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4 and a half months pregnant. Fourth month of pregnancy: changes in the body of the mother and fetus

The fourth month of pregnancy is the start for the most enjoyable and safest trimester in general - the second. By this time, the unpleasant manifestations associated with toxicosis should already subside, or at least noticeably decrease. Intrusive nausea and intolerance to odors are increasingly being replaced by increased appetite - the child in the mother's belly continues to grow and develop actively, requiring the necessary nutrients and nutrients. The growth and development of the fetus at 4 months occurs according to "fabulous laws" - not by the day, but by the hour, and by the end of it, a woman with bated breath for the first time can feel the first movements and jolts of her baby. However, keep in mind that the sensations of the first tremors are a completely individual matter: many mothers can feel the first movements of the child only next month. It depends on the anatomical features, on the physique of the pregnant woman, on whether this is the first pregnancy or the mother is "awaiting" again.

Despite the fact that the second trimester of pregnancy, which started from the fourth month, is considered the calmest and safest, a pregnant woman, as before, needs to be careful, monitor her well-being. Among other things, the most important is good nutrition at 4 months of pregnancy, regular walks in the fresh air, rest and healthy sleep. The expectant mother needs to monitor blood pressure and her own weight.

· Baby development at 4 months pregnant

The development of the fetus at the 4th month of pregnancy goes by leaps and bounds - during this time, the formation of all the internal organs of the baby is almost completed. The child's kidneys are already excreting urine into the amniotic fluid on their own, the children's immune system is actively developing, the adrenal glands produce hormones, all the functions of a tiny organism are controlled by its own nervous and endocrine system. The growth and development of the fetal brain continues: 4 months of pregnancy is a significant period in the formation of the baby's cerebral cortex.

All the functions of transporting oxygen, nutrients and nutrients to the baby are performed by the placenta. She is in charge of removing waste products and harmful substances from a tiny organism, protecting the fetus from harmful bacteria and viruses.

The development of the fetus at 4 months has reached the level where the baby can already bend the legs and arms, clench his palms into fists, he develops grasping and sucking reflexes. During the same month, hair, eyebrows and eyelashes will begin to grow on the head of the child, nails will form on the fingers. 4 months of pregnancy is the time when an embryonic fluff - lanugo - forms on the body of the crumbs, it will hold a special protective lubricant on its skin - the baby's skin secretions, produced specifically for protective purposes.

The baby already knows how to squint, and by about the end of 4 months, it will completely open its eyes. As a result of this period, the growth of the fetus will reach 16-20 cm, and the weight will reach 200 grams.

· Possible problems and sensations during pregnancy 4 months

Now there is a gradual improvement in the condition and general well-being of the pregnant mother: toxicosis passes, the feeling of nausea of the surrounding odors disappears, activity increases, increased appetite sprinkles. The belly at 4 months of pregnancy noticeably grows, changing the figure of a woman: uterus is growing fast , the stomach, respectively, is rounded, and the waist is smoothed out, the mammary glands are increasing in size, but, fortunately, the soreness and swelling of this process gradually disappears.

The fourth month of pregnancy can upset the mother with the appearance of age spots on the skin, darkening or the appearance of freckles. The abdomen at 4 months will acquire a more pronounced strip, the skin of the areolas and nipples also darkens.

Due to the concentration of a large amount of fluid in the body, sweating may increase, whitish vaginal discharge may increase slightly. In case of a change in the nature of the discharge - their consistency, color, smell changes, discharge during pregnancy for 4 months is accompanied by burning and / or itching - you should immediately consult a doctor. With these symptoms, for sure, treatment of the attached infection will be required.

Feelings of periodic headaches and dizziness during pregnancy 4 months are still possible. Some gum bleeding may occur during brushing. Some women experience nasal congestion, and nosebleeds occur if the small vessels cannot withstand the increased blood flow in the body.

A very unpleasant problem of this period can be constipation - a consequence of hormonal changes and the pressure of the growing uterus on the intestines. The best way to deal with constipation is to avoid it, for this you need to carefully monitor the diet, nutrition at 4 months of pregnancy should in every possible way contribute to the normal functioning of the intestines. And if constipation still appears - try to debug the work of the intestines and the digestive system as soon as possible. Indeed, it is often due to constipation that such a painful and delicate disease develops as hemorrhoids of pregnant women .

The growth of the uterus in the abdominal cavity continues, but at this stage of pregnancy it has already increased enough to go beyond the small pelvis. Against the background of a significant increase in the uterus, sprains occur, while many expectant mothers experience painful pulling sensations in the lower abdomen. As a rule, such sensations are within the normal range, but in order to make sure of this, to establish the nature of the pain accurately and to exclude the possibility of the risk of losing a child, it is necessary to consult a specialist about this.

The fourth month of pregnancy can please mommy with the feeling of the first tremors of the baby in the stomach. At the same time, you may feel first fetal movements and you may not feel it. It depends on many factors, such as the anatomical features, physique and weight of the pregnant woman, whether you are pregnant for the first time or already recurrent. Many mothers feel the sensation of the first movements of the baby during pregnancy only in the next month.

· Nutrition at 4 months pregnant

At this stage of bearing a child, the appetite of a pregnant mother can only be envied: her health has improved and the woman is increasingly drawn to “eat and eat”. Along with this, now it is simply necessary to carefully monitor the weight, avoiding excessive correction and avoiding the complications associated with it (for example, stretch marks on the skin, diabetes in pregnant women). Better if 4 months pregnant weight gain will be only from 1 to 4 kg.

That is why it is important to organize correct diet , eating only those foods that are healthy and satisfy the need of both organisms for nutrients. When compiling a daily menu, a woman should take into account that she should gain 2-2.5 kg of weight per month.

Experts recommend organizing meals in such a way as to prevent the feeling of hunger and eat food with maximum benefit. Simply put, you need to eat more often, but in small portions, eat most of the food during the first half of the day. It is most correct that the first and second breakfasts are sufficiently nutritious, lunch is the most satisfying, and in the evening, eat only easily digestible foods. At the same time, it is allowed to eat vegetables and fruits in almost unlimited quantities throughout the day (exceptions are citrus fruits, fresh cabbage, which causes bloating and potatoes, rich in unnecessary starch and carbohydrates).

The nutrition of a pregnant woman in the fourth month should be as natural as possible: no fast foods, semi-finished products, smoked meats, marinades, etc. In addition, salty foods should be abandoned (due to the excessive presence of salt in the body, fluid retention and the development of edema occur), from confectionery and other sweets (“fast” carbohydrates are useless for a developing baby, but dangerous for a woman - they stimulate rapid weight gain).

In the diet of a pregnant woman, protein sources must be present, in the form of lean meat and fish. Milk, sour-milk products, cottage cheese can provide the body with the necessary calcium, and will have a beneficial effect on the activity of the intestines. For normal intestinal motility, fruits and vegetables are required, in addition to fiber, which also supply vitamins, micro and macro elements. An integral part of the diet during pregnancy should be cereals, butter and vegetable oils, whole grain bread, nuts. To avoid anemia in pregnancy you should enrich your diet with iron-rich foods - beef, liver, pomegranates, dried apricots.

It should be borne in mind that iron itself is absorbed from food rather poorly, and the need for it for a period of 4 months of pregnancy is increased, so additional intake of vitamin-mineral complexes may be necessary. In addition to iron, the body of a pregnant woman and a baby in her mother's stomach requires sufficient intake of calcium, magnesium and phosphorus, vitamins of group B. In this regard, the doctor may prescribe a pregnant woman to take some kind of vitamin-mineral complex.

· Sex in the fourth month of pregnancy

The question is, “Is sex allowed in the fourth month of pregnancy?” can be unambiguous - Yes, of course! But only on condition that the doctor leading the pregnancy did not voice a warning about the prohibition of intimacy. In the absence of contraindications, sex in the second trimester of pregnancy acquires new colors, and possibly brings "unprecedented" sensations. After completing the first months of adaptation to a new state, a pregnant woman seems to be “reborn” for physical love with renewed vigor and real rapture. Many women say that the fourth month has become for them a real discovery of the charms of intimate life, and they have never experienced such vivid sensations of pleasure before.

As for contraindications to sex in the 4th month of pregnancy, they include the following conditions:

1. high risk of spontaneous miscarriage;

2. increased tone of the uterus ;

3. vaginal bleeding, spotting during pregnancy;

4. damage to the fetal bladder;

5. low location or placenta previa;

6. the woman or spouse has a genital tract infection.

· Analyzes and examinations at this time

If the pregnancy proceeds normally, the “date” with the doctor during this 4 months will take place once. At a routine examination, a specialist measures the weight and blood pressure of the expectant mother, listens to the fetal heartbeat, and palpates to determine the size and uterine fundus height . Traditionally, a urine test should be taken to detect protein and control sugar levels.

A woman may be advised to take a triple test (or a double "simplified"). This screening test is necessary to determine the concentration of three substances in the blood produced by the mother's body and the placenta, namely: hCG (chorionic gonadotorpin), AFP (alpha-fetoprotein) and E3 (estriol). The optimal time for screening is 15-16 weeks of pregnancy. The triple test allows you to identify the presence of risks of fetal malformations and chromosomal abnormalities, in particular, defects in the neural tube of the fetus, Down syndrome, Edwards syndrome. At the same time, you should not panic at the slightest reason - a triple (double) test is not diagnostic, it only allows you to assume increased risks, but does not indicate the presence of pathologies. With unsatisfactory test results, a woman is recommended an in-depth examination that can confirm or dispel possible suspicions.

Yana Lagidna, especially for mymom . en

4 months pregnant video:

4 months of bearing a baby is a period of relative calm and prosperity. All the stress factors associated with the appearance of a child in the family and early toxicosis have long since passed. However, the difficulties of delivery and bearing a child who has reached a large size are far ahead. During this period, you can enjoy life and do everything possible to protect yourself and your baby from possible complications.

4 months is how many weeks of pregnancy?

The fourth month of pregnancy is 16 obstetric weeks or approximately 18 calendar weeks. The difference is due to the fact that in the obstetric month there are always four weeks of 7 days each (28 days in total). This calculation was introduced for the convenience of planning the timing of pregnancy and the birth of a child. The beginning of this period is the 13th week, and the end is the 16th.

Changes that occur in a woman's body

Already in the fourth month of pregnancy, the female body undergoes colossal transformations. They concern both external factors, such as changes in the shape, color and size of the abdomen, and the restructuring of the functional activity of almost all organs.

External changes

From 13 to 16 weeks, others and the pregnant woman herself may notice the following changes:

Breast augmentation by 1-2 sizes. This process is due to hyperplasia of the glandular tissue of the mammary gland under the influence of estrogens and the intensive growth of blood vessels that feed it.
3 times enlargement of the areolas of the nipples.
Addition of body weight. Until the end of 4 months, weight gain is negligible. It is only 1 - 3 kg. This trend is explained by the fact that the active growth of the fetus and the organs that feed it begins from the 5th month.
Increased skin pigmentation. Areas of hyperpigmentation appear on the face, neck, and perineum. The formation on the abdomen of the "line of pregnancy" is characteristic. The appearance of brown spots on the skin is due to increased production and accumulation of melanin.
Presence of signs of varicose veins. Usually, such symptoms disappear after childbirth, and in the presence of the disease before the onset of pregnancy, it becomes more severe. On the skin of the legs, usually the legs, small spider veins appear, bluish veins appear through the skin.
The belly looks more voluminous than in the photo taken before pregnancy. You can forget about the "bad" times. The uterus is located at a height of 11-12 centimeters above the womb, so it can be clearly visualized.
Beginning of fetal movements.
Ability to listen to the fetal heartbeat. By the end of the 4th month of pregnancy, it is already possible to observe the baby's cardiac activity.

Inner feelings of a woman

In the body of the expectant mother, many processes are new for her, so the sensations also change. The following symptoms may be observed:

A slight increase in temperature in the early stages, worsening the general condition. By the beginning of the 2nd trimester, the temperature curve returns to normal.
Problems with gums and teeth begin. Enamel thinning is observed against the background of microelement deficiency and the likelihood of caries formation increases. The gums begin to bleed actively (due to the lack of iron and vitamin C), and therefore it is recommended to rinse the mouth with anti-inflammatory solutions.
Dizziness and fainting. Any violation of the daily routine can lead to such conditions. You need to get enough sleep, eat more fruits and vegetables, walk more often in the fresh air.
Against the background of changes in the intensity of blood flow in the gastrointestinal tract, dyspeptic disorders often occur. For example, heartburn.

Is there any toxicosis?

As a rule, by the end of the 1st trimester of pregnancy (week 13), the signs of early toxicosis already disappear. However, in some cases, vomiting and nausea do not stop and linger for longer periods. Toxicosis causes a lot of problems. Not only the subjective attitude of a woman to pregnancy is changing, but also the state of the body as a whole against the background of a constant shortage of all the necessary substances.

Allocations at 4 months

Normally, the 4th month of pregnancy should be accompanied by clear or whitish discharge. Brown discharge from the genital tract may indicate the presence of bleeding (abruption and placenta previa). The appearance of discharge with a yellowish or greenish color indicates the development of an inflammatory process.

Medical examinations

In the normal course of pregnancy, a meeting with a doctor at this time should take place only 1 time. When visiting a specialist will be carried out:

Ultrasonography. Ultrasound is performed to assess the development of the baby, determine the number of children and their gender. Usually at 4 months severe defects of the central nervous, cardiovascular and musculoskeletal systems are already visible.
Dopplerography - determination of the state of uteroplacental blood flow. Allows you to evaluate various disorders in the "mother-placenta-fetus" system and timely diagnose such abnormalities as intrauterine fetal hypoxia, delayed fetal growth and development, as well as any pathology of placenta attachment and position.
Determination of the level of a-fetoprotein. The norm for this period is from 15 kU/l to 16 kU/l. The level of the hormone increases with multiple pregnancies, malformations of the fetal nervous system (spina bifida, absence of the brain), the presence of Down syndrome, Klinefelter and fetal growth retardation.
UAC. Allows you to identify or exclude the presence of anemia, infectious and inflammatory processes, as well as to characterize the effect of the immune system on the fetus.
OAM. Using this method, they get an idea of the general condition of the kidneys and urinary tract. Allows you to exclude pyelonephritis of pregnant women, which often begins to develop at this time.
Determination of body weight. The procedure is needed to assess weight gain.
Measurement of blood pressure is used for the timely diagnosis of the most severe complication of pregnancy - preeclampsia.

Changes in the daily routine

Features of the daily routine for a pregnant woman who is 4 months pregnant can be represented as follows:

frequent walks in the fresh air: in parks, forests;
regular ventilation of the premises (at least 2-3 times a day);
ensuring proper sleep - 8 - 10 hours a day;
providing time for daytime rest and, if possible, sleep.

Nutrition and drinking regimen

A woman should receive a maximum of vitamins, micro and macro elements, minerals, valuable nutrients that are essential for a child growing in the womb. Deficiency of any of the listed components can lead to various diseases of the fetus.

For the 4th month, a pregnant woman gains 1.5 - 2 kg in weight, the calorie content of food should be increased. The first 2 meals should be as nutritious as possible, lunch and afternoon snack should be medium in calories, and dinner and a snack before bedtime should be dietary. The volume of liquid used should not exceed 2 - 2.5 liters. If you follow the drinking regimen, complications such as edema of pregnant women and preeclampsia will not threaten in the future, and kidney function will not be impaired.

It is recommended to eat as many fresh vegetables and fruits as possible. Instead of frying, give preference to stews or steaming (in a double boiler or slow cooker). The diet should contain the required amount of calcium, phosphorus, magnesium, iodine, vitamin C and group B.

To prevent anemia, it is advisable to eat more foods that are rich in iron (dried apricots, beef, pomegranate, pork liver). Improve the digestion of porridge, vegetable and butter, whole grain bread.

Physical exercise

It is recommended to perform exercises for the muscles of the back, legs, abs and to increase functional activity. Training should be carried out no more than 2-3 times a week for 30-45 minutes. The following exercises may be suggested:

25 - 30 squats;
alternating deep inhalation and exhalation 3 times in a row in the prone position;
raising and lowering the legs alternately 20-25 times;
alternate throwing of the right and left legs in the supine position;
in a position on all fours - retraction of the abdomen.

A good result for strengthening immunity, increasing endurance, improving the general condition was shown by such sports activities as swimming, yoga, water aerobics. It is recommended to devote about 60 minutes of time to these classes at least four times a week.

intimate life

If the pregnancy proceeds without complications, sex is not prohibited. If during the examination contraindications were identified, sexual activity should be abandoned:

the threat of termination of pregnancy;
multiple pregnancy;
infectious and inflammatory diseases of the reproductive and urinary systems.

Many expectant mothers are wondering what method of protection to choose. It should be remembered that during pregnancy it is necessary to use barrier methods of contraception (male or female condom, vaginal rings). These methods serve as a reliable means of preventing various diseases, including sexually transmitted infections, which can cause irreparable harm to the health of the fetus.

Possible Complications

By the end of the fourth month, the laying of all organs and systems of the fetus is completed, therefore, the “critical” periods are already behind. Any complications from the fetus are echoes of early pregnancy. In the 2nd trimester, all necessary examinations should be carried out in order to identify complications such as fetal hypoxia and placental abruption in time.

Pregnancy for a period of 4 months is an interesting and important period, both for the expectant mother and for the child. By this time, the formation of the important organs of the baby has been completed and their improvement continues: the development of the cerebral cortex, the kidneys and endocrine glands are included in the work.

At this time, the baby is rapidly gaining weight. If by the end of the 13th week the child weighed 45-50 grams, then by the 16th week the weight increases to 200 grams. He has the first timid movements and major reflexes. And what does a woman feel during this period?

In some cases, a pregnant woman should immediately see a doctor.

This should be done when:

cramping pains in the lower abdomen
bleeding occurs from
woman experiencing increased thirst on the background of frequent urination
pain when urinating
swelling of the whole body: arms, legs and face
there are strong and prolonged
vision is suddenly disturbed, a veil appears before the eyes
the woman ceases to feel movement
woman feels too active fetal movement
when urinating, there is a change in color
itching all over the body

A woman during pregnancy should continue to lead a normal life, without limiting her movements. After all, pregnancy is not a disease, but a completely normal and viable condition. A woman needs to move more, walk in the fresh air, do feasible housework. In difficult situations where a lot of physical effort is required, it is better to seek help from relatives or friends.

If a woman has carefully prepared for a planned pregnancy and follows all the doctor's recommendations, then health problems should not arise.

The fourth month opens the second trimester - the most calm and comfortable period of pregnancy. By this time, the manifestations had almost disappeared, the woman underwent an initial examination at the antenatal clinic, the recently formed placenta reliably protects the fetus from the negative effects of the external environment. The unborn child has already formed all the organs, and the baby's life support system has begun to function.

During the fourth month of pregnancy, the uterus grows very rapidly in size. If by the beginning of the first week of this month it barely rises above the pubic joint, then by the end of the fourth month the bottom of the uterus approaches the level of the navel. Another significant change is an increase in blood volume by 30-40%. This increase in circulating blood volume puts more stress on the heart muscle. A healthy heart copes with it, and in case of pathology of cardiovascular activity, these changes can affect the work of the heart in a bad way.

An increase in the level of melanin in the blood affects the condition of the skin and hair - moles darken, age spots appear on the skin, the strip of skin between the navel and the pubic bone, the skin of the perineum darkens. These changes will disappear some time after childbirth. To reduce the intensity of the appearance of spots, you need to actively use sunscreen for the face.

The stomach at 4 months of pregnancy may be completely absent, and most pregnant women still use the usual clothing models. However, an increase in waist volume is already noticeable, and in some women, a rounding of the abdomen. Since the uterus is growing rapidly, severe pain in the groin and lower abdomen may appear due to sprain. They pass as quickly as they appear.

Due to the increase in the total volume of fluid in the body, a woman feels. The volume of vaginal discharge also increases. The load on the circulatory system causes a violation of the integrity of small vessels, bruises and nosebleeds. They may appear less frequently if the air is intensively humidified in the dwelling.

Due to frequent constipation, prerequisites for - varicose veins of the rectum may appear. Outside and inside the anus, venous nodules appear, which bleed when straining, become inflamed and swell.

A pleasant sensation for women undergoing a second and subsequent pregnancies, and for slender thin women, is the feeling of the first movements of the unborn child.

The placenta is a universal organ - it protects the fetus from pathogenic bacteria and viruses, synthesizes the necessary proteins and hormones, removes the waste products of the unborn child with venous blood, filters out harmful substances, delivers oxygen and nutrients from the mother's body. Thanks to her, a woman manages to avoid accidents and not be afraid of abortion due to the negative impact of the external environment.

The baby's waste products are urine, which the fetus releases every 40-45 minutes into the amniotic fluid. The amniotic fluid is renewed every 2-3 hours, it is sterile and has a constant chemical composition. Amniotic fluid protects the fetus from damage, stimulates the baby's metabolism, and allows him to move freely. At the 4th month of pregnancy, the fetus imitates respiratory movements, drawing water into the lungs, training the respiratory system.

The weight of the fetus by the end of 4 months, and its height increases from 12 to 20 cm.

The unborn child has already formed a swallowing and sucking reflex - from time to time he sucks his finger. The arms are bent at the elbows, the palms and fingers can be folded into a fist, the fetus can grab the umbilical cord, touch its face. Despite the fact that the baby moves a lot and willingly in the uterine cavity, these gentle movements are not yet fully felt by the woman, they can easily be mistaken for sensations from intestinal motility.

A light and thin fluff appeared on the skin of the child - lanugo. It covers the entire body of the fetus, and will disappear only after childbirth. The fluff helps to keep the original lubricant on the body, which protects the skin from the action of amniotic fluid. Eyebrows, hair, eyelashes are outlined on the head and face of the fetus. On the fingers, the formation of nails begins.

The genitals of the child are in the process of formation, but its gender can already be determined. When conducting an ultrasound, it is still very difficult to distinguish a boy from a girl. In the male fetus, the prostate begins its development, in future girls, the ovaries already contain eggs, and have descended into the small pelvis from the abdominal cavity.

The baby's ears gradually take their permanent place, rising from the side of the neck to where they should be. The formation of the inner ear is not yet complete, but the baby is already reacting to strong noise. The sensitivity of the retina increased, and the fetus was able to raise and lower the eyelids.

The psychological state of the pregnant woman

Women undergoing their first pregnancy, at the fourth month, finally realize that expecting a baby can bring positive emotions. They begin to feel that they have an extremely important mission to perform, and they anxiously await the first movements of the fetus. Those who already have children know that in the second trimester of pregnancy they will enjoy the joyful excitement during a kind of communication with an unborn child, from his first gentle, and then more and more tangible movements and movements.

During the fourth month of pregnancy, if there are no deviations from the normal course, the woman visits her doctor once. The obstetrician-gynecologist will evaluate the results of previously passed tests, ultrasound data. If the results of a smear test for urogenital infections are unfavorable, a course of treatment with antibacterial drugs should be completed within the fourth month. After a course of therapy, a control examination of a smear from the vagina is prescribed.

At the end of the fourth month, the doctor may order tests related to screening for the second trimester of pregnancy. It is carried out from 15 to 20 weeks of the gestational period. This screening includes a blood test, or “triple test,” and another ultrasound.

Analysis of the concentration in the blood of the hormone hCG, or chorionic gonadotorpin;

Analysis for ?-fetoprotein (AFP);

Analysis for unconjugated (free) estriol.

If the level of these markers deviates significantly from the norm, the risk of having a child with congenital pathologies is high:

craniocerebral hernia;

Cleavage of the anterior abdominal wall of the fetus.

Risk factors:

The woman's age is over 35;

Radiation impact;

Harmful working conditions;

Side effects of drugs;

The presence in the family of children with pathologies;

History of habitual miscarriage.

An increased content of markers indicating a high risk of anomalies in the results of screening of the first and second trimester is a reason for amniocentesis. This study is voluntary, it consists of a puncture of the uterus under ultrasound control to collect amniotic fluid. This is an extremely informative analysis, which is performed only with significant indications for it. One procedure out of 200 ends with spontaneous abortion.

According to the results of the study of amniotic fluid determine:

Genotype and sex of the fetus;

The level of ?-fetoprotein, indicating malformations of the central nervous system;

Since nausea no longer accompanies meals, a pregnant woman's appetite increases. You should not thoughtlessly eat various dishes, because there is a danger of weight gain in excess of the permissible norm. If you count from the initial weight before pregnancy, at this time the increase should be no more than 2-2.5 kg.

The optimal diet is to eat often, but little by little, without overeating. Most of the diet is consumed in the morning, during lunch and breakfast. In the morning they mainly eat cereals, dairy products, at lunch - hearty meals, and in the evening it is better to leave easily digestible foods. For snacks, it is better to use not cookies and sandwiches, but fruits and vegetables.

The use of salty foods is limited, it is better not to salt food in order to avoid edema. Smoked meats, fatty and fried foods, semi-finished products are prohibited. Sweets, rich pastries can lead to an increase in excess weight.

Very helpful products. containing protein - meat, fish, cottage cheese, cheese. Dairy products will not only make up for the lack of calcium in the body, but also help to improve digestion and bowel function. Recommended for the use of beef, liver, apples, dried apricots. In practice, the doctor will recommend supplementing such a diet with iron supplements.
Problems 4 months - the threat of miscarriage and constipation

Despite the fact that the threat of miscarriage is no longer as great as in the first trimester, it still exists. The main reason is cervical insufficiency. It occurs due to the weakness of the muscle bundle, which normally holds the internal os of the cervix tightly compressed. The pharynx of the cervix does not hold the fetal bladder for the following reasons:
The diagnosis of "istvico-cervical insufficiency" threatens with infection of the membranes and death of the fetus. It is put on palpation, confirmed by ultrasound. Treatment is a surgical suture on the cervix or a ring on the cervix. A woman with such a diagnosis is categorically not recommended to strain, do housework.

Primary placental insufficiency is another risk factor for maintaining pregnancy. In this condition, the fetus does not receive the right amount of oxygen and nutrients due to endocrine disorders, the action of an infection, or due to a genetic factor that manifests its effect before the 16th week of pregnancy.

Symptoms of placental insufficiency are similar to those of a miscarriage:
Due to insufficient supply of nutrients to the fetus, congenital malformations may occur. Diagnosis - a study of the level of placental hormones in the urine, blood and amniotic fluid.

Treatment of placental insufficiency:
- Methionine;
  
  Soothing herbal preparations.
Bleeding

The appearance of bloody discharge, accompanied by pain in the abdomen and lower back, is a very dangerous symptom that indicates the onset of spontaneous abortion. The discharge is bright red and may contain blood clots. If these symptoms appear, you should immediately seek emergency help. If timely measures are taken, miscarriage can be prevented.

Minor painless discharge that appeared after an intimate relationship may be a sign of cervical erosion. This condition should be treated after childbirth.
intimate relationship

The well-being of a pregnant woman at 4 months improves significantly, she becomes more active and energetic. If the doctor sees no contraindications for intimate relationships, you should not refrain from them.

Possible contraindications:
In addition, for many women, under the influence of hormones, libido only increases, and positive emotional experiences will benefit them.

Video about the rules of conduct and features of the course of the fourth month, mandatory examinations:

Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.

Pregnancy is 9 months of joyful expectation of a baby. During this not at all short period, a lot of changes occur in the mother's body, the baby grows from two cells with half a set of chromosomes in each into a full-fledged person. In some months, the life of a pregnant woman is especially difficult, in some it becomes possible to relax a little and enjoy her condition. The fourth month of gestation is usually referred to as the second type of period, when the condition returns to normal and discomfort does not disturb.

Feelings of a woman in the 4th month of pregnancy

The fourth month of pregnancy is the first month of the second trimester, the period from the beginning of the 13th to the end of the 16th week of gestation. The woman's condition usually improves, nausea and vomiting go away, the taste for food returns. This has a positive effect on the psychological state, the expectation of the baby becomes more joyful and conscious. At this time, some already begin to noticeably round the tummy. The average weight gain this month is 1-2 kg, but there will be an upward trend in this figure.

At the 4th month of pregnancy, the tummy begins to gradually round and become noticeable

Pregnancy is felt in full, changes affect both behavior and appearance:

Most women meet the 4th month with joy, they begin to clearly understand their position and enjoy it.

Changes in the body of the expectant mother at the 4th month

At the 4th month, changes in the mother's body affect the following systems:

reproductive. The uterus extends beyond the small pelvis and begins its growth already in the abdominal cavity. The height of its bottom by the end of the month will be 12–14 cm (this is the distance from the upper edge of the pubic joint to the highest point of the enlarged uterus). From the 4th month, progesterone is no longer produced by the corpus luteum in the mother's ovary, but by the placenta formed in the uterus. Now all metabolic processes between the fetus and mother will pass exclusively through this organ. The diameter of the uterine arteries increases, the intervillous space, where the contact of organisms occurs, contains 500 ml of blood, which constantly circulates and is updated;
endocrine. The so-called pregnancy cells are actively produced, producing the hormone prolactin, which prepares the mammary glands for lactation;
CNS. At the beginning of the second trimeter, the excitability of the central nervous system begins to increase, causing the so-called pregnant dominant - a woman becomes a little distracted, immersed in herself, her interests are primarily aimed at bearing a child. The lower parts of the central nervous system, in turn, reduce their sensitivity, which ensures the relaxation of the uterus and normal conditions for the growth of the fetus;
metabolism. At the 4th month, the metabolism and oxygen consumption increase significantly, by the 16th week the increase occurs by 15–20% compared with the first months. There is a process of intensive accumulation of lipids in the body, in particular in the mammary glands, the formed placenta;
digestive system. At the 4th month of gestation, early toxicosis disappears, aversion to food, nausea and vomiting disappear. This is due to an increase in progesterone levels and relaxation of the smooth muscles of the stomach.

Discharge at 4th month

At the beginning of the second trimester, yellowish or creamy mucous discharge from the vagina may appear. Do not worry, this is normal - under the influence of hormonal changes and increased estrogen production in the second trimester, the mucous membrane works more actively, and the discharge becomes more abundant and liquid. Discharge that causes discomfort should be a cause for concern: a burning sensation, itching, and an unpleasant odor. Saturated yellow and green color - evidence of the presence of pus, which requires immediate medical attention. Also a dangerous signal is pink, red and brown - this is a signal of the presence of blood impurities. At this time, bleeding that threatens the life of the fetus may open, indicating placental abruption. This is a direct threat of abortion, so when drops of blood appear, it is urgent to call an ambulance.

Baby development at 4 months

By the 4th month, the placenta has already been formed, and now the baby in the womb protects the placental barrier from the penetration of pathogenic microorganisms and harmful chemical compounds. In the first month of the second trimester, the active development of the fetus begins, during these 4 weeks it grows to 120-150 grams and will be about 12 cm tall. Its organs and systems are also rapidly forming:

the bone marrow begins to function, the vascular system continues to develop;
a layer of fat is formed, which will provide the baby with normal heat transfer after birth;
the endocrine system is actively formed;
towards the end of the month, the thymus gland or thymus is formed - the organ responsible for the formation of immunity;
the first hairs appear on the head and in the eyebrow area;
arms lengthen, and by the end of the 4th month, the baby can close them in front of him, connecting his palms;
the baby begins to hear sounds from the world that surrounds him;
the formation of the eye retina occurs, and the child can already distinguish between light and shadow;
a swallowing reflex is formed, and the baby can swallow the amniotic fluid;
the foundations of the sucking reflex are laid, but it will be fully formed only by the 8th month.

At the 4th month, the baby can already close his hands in front of him, all his systems and organs are actively developing

At the end of the 4th month, the baby will already be able to bend his arms, suck his thumb and clench his fists.

Video: Ultrasound at the 4th month of pregnancy

Gynecological visits and examinations in the 4th month of pregnancy

In the fourth month of pregnancy, the regularity of visits to the antenatal clinic does not change - the doctor will wait for the pregnant woman for a scheduled visit every 2-3 weeks. Every time before a visit to the gynecologist, a woman needs to take a urine test. An examination on a chair at this time is not carried out, only blood pressure, weight and volume of the abdomen are measured for the mother. At the appointment at the end of the month, the doctor will already begin to measure the height of the bottom of the uterus - the pregnant woman will need to lie on the couch on her back, and the doctor will measure the distance from the pubis to the top of the uterus with a centimeter tape. No planned ultrasound and additional examinations are normally planned at this time.

Usually, the course of IVF pregnancy at the 4th month does not differ from the usual one, therefore, there is no need for more frequent visits to the doctor at this time. The only feature may concern hormonal support, which often occurs with in vitro fertilization - patients are advised to drink hormonal preparations before the 20th week, so blood tests may need to be taken more often - this will help regulate the required dose of medication.

If a woman did not pass the first screening at the 3rd month of gestation, then it can still be done in the first quarter of the 4th month until the baby is 13 weeks and 6 days old. Conducting it at a later date is not informative - the results are accompanied by a large error and their reliability is doubtful. The dual test involves an ultrasound examination and a blood test for the content of human chorionic gonadotropin and plasma protein. Based on the results of such an examination, one can judge the risk of a baby having chromosomal abnormalities - Down and Edwards syndrome.

Pathologies and complications of pregnancy in the fourth month

At the 4th month of pregnancy, threats that were previously irrelevant may arise. So, the possible complications include:

At the 4th month, an increased tone of the uterus can be detected - the tension of its muscles, which makes it difficult for the baby to feed and jeopardizes successful bearing. The condition is manifested by discomfort in the lower abdomen, a pronounced feeling of tension, often of a cramping nature. All the problems described require medical attention on an emergency basis.

Until the 22nd week, the risk of miscarriage remains - spontaneous termination of pregnancy, and at the 4th month it is classified as late. Risk factors remain:

complications of the course of pregnancy, in particular Rhesus conflict and developing fetoplacental insufficiency;
complex infectious diseases (pneumonia, rubella);
hormonal disbalance;
congenital and acquired defects of the uterus (cervical failure, fibroids, malignant tumors);
hyperglycemia (high blood sugar) in diabetes;
maternal high blood pressure.

The threat of a late miscarriage is characterized by the appearance of bleeding, in some cases severe pain in the lower abdomen, nausea and vomiting. When symptoms appear, a woman needs urgent medical attention.

Features of the course of multiple pregnancy

With multiple pregnancies, a large burden falls on the mother's body, because not one, but two or more babies develop at the same time. They grow on the principle of competition, because they have to share food and oxygen, so the expectant mother needs to pay more attention to herself and provide the children with everything they need. At the 4th month, active growth of the fetus begins, so the woman is recommended:

once again review your diet, focusing on the quality of the products consumed. It is better to minimize the amount of salt and sweets, as the problem of edema becomes relevant, because the load on the kidneys during multiple pregnancy is even greater;
maintaining a comfortable emotional regime and ensuring sufficient rest. If there are several babies in the uterus at once, it stretches more, which increases the risk of tone on the 4th month. To avoid this, the expectant mother is advised to rest more and avoid stress;
more frequent visits to the doctor, blood tests and ultrasounds. With multiple pregnancies, there is a high risk of placental insufficiency, since the load on the placenta is greater and it wears out faster, and the likelihood of anemia in the mother also increases. Careful medical supervision will allow timely detection of dangerous conditions and neutralize them.

nutrition. Despite the fact that the appetite increases from the 4th month, you should not lean on food, especially buns and sweets. The risk of excessive weight gain becomes relevant, which creates additional dangers for gestation and childbirth. It is better to refuse culinary experiments, alcohol is also prohibited;
taking vitamins. At a doctor's appointment, you should ask about the need to take vitamin complexes for pregnant women - they are usually prescribed to maintain the mother's body at the stage of active growth and development of the fetus;
sex. Reasonable intimate relationships at this time are not only allowed, but also recommended - the stomach is not too big yet, but due to hormonal changes and improved well-being, the desire returns;
In the presence of threats and complications, sexual contacts will have to be abandoned - the doctor will definitely tell about this.
moderate physical activity. Daily walks in the fresh air will bring maximum benefit to the condition of the mother and baby. Physical activity is also allowed, but without weights and in a volume that is comfortable for the mother;
cloth. Despite the fact that the belly may not yet be very visible, the wardrobe will already have to be updated. This applies primarily to pants - you need to abandon ordinary jeans and all trousers that put pressure on your stomach. It is recommended to give preference to special clothes with a soft belt for pregnant women;
treatment. Colds and flu are no longer so terrible for the child as in the first trimester - due to the fact that the placenta has already been formed, the mother's disease can no longer cause serious deviations in the development of the fetus. But the risk remains, since the disease can become the root cause of hypoxia (lack of oxygen) and the appearance of placental insufficiency. Treatment is carried out exclusively with those drugs that the doctor prescribes, but it is worth considering that their list is now wider, again due to the presence of a protective barrier in the baby. Avoid prescribing antibiotics, dietary supplements, drugs with aspirin;
visiting the bath and sauna remains prohibited, and until the very birth;
air travel for this period is still allowed, but only after consulting a doctor. If there is the slightest risk, it is better to refuse from this type of transport, as well as from long trips.