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?
The woman in the twenty-first week (20.1-21 tc) is in the 5th month and the second trimester, entering the second half of pregnancy. Her abdomen at 21 weeks of pregnancy becomes visibly rounded and the bottom of the uterus is at the navel line. Many mothers-to-be are now experiencing a surge of strength, so this is a very good time to start antenatal 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 twenty-first week of pregnancy, you can also choose to attending birthing school, in which future parents can undergo education before childbirth among other couples expecting a child. Many of these schools offer free classes, refunded by the National Health Fund. In turn, paid birthing schools often operate very flexibly (also online), adjusting the dates and the detailed program of classes to the busy work schedule of future parents. From the 21st week of pregnancy, it is definitely worth spending time preparing well for the birth itself and for caring for the newborn baby.
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
Each woman's pregnancy symptoms may have a slightly different course, and some pregnant women do not feel them at all. The common denominator for most ladies during this period of pregnancy is enlarging bellywhich is already difficult to hide, especially under tight-fitting clothing. Many women in their 21st week of pregnancy exchange photos of their growing bellies and questions about their weight gain on the internet forum.
A pregnant woman at this time should gain weight of about 300-500 grams per month, but in the 21st week of pregnancy, the mother's weight is a very individual matter for her, depending on, among others, on pre-pregnancy body weight or lifestyle. Therefore, it is not worth comparing yourself excessively with other women, and it is good to consult your doctor about any doubts about weight gain or ailments in the 21st week of pregnancy.
Pregnancy chloasma
During this time, many future mothers notice discoloration on their skin, most often in the area of the face. This is called pregnancy chloasma, i.e. excessive pigmentation associated with hormonal changes and overproduction of melanin. This ailment in the 21st week of pregnancy is preventable, by applying a cream with a high SPF 50 filter to the exposed parts of the body (preferably throughout pregnancy). It is also worth avoiding prolonged, direct exposure to the sun.
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 the full length of the abdomen).
Calf cramps
A large proportion of women in 21 weeks of gestation complain of calf cramps, which bother them especially at night. It may help to gently stretch and massage your tense leg muscles before going to bed. During the day, you need to look after adequate hydration of the body, eating plenty of fresh vegetablesand if the problem intensifies, ask your doctor for a recommendation of 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?
We talk about gestational hypertension (blood pressure of a pregnant woman is 140/90 mmHg or more) if it is diagnosed after the 20th week, which is actually from the twenty-first week of pregnancy. If, during the follow-up visits, the gynecologist finds too high blood pressure before the end of the 20th week, we are talking about chronic hypertensionwhich probably occurred in a woman before pregnancy, but was not diagnosed for various reasons.
Pregnancy-induced hypertension it is most likely related to abnormalities during placental implantation and occurs in up to 10% of pregnant women. We distinguish:
- 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 accumulate fatty tissue under the skin, which will be used to ensure proper thermoregulation after delivery. The movements of the baby in the 21st week of pregnancy are still uncoordinated, but the brain begins to clearly register their course: the baby kicks with his legs and hands, turns and even starts to play with the umbilical cord (don't worry, he won't hurt himself). Iny also reacts clearly to sudden sounds and soothing voices of her mom, dad 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.
Fetal weight in the 21st week of pregnancy it is about 340-360 grams, but it may differ from these values individually - each child begins to develop at its own pace. This is dictated, among others, by genetic and environmental factors, e.g. lifestyle and body structure of a pregnant woman. The doctor informs the future parents during the control visits about 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 her gynecologist, a pregnant woman should perform a blood count and a general urine test. In women in whom IgM antibodies were not detected in the first trimester, it is recommended to repeat the diagnosis. In turn, in pregnant women with a negative blood group factor (Rh-), it is recommended re-testing of anti-D antibodies.
Between 18 and 22 tc it is also recommended to perform a very important ultrasound of the second trimester. Performing this ultrasound in the 21st week of pregnancy is a good time, because in addition to a detailed assessment of the anatomy of the fetus (including the presence of birth 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 in the course of specialization in gynecology and obstetrics, Department of Obstetrics and Gynecology at the Institute of Mother and Child.
