What should worry me in the third trimester of pregnancy?

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In the third trimester of pregnancy, the uterus is significantly enlarged, the pregnant belly is clearly visible. Stretch marks appear on the skin, of course not in all women, because it is individually variable and genetically determined.

Varicose veins may appear on the lower extremities and the vulva. Sometimes they are very annoying, the legs become heavy and hurt. A woman should be advised to rest lying down with her limbs up and down, and to use gradual compression stockings. In the case of increasing pain in one limb, its swelling, redness, increased heat, contact a doctor, because deep or superficial vein inflammation may develop, and then hospitalization is required.

Edema appearing on the lower limbs, if they are an isolated symptom and disappear after rest, are not particularly disturbing, but if they are a permanent symptom, they require contact with a doctor, as they may be the first symptom of the so-called gestosis (pregnancy poisoning), or pregnancy-induced hypertension. Hemorrhoids are also associated with varicose veins of the lower extremities, which are troublesome but not dangerous. Use ointments, rectal suppositories, take care of your diet and bowel movements.

Pollakiuria is a natural symptom of pregnancy, but sometimes it may indicate an infection in the urinary tract, therefore urine is routinely tested in pregnant women. In the case of inflammation, treatment with an antibiotic and subsequent prolonged disinfection of the urinary tract are required.

In the 24th week of pregnancy, a screening test with 50 g of glucose is carried out, if the measurements of sugar in this test are incorrect, then the test with 75 g of glucose is repeated (patient on an empty stomach), if the results are still abnormal, the patient must be consulted at a diabetes clinic, requires inclusion a diabetic diet and sometimes insulin.

Hypertension appearing in pregnancy of more than 130/80 requires constant supervision, it can be at home, but with the rigor of measuring pressure several times a day, recording them in a specially designed notebook, rest, release from work and, of course, from work. If this does not work, the patient should be admitted to the ward and the necessary monitoring should be performed, because the pressure increasing during pregnancy may be associated with proteinuria, edema and, consequently, pre-eclampsia and eclampsia, which pose a direct threat to the health and life of the mother and the fetus.

Of course, any deviations from routine tests performed during pregnancy require consultation with your doctor. If the results of tests for toxoplasmosis – antibodies – increase, this indicates an active inflammatory process that is dangerous for the developing fetus and requires intensive antibiotic treatment.

Any changes in the nature of the fetal movements, or if you do not feel them, require immediate medical attention. A good indicator of observing the fetal movements is counting them at the same time for an hour, preferably after a meal and while the pregnant woman is resting. If it is done at the same time, the number of movements of the fetus is usually similar and not less than 3 large movements per hour. If, for example, there were 10 movements so far, and suddenly there is no one, this situation requires clarification with a doctor.

Bleeding in any stage of pregnancy is worrying and requires immediate consultation at the hospital ward. It may be caused by a trivial cause, e.g. a cervical polyp, but it may also indicate detachment of a properly seated placenta, or bleeding from the placenta, and both of these conditions pose a threat to the life of the mother and the fetus.

The outflow of amniotic fluid at the time of the upcoming delivery may be a signal of the commencement of labor. However, if the amniotic fluid drains before this date, it requires immediate contact with the hospital ward. Sometimes it is possible to maintain the pregnancy despite the outflow of amniotic fluid in the antibiotic cover until the fetus is able to live outside the womb. Unfortunately, most often such a situation ends up being unsuccessful and leads to the delivery of a premature child who is unable to live after birth.

Any abnormal vaginal discharge called a vaginal discharge requires consultation with your doctor not immediately but urgently. This is because it shows inflammation in the vagina, which, if left untreated, can lead to ascending infections in the fetal egg and may cause premature rupture of the fetal bladder and premature birth.

Text: lek. med. Ewa Zarudzka

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