All about pregnancy
Critical periods of pregnancy: reduce risks
Did you know that there are several critical periods of pregnancy, when the embryo is most sensitive to damaging factors that can cause abortion? What should the future mother do to calmly survive this time and not endanger her baby?
Nina Abzalova Doctor obstetrician-gynecologist, cand. honey. of Sciences, Altai State Medical University, Barnaul
Critical periods of pregnancy arise when the fetus and placenta most actively grow and develop. Adverse effects can lead to abortion, death of the embryo or malformations of the fetus.
In addition, there are also individual critical periods of pregnancy:
- the timing of premature termination of previous pregnancies (if in the past were spontaneous miscarriages),
- the terms on which abortions were made,
- days corresponding to the timing of the onset of suspected menstruation.
Critical periods of pregnancy in the first trimester
Most critical periods of pregnancy occur in the first trimester. This is due to the fact that for this time the most important moments are: implantation (introduction) of the fetal egg into the uterine mucosa and the beginning of the laying of all the systems and organs of the unborn child. The less time passed after conception, the pregnancy is less resistant to damaging factors.
2-3 weeks of pregnancy
Первым критическим периодом беременности являются первые 2-3 weeks of pregnancy, в этот период происходит прикрепление и внедрение эмбриона в слизистую матки. Этот процесс приходится на 8-е сутки с момента оплодотворения.
To successfully implant the implantation, a very important role plays state of the endometrium (the inner shell of the uterus), so the risk factors in the first critical period are:
- inferiority of the endometrium as a result of medical abortion, uterine cavity scraping, inflammatory diseases of the genital organs, prolonged wearing of the intrauterine device;
- presence of scar on the uterus after caesarean section;
- uterine fibroids.
In addition to these factors, the frequent cause of termination of pregnancy in the early chromosomal and genetic abnormalities of the fetus.
3-7 weeks of pregnancy
Следующими критическими периодами беременности являются периоды органогенеза (3-7 weeks of pregnancy) – время закладки всех органов и тканей плода и плацентации (9-12 weeks of pregnancy) – период формирования плаценты.
AT organogenesis period there is an active division of cells, the laying of embryonic leaves, from which whole systems of organs are subsequently formed. The embryo is very sensitive to unfavorable factors, the effect of which can lead to gross anomalies of development, death of the embryo, undeveloped pregnancy and spontaneous miscarriage. The nervous and endocrine system of the embryo, the organs of vision, the sex glands are most sensitive to adverse effects on the fetus, therefore, violations of the development of these organs are more common.
9-12 weeks of pregnancy
Up to 12 weeks of pregnancy is placentation process: during this period the placenta starts to function, which takes on the function of the synthesis of the hormone progesterone - the main pregnancy hormone, previously produced in the yellow body. The process of transfer of important functions for the further development of pregnancy from the yellow body to the placenta is critical, because a decrease in the level of progesterone, leading to a threat of termination of pregnancy, may occur.
Critical period of pregnancy in the second trimester
Критическим периодом беременности во втором триместре считается срок 18–22 недели – период активного роста матки и плода. AT это время угрозу прерывания беременности могут представлять – формирование истмико-цервикальной недостаточности и возникновение кровотечения вследствие неправильного расположения плаценты.
Isthmicocervical insufficiency - is the inferiority of the cervical umbilical function. The cervix can not normally hold the fetal egg in the uterine cavity, so it descends, the neck opens and the pregnancy aborts. "Insidiousness" of this complication is that it can often take place practically without showing itself. Treatment of ischemic-cervical insufficiency is the imposition of a suture on the cervix, which is produced in the second trimester of pregnancy (at 16-20 weeks).
Disorders of the location of the placenta include placenta previa and low placentation. Что это значит? AT норме плацента прикрепляется в верхней части матки, где имеются наилучшие условия для кровоснабжения. При предлежании плаценты она полностью (центральное предлежание) либо частично (неполное предлежание) перекрывает выход из матки. А низкая плацентация – состояние, при котором край плаценты находится достаточно низко (менее чем за 6 см от канала шейки матки), но не доходит до выхода из матки.
Abnormal location of the placenta can lead to bleeding, which in some cases may threaten the life of the future mother and fetus. The risk of developing this dangerous condition becomes greater with an increase in the gestation period, reaching a maximum to its final.
The critical period of pregnancy in the third trimester
The critical period of pregnancy in the third trimester is 28-32 weeks, because during this period there can be an interruption of pregnancy due to its complications or deterioration of the general well-being of the future mother. This is most often due to diseases of the cardiovascular system. This period is considered critical because
1. AT это время плод растет и развивается очень интенсивно.
2. There is a maximum increase in the volume of circulating blood, which exerts a considerable load on the cardiovascular system of the pregnant woman.
3. If there is a termination of pregnancy in 28-32 weeks, the child will require intensive treatment, supervision and application of special equipment due to deep prematurity.
The main complications that can develop in 28-32 weeks and lead to premature termination of pregnancy include late gestosis and placental insufficiency.
Late gestosis Is a complication that develops in the second half of pregnancy and is manifested by swelling, increased pressure and the appearance of protein in the urine. In severe, long-term forms of late gestosis, a premature detachment of the normally located placenta may occur-the separation of the placenta from the uterine wall to the moment of the birth of the baby, which is accompanied by bleeding and the development of acute oxygen starvation of the fetus.
Placental insufficiency Is a condition in which the placenta is not able to fully support the growth and development of the fetus, which leads to its intra-uterine suffering: hypoxia (lack of oxygen) and delayed development.
Also, the reasons for abortion in the third trimester may be aggravation or weighting chronic diseases: the greatest role is played by diabetes mellitus, hypertension, heart and kidney diseases.
What to do to safely pass critical periods of pregnancy?
It is necessary to register with a woman's consultation as soon as possible (for up to 12 weeks), especially if in the past the woman had spontaneous miscarriages or a frozen pregnancy. Careful you need to be a future mother with a habitual miscarriage (who had 2 or more miscarriages in a row). For this, during critical periods of pregnancy and the days of expected menstruation it is necessary:
- exclude physical activity (lifting weights, sports exercises, running, etc.);
- provide sexual rest;
- maximally protect yourself from stressful situations;
- to get enough sleep (at night - not less than 8-9 hours, it is advisable to sleep and during the day for 1-2 hours);
- do not take medication without prescribing a doctor, because the less the gestation period, the fewer medications approved for use, and the uncontrolled intake of certain drugs can significantly harm the developing fetus;
- исключить резкие перепады температур, так как перегрев в ранние сроки беременности может крайне неблагоприятно повлиять на процессы закладки плодного яйца (нежелательно посещение солярия, сауны, бани, особенно инфракрасной кабины), а переохлаждение может спровоцировать обострение chronic diseases (пиелонефрит, цистит и т. п.) или ОРATИ;
- refrain from smoking and drinking alcohol; do not stay in a smoky place;
- in the first trimester to measure basal temperature (measured in the morning, not getting out of bed, by inserting the thermometer in the rectum), since its decrease (less than 37 ° C) is the earliest sign of the threat of termination of pregnancy until the obvious signs of this dangerous condition appear.
Disturbing symptoms during critical periods of pregnancy
Signs indicating a threat of termination of pregnancy include:
- feeling of heaviness in the lower abdomen;
- Stretching, aching, or cramping pain in the lower abdomen;
- in the second half of pregnancy - compaction of the uterus (due to increased tone), which can be accompanied by pain;
- the appearance of vaginal discharge - watery, from smearing brown to abundant bright bloody.
What should you do if you notice these symptoms?
When bloody discharge any intensity should be called "first aid", since these symptoms indicate the detachment of the fetal egg from the uterine wall (as a rule, the larger the detachment area, the more bleeding is more abundant).
Also, the reason for calling an ambulance is sharp cramping pains in the lower abdomen, даже если bloody discharge из влагалища нет. При наличии умеренно выраженных симптомов (например, тянущих, ноющих болей внизу живота) необходимо срочно обратиться к врачу, наблюдающему вашу беременность. ATрач проведет осмотр, ультразвуковое исследование, если необходимо, назначит анализы или предложит госпитализацию в отделение патологии беременности.
Before the arrival of an "ambulance" or a doctor's appointment:
- Lie down on your back, lift your legs (place a pillow under your feet, a roller from a folded blanket) or take another pose, in which painful sensations decrease;
- take a sedative (valerian, motherwort);
- to reduce the increased tone of the uterus and reduce pain, drink 1-2 tablets no-shpy or put a candle with papaverine.
AT стационаре вам будет проведено полное обследование для выявления возможной причины угрозы прерывания беременности, назначения наиболее эффективного именно для данного случая лечения. ATрачи обязательно будут контролировать, как себя чувствует малыш.
The tactics of treating the threat of termination of pregnancy will depend on the cause that caused it.
Современное акушерство располагает богатым арсеналом лекарственных средств и лечебных мероприятий, направленных на сохранение беременности. ATажнейшим моментом является своевременность начала лечения, поэтому при появлении тревожных симптомов как можно быстрее обратитесь к специалисту, это может сохранить жизнь и здоровье вам и вашему малышу.
Risk factors: check yourself
The risk factors that can have a negative effect on the fetus during the periods of the laying of organs and the formation of the placenta are:
- adverse effects of the environment (hypoxia - lack of oxygen, hyperthermia - overheating of body tissues, ionizing radiation, vibration in harmful production, interaction with harmful chemicals - pesticides, mercury, lead, phosphorus, etc.);
- infection (rubella virus, primary infection with the virus of cytomegalovirus, herpes, infection during pregnancy with toxoplasmosis);
- taking medications that are contraindicated in pregnancy, with a teratogenic effect (that is, triggering the development of fetal anomalies) - some groups of antibiotics, hypnotics, analgesics;
- hormonal disorders as a result of gynecological diseases, pathology of the endocrine glands (thyroid gland, adrenal glands, pituitary gland, etc.);
- exacerbation of extragenital (non-sexual) diseases - cardiovascular, kidney disease - leads to a violation of the blood flow in the uterus, provoking an increase in the tone of the uterus and the threat of spontaneous miscarriage;
- stress and fatigue, lack of adequate sleep and rest have a negative impact on the endocrine and nervous systems, which leads to the threat of termination of pregnancy;
- physical overload (weight lifting, abdominal wall abruptness in sports), as well as trauma (falling, sharp and pronounced compression of the abdomen) can provoke an increase in uterine tone.