. This is known as chloasma gravidarum , or excessive pigmentation related to hormonal changes and overproduction of melanin. This condition can be prevented in the 21st week of pregnancy by applying a high-SPF 50 sunscreen to exposed areas of the body (ideally throughout pregnancy). It's also advisable to avoid prolonged, direct sun exposure.
Linea nigra
Increased melanin secretion also leads to darkening of the nipples and the appearance of the so-called linea negra – a black line on the skin running from the navel to the pubic symphysis (and often along the entire length of the abdomen).
Calf cramps
Many women in their 21st week of pregnancy complain of calf cramps, which are especially bothersome at night. Gently stretching and massaging the tense leg muscles before bed can be helpful. During the day, ensure adequate hydration, eat plenty of fresh vegetables , and if the problem worsens, ask your doctor for a recommendation for magnesium-rich supplements that are safe for pregnant women.
Pregnancy-induced hypertension detected in the 21st week of pregnancy - what consequences may it have for the mother and child?
Gestational hypertension (a woman's blood pressure is 140/90 mmHg or higher) is diagnosed after the 20th week, which is actually the 21st week of pregnancy. If a gynecologist detects high blood pressure during follow-up visits before the 20th week, it's considered chronic hypertension , which most likely existed before pregnancy but went undiagnosed for various reasons.
Pregnancy-induced hypertension is most likely related to abnormalities during placental implantation and occurs in up to 10% of pregnant women. It includes:
- benign gestational hypertension (not exceeding 140/90 mmHg);
- and severe gestational hypertension (values equal to or greater than 160/110 mmHg).
Gestational hypertension is characterized by the fact that it is not accompanied by proteinuria and resolves spontaneously up to 6 weeks after delivery. If you are hypertensive at 21 weeks, your doctor will recommend daily, regular blood pressure checks at home, more frequent blood and urine tests, and lifestyle changes. It may also decide to introduce appropriate pharmacological treatment from the 21st week of pregnancy.
Complications of untreated hypertension in pregnancy may include: pathologies within the placenta leading to hypoxia and malnutrition of the fetus, preterm labor, occurrence of a stroke in a pregnant woman, HELLP syndrome (haemolytic anemia, elevated levels of liver enzymes and thrombocytopenia) or severe eclampsia.
What is the baby's weight at 21 weeks of pregnancy and how does it develop?
The fetus begins to rapidly accumulate fat tissue under the skin, which will help ensure proper thermoregulation after birth. At 21 weeks of pregnancy, the baby's movements are still uncoordinated, but the brain begins to clearly register them : the baby kicks its legs and arms, turns, and even begins to play with the umbilical cord (don't worry, it won't hurt itself). It also responds clearly to the loud noises and soothing voices of its mother, father, and siblings.
How often in the 21st week of pregnancy should the baby's movements be felt by the mother-to-be?
First of all, the fetus still has a lot of space in the uterus for all flips and kicks, so its activity can be felt quite delicately by the pregnant woman. Most often, the fetal movements can be felt after a meal and when the woman stops moving intensively, deciding to rest.
The fetal weight at 21 weeks of pregnancy is approximately 340-360 grams, but may vary from person to person – each baby begins to develop at its own pace. This is dictated by genetic factors, as well as environmental factors such as the lifestyle and physique of the pregnant woman. During follow-up visits, the doctor will inform the expectant parents whether the baby's weight at 21 weeks of pregnancy is within the normal range.
During this time, the fetal bone marrow takes over from the liver to produce white blood cells, which play a very important role in shaping the baby's immune system. All of the baby's organs mature, slowly preparing for independent functioning outside the uterus.
Diagnostics in the 21st week of pregnancy - is ultrasound mandatory? What tests should be performed during this time?
When visiting a gynecologist, a pregnant woman should first have a complete blood count and a urinalysis. For women who did not have toxoplasmosis antibodies (IgM) detected in the first trimester, repeat testing is recommended. In pregnant women with a negative blood group factor (Rh-), a repeat test for anti-D antibodies is recommended.
A crucial second-trimester ultrasound is also recommended between weeks 18 and 22 of pregnancy. Performing this ultrasound at 21 weeks is a good time because, in addition to a detailed assessment of the fetal anatomy (including the presence of congenital defects), the doctor will also be able to confirm:
- the sex of the child;
- pregnancy age;
- placental condition;
- amniotic fluid;
- and the uterus.
Some birth defects of the fetus (e.g. heart defects) can be treated while pregnant, which is why half-time ultrasound is such a diagnostically important test. If up to the 21st week of pregnancy has not yet been performed, it is the last call to sign up for it on the date recommended by PTGiP.
Consultation:
Ph.D. n. med. prof. IMID Tadeusz Issat - Head of the Obstetrics and Gynecology Clinic at the Institute of Mother and Child;
Maria Krowicka-Wasyl – resident physician during specialization in gynecology and obstetrics, Clinic of Obstetrics and Gynecology at the Institute of Mother and Child.
