The first half of pregnancy is behind us. Week 21 opens the second half of this interesting and difficult period, filled with hopes and new feelings. At this time, a second screening test may be scheduled.

Purpose of the survey

The second prenatal screening, or rather, one of its components - an ultrasound examination, is carried out on any day between 18 and 21 weeks of pregnancy. Laboratory blood tests for hormones and proteins, the so-called triple test, are taken earlier - from 16 to 20 weeks. Thus, at 21 weeks, all pregnant women who did not have time to undergo this examination in the previous three weeks will be sent for an ultrasound scan.

Purpose of the study - identify the risks of possible genetic abnormalities in the fetus. Ultrasound diagnostics plays a special role in this process; its results significantly influence the overall conclusion.

In addition, at 21 weeks the expectant mother may visit the ultrasound room for other reasons. The appearance of pain, abnormal discharge for the period, ichor, signs of inflammation, the emergence of a threat to the continuation of pregnancy - all this is the basis for urgent unscheduled diagnosis of the condition of the mother and fetus. An obstetrician-gynecologist may recommend an ultrasound if the height of the uterine fundus does not correspond to the obstetric period, if a woman complains that she suddenly stopped feeling fetal movements, although they were there before.

Sometimes it becomes necessary to clarify the timing of pregnancy and determine the date of the upcoming birth.

Preparation and features

At this stage, the ultrasound examination procedure is transabdominal: the sensor is located on top of the abdomen, and the uterus and baby are viewed through the anterior abdominal wall. A specialist can use a vaginal sensor only if the view through the abdomen is difficult due to the pregnant woman’s excess weight, obesity, and also in cases where it is necessary to examine the cervix and cervical canal to assess the possible threat of termination of pregnancy at this stage.

This ultrasound does not require any specific preparation from the woman. there is no need to fill the bladder, since the amount of amniotic fluid is sufficient for good visualization, and intestinal gases, which had to be dealt with before ultrasound scanning in the first trimester, can no longer affect the result of the examination, because the uterus has grown and it is no longer possible to compress it with a swollen intestine.

What can be seen on an ultrasound?

The baby has grown and “formed”: his height is already close to 25 centimeters from heels to top, and his weight has exceeded 350 grams. The smallest babies at this stage are about 18 centimeters tall. A toddler with such parameters is clearly visible on any scanner, even if this equipment does not belong to the category of modern innovative technology. 21 weeks by obstetric standards - about 19 weeks from the moment of conception. During this time, the child has learned a lot and is ready to demonstrate a lot to his mother and the doctor, who will observe him for several minutes through an ultrasound sensor.

The baby has perfectly mastered a variety of facial expressions; this will be especially noticeable if a 3D ultrasound is performed. He sucks his fists and plays with the umbilical cord. At this stage, hair begins to grow on the baby’s head, and the functioning of the digestive system begins to develop. The baby swallows about half a liter of amniotic fluid per day.

At 21 weeks, the baby learns to distinguish tastes, since taste buds appear on his tongue at this time. The arms and legs are still moving somewhat chaotically, and this is easy to see on an ultrasound; coordination of movements is a task for the near future. The child hears various sounds; during the procedure, he can respond with increased motor activity to the unfamiliar voice of the doctor, to the measured buzzing of the equipment.

21 weeks is a great time to find out the gender of your baby. If before this the doctor spoke uncertainly about the baby’s gender or it was not possible to examine the genitals, now the secret may become apparent. The uterus is still quite free, and the baby is constantly changing its position in space.

It is possible that during the ultrasound the baby will turn around so that his external genitalia will be accessible for inspection.

Decoding and norms

The doctor's conclusion about the ultrasound scan always begins with determining the number of children. For each of them, the specialist sets vitality criteria - the baby must have a beating heart and physical activity. The specialist also determines the type of location of the child in the uterus - cephalic, pelvic or transverse.

However, for now a woman should not be upset by either breech or transverse presentation, because there is still a long time before the birth, the baby is constantly moving, and his position will change more than once.

Fetal fetometry

Obstetricians have a special attitude towards fetometric data - the sizes of individual parts of the child’s body allow them to get an idea of ​​how proportionally complex he is, whether he is growing and developing correctly. Such data includes abbreviations already familiar to a woman - BPR, LZR, OG and coolant:

• Bipariental size - a visual segment drawn between the two temporal bones of the head,
• The fronto-occipital size is a longitudinal segment from the frontal bone to the occipital bone.
• Head circumference and abdominal circumference are two additional parameters that allow you to judge the development of a child.

The length of the paired bones - femur, tibia, forearm and shoulder - are important signs of successful growth of the baby, as well as markers of possible chromosomal disorders.

The table of average norms of fetometric indicators at 20-21 weeks is as follows:

The table of norms for the length of paired bones at 21 weeks is as follows:

The interhemispheric size of the baby’s cerebellum at this stage is approaching 21-23 mm. The estimated weight of the baby is already in the range of 350-420 grams.

Anatomical features of the fetus

All internal organs of the child are fully formed. Most of them are functioning in a well-functioning mode, some are just starting to work. An ultrasound examines the hemispheres of the brain, the presence and features, if any, of the lungs, organs of the urinary system - the bladder and kidneys. The heart must have 4 chambers and beat rhythmically and evenly. Since the gastrointestinal tract begins to actively work at week 21, The doctor carefully examines the stomach, intestines, and gall bladder. The spine and bones of the face and skull are assessed.

If no visible defects are found, the doctor does not go into detail describing each organ examined and indicates that they are all normal and have no special features. If a defect is detected, the doctor describes in detail the type of pathology, the decision on additional diagnostics and possible treatment.

In this case, all decisions will be made by the obstetrician and the pediatrician jointly.

Placenta, uterus, amniotic fluid

This week, zero degree of placental maturity is considered normal. This means that this temporary body, which is entrusted with important responsibilities - to provide the child with everything necessary, is quite young and successfully copes with its main task. If the doctor claims that the placenta is located low, do not worry, because the uterus has yet to grow, and along with the stretching uterine walls, the “baby place” can “migrate”.

However, low placentation leaves its mark on the daily life of the expectant mother - she needs to treat her pregnancy more carefully and carefully, take care of yourself, do not lift heavy objects, do not make sudden movements, take vitamins and visit your doctor more often than other pregnant women so that control is constant. Amniotic fluid at 21 weeks should be clean, transparent, and free of suspended matter. Their normal number at this stage is 143-214 mm.

The uterine walls should not be toned, the cervix should not undergo changes, and the cervical canal is normally tightly closed.

Possible problems

There are several problems that can be detected by ultrasound at this stage.

Fetometric data differs from the real period

A slight deviation of the baby’s individual sizes from the average norms may not indicate pathologies of fetal development. The reason may be heredity: the short stature of the parents will most likely be passed on to the child, and therefore you should not expect long bones from him. If the mother or father has a large head, then the child’s may be the same, and therefore the parameters of the head according to ultrasound will be somewhat ahead of the normative data.

Such a deviation is considered alarming in which the deadline according to the tables is “shifted” by 2 or more weeks. If at 21 weeks the size of the head (BPR and LZR) barely reaches the indicators of 18-19 weeks, this is the basis for prescribing additional diagnostics, since there can be many reasons for this - microcephaly, malformations, genetic pathologies, oxygen starvation, insufficient nutrition of the fetus, developmental delay.

An increase in size for 2 or more weeks can also indicate possible problems in the future, but other sizes should be assessed as well. If the increase is proportional, and other parameters are also ahead of the standards, then we may be talking about a tendency towards the birth of a large or gigantic child. If only certain parts of the body are enlarged, a detailed investigation into the reasons for this phenomenon is required.

The baby is able to move around inside the placenta, but is not yet able to open its eyes. At week 21, the baby's growth rate begins to slow down. However, there is still quite a lot of space for the baby inside the uterus, and he moves there as he pleases. Extra worries about the child’s position there are useless. He will move and turn over in the womb many more times until it comes to giving birth.

Weight, height and dimensions of the baby

Your child already weighs approximately 300-310 g. His height from the crown to the coccyx is approximately 18 cm. However, starting from this week, we will no longer talk about the parietal-coccygeal length of the embryo, now we will indicate the growth of the fetus from the crown to the heels.

By the way, now this value is about 26-27 cm. At the moment, the baby has already reached half of its height before birth. That is, if the size of the fetus at the twenty-first week of pregnancy is approximately 26 cm, then it will be born with a height of 52 cm.

News of the intrauterine world

• Digestive system. A child's digestive system is developing rapidly. The baby has already learned to swallow amniotic fluid, which contains dead skin cells. During digestion, the child absorbs useful substances, and the remains of dead skin, since they are hard, go into the intestines. By the way, we note that alcohol and nicotine are also absorbed by the baby’s body if the mother abuses it. Already now the baby is able to drink about 500 ml of surrounding water per day. This helps increase the amount of nutrients in his body;
• Taste preferences are formed. Taste buds begin to appear on the tongue, so the baby becomes able to distinguish tastes. By the way, the taste of amniotic fluid directly depends on the mother’s diet. By eating a varied and balanced diet, you can influence the formation of correct taste preferences in your child;
• The immune system. Leukocytes and platelets begin to be produced. The functioning of the immune system is improved. Antibodies are already transferred from the mother to the fetus. They will protect him from infections that his mother suffered during her life. This is called passive immunity;
• Endocrine system. All organs of the endocrine system begin to work in the baby - adrenal glands, pituitary gland, pineal gland, thyroid gland, pancreas and parathyroid gland. Their task is to produce hormones necessary for the growth and development of the unborn child;
• Vestibular apparatus. Fetal development at 21 weeks of gestation also includes the beginning of the vestibular apparatus, which allows the baby to determine the position of its body in space.

Fetal activity and movements

Sometimes a baby may not sleep at night, but play in his mother’s tummy, thereby preventing his mother from falling asleep. While he has plenty of room for activity, you can already determine in which part of the abdomen he is now frolicking.

At 20 weeks, a baby can already distinguish sounds and voices, and also understands the mother’s mood.

If he is really pushing in his tummy, try singing him a song or a lullaby, he will hear you and calm down. Even if you don’t know the gender of your baby yet, just address him kindly and stroke his belly! The baby feels your warmth!

Condition of the expectant mother at 21 weeks

You are still in excellent shape, so unbearable fatigue and shortness of breath when walking up the stairs may not be a problem for you yet. By the 21st week of pregnancy, your initial weight has increased by about 4-6 kg.

The child begins to grow adipose tissue. So try to be especially careful about what you consume. You can discuss the diet menu for pregnant women with your doctor. Take the vitamins prescribed by your doctor, eat cottage cheese, fruits and vegetables. This all contributes to the proper development of the baby, and also helps the body cope with the load placed on it during this wonderful period.

After all, carrying a healthy baby is a difficult test for every mother.

Symptoms and features of pregnancy

Associated symptoms at 21 weeks of pregnancy may be as follows:

• Breast enlargement and the appearance of colostrum. During pregnancy, the breasts become slightly larger in preparation for the upcoming lactation period. The nipples stand out even more and become sensitive. Gaining more than normal weight can lead to stretch marks on your chest in the future. For most pregnant women, at the 21st week of pregnancy, small drops of colostrum may begin to be released from the nipples when pressed. Colostrum is a yellowish, thick liquid that is the prototype of breast milk. The release of colostrum can begin either at 20-22 weeks or immediately before birth. In both cases, this is not considered a pathology. If there is heavy discharge, you can put breast pads or special napkins in your bra or underwear to prevent the discharge from staining your underwear and clothes;
• Increased size of the uterus. What happens to the uterus at 21 weeks of pregnancy? The uterus is already located approximately 1 cm above the navel, and the height of its bottom from the pubis reaches approximately 21 cm;
• Discharge. Vaginal discharge during pregnancy should not be much different from normal. They can only become a little more abundant (this is due to the effect of the hormone progesterone on the mucous membrane). Normal discharge from a healthy woman during pregnancy is translucent or gray-white with a sour odor. If you notice flaky, purulent, cheesy, or strong-smelling discharge, this may indicate a pathology. Watery or bloody discharge accompanied by pain in the abdomen and lower back can lead to miscarriage! Call an ambulance as quickly as possible to avoid harm to the baby;
• Increased hair and nail growth. Due to hormonal changes occurring in a woman’s body, hair and nails may begin to grow faster. The most unpleasant thing about this is that hairs often grow especially actively in undesirable places.

Anxiety and well-being of a pregnant woman

Typically, the twenty-first obstetric week of pregnancy is considered a quiet period. However, all kinds of pain can make it more difficult for a woman to cope with it. Barely perceptible pain in the uterus may be Braxton Hicks contractions, but don't worry, they pose no threat to the baby or you.

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A pregnant woman may also be concerned about:

• Heartburn. Some expectant mothers may experience discomfort from heartburn. The reason for its appearance is that the enlarged uterus puts pressure on the stomach. It lifts the stomach upward, which leads to the reflux of acidic contents into the esophagus, thereby causing discomfort. To avoid it, experts advise not to eat fried, sour, pickled and smoked foods. You should also avoid sour fruits and drinks, and carbonated water. It is advisable not to bend over immediately after eating. Before going to bed, to save yourself from heartburn, you can put another pillow under your head. If relief does not occur, be sure to tell your doctor;
• Dyspnea. The uterus, constantly increasing in size and volume, begins to compress the internal organs, lifting the diaphragm. Therefore, a pregnant woman may periodically experience shortness of breath. To cope with this unpleasant feeling, doctors recommend starting to master breathing techniques. The ability to breathe correctly will be very useful, especially during childbirth;
• Constipation and bloating. Bloating and constipation often accompany a woman throughout pregnancy. This happens because almost all of a woman’s internal organs are under pressure from the weight of the uterus and child. To get rid of constipation, eat more fresh vegetables and fruits that contain fiber;
• Painful sensations. At this time, sitting for a long time in one position can be fraught with pain in the back and lower back. To get rid of them, you can try simply changing your position. Learn to listen to your body and relax. Excess weight during pregnancy can cause pain in your leg joints, back, and muscles. Under pressure from the uterus, pain and discomfort may appear in the navel area. But if there is a cramping pain or a pronounced stretching pain in the lumbar region, then this should not be ignored! To promptly diagnose increased uterine tone, consult a doctor as soon as possible;
• Sleep disorders. Firstly, a fetus at 21 weeks of gestation may interfere with sleep at night due to excessive activity in the tummy. Secondly, the lack of proper sleep may be due to strong pressure from the uterus on the bladder. That is why the expectant mother has to wake up many times during the night to go to the toilet. Thirdly, due to changes in the size of your tummy, it is not easy to immediately get used to sleeping on your side (especially if you previously preferred to sleep on your stomach or back). Therefore, you need to choose the optimal comfortable sleeping position for yourself. Several pillows, or special pillows for pregnant women, can help with this. A bagel-shaped pillow is a very good thing: it is comfortable to sleep with during pregnancy, and after childbirth it can be used to feed the baby. And don’t forget to ventilate the room before going to bed and during the day.

Your rapidly growing belly

When the belly begins to grow, many expectant mothers feel that the skin on their sides begins to itch. This is a sure sign of stretching. Using a moisturizer or lotion can help relieve symptoms. There are also special creams for pregnant women against stretch marks on the body.

If the itching does not go away, you should visit a doctor. Additional testing may be needed to determine the cause of the discomfort.

Photos of bellies at the twenty-first week:

Tests and ultrasound at 21 weeks

No special medical examinations will be required at this time. Your gynecologist can only give you directions for a urine test and a general blood test.

An ultrasound scan at the twenty-first week of pregnancy is prescribed by the doctor you are seeing. You will finally be able to see your baby and, if he allows you, consider whose birth you can expect soon - an heir or an heiress. In addition, you can already agree with the doctor and take the first photo of the baby, revealing the chronicle of his life, as, for example, the mothers of these little ones did:

What dangers should you watch out for?

Premature labor can often begin at this stage. It is important for every expectant mother to know the accompanying symptoms in order to be able to behave correctly in such a situation. Signs of premature birth:

• bloody discharge from the genital tract;
• severe pain when urinating;
• acute or continuous vomiting;
• frequent loose stools;
• sudden leakage of copious watery fluid from the vagina;
• severe pain in the lower back;
• sharp or lingering pain in the back or lower abdomen.

If you feel any of these symptoms, call an ambulance immediately!

The female body is unique in nature, so all physical sensations in the twenty-first week of pregnancy are also unique.

Hormonal changes continue during this period, and completely new sensations are added to them; a sharp change in mood is observed.

Our helpful tips this week are:

1. Don't worry if you gain a little more weight than normal. But still try to watch your appetite, eat less flour and forget about the existence of semi-finished products and fast food;
2. To take a little break and relax, you can write a list of things you need to care for your newborn. Start taking a closer look at the assortment of socks, caps, and rompers. This is very inspiring!;
3. Sports activities are welcome. If sport occupied an honorable place in your life even before conceiving a child, then you can reduce the load and continue to exercise. But consultation with your doctor and instructor is required! And if the desire to play sports appeared after conception, then it would be best to start with light stretching exercises and strengthening the back muscles. You can choose for yourself, for example, yoga for pregnant women, fitness or visiting the pool;
4. You can already get in line to attend special courses for pregnant women!;
5. Extract as many positive emotions as possible from everything that happens in your life. You now have increased sensitivity, so worries and stress are completely unnecessary. Have more fun and walk in the fresh air more often! Don't be afraid to pamper yourself!

More positive! Appreciate every new day, because it brings you closer to a long-awaited event - the birth of a baby!

This material is for informational purposes only; before using the information provided, you must be sure to consult with a specialist.

The 21st week of pregnancy is a favorable period. A woman blossoms at this stage, the feeling and condition of the mother at 21 weeks of pregnancy improves, along with the condition of the skin, hair and nails, and the contours of the body become more feminine. The belly is not very large yet, so the expectant mother is very active and energetic.

What happens at 21 weeks of pregnancy?

Metabolic processes are activated in the female body, which leads to an increase in appetite. The growth and proper development of a child requires more energy, and the expectant mother needs to eat right. The increase in daily energy needs should be 500 Kcal.

The child's growth rate has slowed down slightly, but the fetal weight is actively increasing at 21 weeks of pregnancy. Since he has already grown up enough, the woman may feel pressure on the internal organs and systems.

At this time, the first stretch marks may appear, which may be due to a genetic predisposition. In this case, the fight against them is difficult and ineffective. In some expectant mothers, even with a strong weight gain, stretch marks do not appear.

What happens in the 21st week of pregnancy in a woman’s body?

The uterus continues to increase in size, the height of its fundus reaches 21-22 cm and is located one finger above the navel. The uterus significantly supports all internal organs - intestines, liver, lungs, stomach. The abdominal circumference at this stage is about 75-80 cm; exceeding this parameter may indicate:

• pathology of placental development -;
• multiple pregnancy;
• chorionepithelioma is a malignant tumor.

If the abdominal circumference is less than the established norm, we can talk about oligohydramnios or delayed fetal development as a result of placental insufficiency. All these pathologies require careful examination and management of pregnancy by an experienced doctor.

The weight gain at the 21st obstetric week of pregnancy from the beginning of the “interesting” situation is about 6 kg, but this is the reference value. In women, due to individual characteristics, the increase in body weight can fluctuate between 3-8 kg, but there should not be a sharp increase. Weekly weight should increase by a maximum of 500 g.

WOMAN'S FEELINGS

A fetus at 21 weeks of gestation, while in the womb, already makes about 200 movements per day. He is still quite comfortable in the uterine cavity, he can tumble and change position freely. But amniotic fluid and the walls of the placenta significantly smooth out these movements, so not all of them can be felt by a woman.

The mother’s condition is characterized by a feeling of concern and at the same time joy for her growing baby. During this period of pregnancy, a woman can feel from 1 to 14-15 movements per day, more often in a calm state. The movements are still very light and represent soft “touches of a cat’s paw”, there are no pushes or bulging yet.

The 21st obstetric week of pregnancy is the time when the expectant mother can already determine the condition of the fetus by the nature and frequency of movements. If they increase sharply or, conversely, are absent for a long time, this may indicate a lack of oxygen. Fetal hypoxia can lead to dangerous consequences, so it is important for a pregnant woman to spend as much time as possible in the fresh air.

Ultrasound

An ultrasound examination during this period can be performed as part of a second screening examination, if the woman did not have time to undergo it earlier. In the practice of modern medicine, ultrasound scanning can be used outside of routine examinations only in the presence of pathologies and to confirm the correct development of the fetus and its weight at 21 weeks.

DISCHARGE FROM THE GENITAL TRACT

A sign of normal pregnancy is clear, milky or slightly yellowish discharge with a slight odor. They may increase slightly in volume or become more liquid, which is due to physiological processes in the female body. Purulent, bloody and other unusual discharge indicates the presence of a sexually transmitted infection, which can adversely affect the development of the fetus at 21 weeks.

If even a small amount of blood appears, you should immediately seek help from a gynecologist, since such symptoms may indicate placental abruption and cause premature birth. With timely assistance, a woman can carry a child to term - at least up to 37 weeks.

Thin and watery discharge indicates leakage of amniotic fluid. To determine the pathology, the doctor performs a special analysis. If amniotic fluid is detected in the discharge, emergency measures are prescribed, since in the absence of appropriate assistance, an infection can enter the amniotic sac on the first day.

Fetal development at 21 weeks of gestation

At the twenty-first week, the baby is actively accumulating body weight. How much does a fetus weigh at 21 weeks? Its height is about 18 cm, and the weight of the fruit reaches 390 g. In size, it is similar to a large grapefruit. The baby still has a lot of room in the uterus, so it can make a variety of movements, which can be seen during an ultrasound examination.

What happens in the twenty-first obstetric week? The fetus continues to develop its digestive system, which prepares for the first meals. Already at this stage there is a small amount of hydrochloric acid and digestive enzymes in his stomach. The child drinks about 500 ml of amniotic fluid per day.

The baby receives a large amount of nutrients from amniotic fluid; sugar and water are actively absorbed by his body. Thanks to these metabolic processes, subcutaneous fat tissue grows and energy for movement appears. Unnecessary elements are digested, turning in the intestines into the original swamp-green feces - meconium.

Lanugo fluff continues to grow on the baby's skin, which already covers the entire head. The sebaceous glands actively produce a lubricant that protects the epidermis from penetration of the amniotic fluid. In the future, it will help the baby “slide” along the birth canal.

At this stage, the fetus already has actively functioning endocrine glands - the thyroid gland, hypothalamus, pancreas, spleen, as well as the adrenal glands and gonads. The skeletal and muscular systems are gradually strengthened.

The baby's nervous system is already fully formed. He hears surrounding sounds well and also recognizes his mother's voice. His immune system produces his own white cells, interferon and immunoglobulin, which will allow him to independently fight infections and viruses after birth.

POSSIBLE PROBLEMS

Possible pathologies at this stage of pregnancy include:

• uterine hypertonicity is a pathological condition caused by muscle contraction and tension;
• Diabetes mellitus in pregnancy is a condition characterized by increased blood sugar levels. Can cause a sharp increase in fetal weight, which can cause problems with pregnancy, as well as difficult premature birth;
• phlebeurysm.

Premature birth poses a great danger, since the baby cannot yet function outside the mother’s body. Symptoms of the onset of labor can be: painful urination, spotting, increased uterine tone, vomiting, sharp acute pain in the abdominal area.

WHAT TO PAY ATTENTION TO?

The feeling and condition of the mother after 21 weeks determines her activity. Even at this stage of pregnancy, a woman can play sports, but dangerous and intense loads (skating, skiing, cycling) must be excluded. Yoga and fitness, walking, and swimming are ideal for strengthening muscles and increasing their tone. It is also recommended to do vaginal exercises to adjust the pelvic diaphragm; they are necessary for quick pre- and postpartum recovery.

If you experience back pain, you need to stop sitting in one position for a long time, taking an uncomfortable position. You should learn to relax and listen to your body. To reduce pain in a pregnant woman’s back, you can wear a special bandage, which is a thick elastic band. If there is a risk of varicose veins, the doctor will recommend wearing special compression stockings.

You can’t give yourself any slack in terms of appetite. One extra glass of soda and a fragrant pie can be the start of weight gain. The expectant mother should accustom herself to a routine in order to keep her body and body in excellent shape until the birth. To do this, you need to eat according to the following scheme: a hearty breakfast, a second (lighter) breakfast, a full lunch (in small portions), an afternoon snack of healthy foods and a light dinner.

We should not forget about fluid, which is necessary to increase blood volume, maintain the level of amniotic fluid in the membranes, and also to improve the general well-being of the expectant mother.

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Considering that the size of the abdomen is growing every day and can cause discomfort, the expectant mother needs to take preventive measures:

Enlarged uterus

At 21 weeks of pregnancy, the uterus is approximately 1 cm above the level of the navel, and the height of the fundus of the uterus is 21 cm. The increase in its size has already led to the displacement of nearby internal organs, which leads to problems in digestion and frequent urination. In addition, the woman feels short of breath, because the uterus puts pressure on the chest area.

At each appointment, the doctor will measure the volume of the abdomen and the height of the uterine fundus to ensure full growth of the fetus. If the indicators do not correspond to the norm, then this may indicate a developmental disorder.

Pain and discomfort

The growth of the uterus can provoke pain in the abdominal area, especially on the sides. This indicates that muscle ligaments are being stretched in this area. Normally, such sensations should occur infrequently and be mild. A pregnant woman may also experience pain:

• in the back (due to the growth of the uterus);
• in the head (due to pressure changes);
• in the legs (due to swelling and varicose veins);
• in the anus (due to hemorrhoids).

It is necessary to go to the hospital if the pain in the lower abdomen resembles the sensations during menstruation, intensifies, and radiates to the lower back. They may be signs of spontaneous abortion.

Discharge

An alarming signal indicating a threat of miscarriage is also the appearance of blood from the vagina. Such discharge indicates that not everything is all right with the baby. However, you should not panic. You urgently need to call an ambulance to take you to the hospital. There is no need to worry ahead of time, because very often everything ends with treatment and a further successful pregnancy.

Expectant mothers need to know that normal discharge should not smell like anything. They should be colorless and of uniform consistency.

If the discharge looks like cottage cheese and has a sour smell, it means there is an infectious disease - thrush. It requires medication under the supervision of a gynecologist.

Premature birth

Unfortunately, premature birth at 21 weeks of pregnancy is always a bad outcome for the baby. The fetus at this stage is not yet developed enough to survive. Therefore, it is so important that a woman pays as much attention as possible to the slightest changes in her well-being.

Signs of premature birth include sharp pain in the lower abdomen, uterine contractions, and spotting. If at the same time you feel sick and start vomiting, then this is without a doubt a threat of miscarriage. We need to go to the hospital urgently.

• Don't miss an opportunity to communicate with your child. He listens carefully to what is happening in the mother’s body and outside the womb. After birth, he will definitely recognize your voice among everyone else.
• Do not lift heavy objects and avoid situations that can cause stress and nervous tension.
• Visit your gynecologist regularly to keep your well-being and your child's development under control. Follow all recommendations.
• It's time to sign up for courses for expectant mothers. The knowledge gained in the classes will be useful in the last months of pregnancy, as well as during and after childbirth.
• Eat a healthy diet and watch your weight.

When swelling occurs, you must take a lying position with your legs raised up. To prevent them, you need to limit your salt intake and also change your body position more often.

Necessary studies and analyzes

The pregnancy calendar provides for three screenings. By week 21, the results of the second study will be known, which includes:

• analysis for the hormone human chorionic gonadotropin (hCG);
• analysis for the hormone free estriol;
• alpha-fetoprotein protein test;
• ultrasound examination of the fetus.

The first three analyzes make up the so-called triple test, which shows the degree of fetal development and the presence or absence of pathologies. The results of the study reveal how likely the risk of chromosomal abnormalities and hereditary diseases is. If it turns out that the test is positive, the doctor will send the pregnant woman for additional examinations. These are invasive methods that are used only as a last resort, as they can cause harm.

The expectant mother should visit a gynecologist at least once a month, having previously undergone urine and blood tests. With their help, the doctor monitors the well-being of the pregnant woman and evaluates the parameters of fetal development based on indicators such as heartbeat, height of the uterine fundus and abdominal volume.

Ultrasound at 21 weeks of pregnancy

An ultrasound at 21 weeks of pregnancy is routine. It is at this time that the ultrasound diagnostician conducts a study of fetal development parameters and determines their compliance with the norm. In particular, we are talking about assessing the maturity of the placenta, the condition of the cervix and umbilical cord, the quantity and quality of amniotic fluid.

In addition, a photo of 21 weeks of pregnancy can show parents expecting a girl and expecting a boy the gender of the baby. It is during the second planned ultrasound that doctors prefer to determine the gender of the fetus, since the likelihood of error is already minimal.

The second part of pregnancy is aimed at the baby gaining weight, at this time the indicators of his growth are already taken into account, and coordinated directed movements are actively felt. The 21st week of pregnancy is marked by a routine ultrasound, at which you can find out who you should expect, a boy or a girl, or perhaps you are expecting twins.

By the 21st week of pregnancy, a woman already has a well-rounded belly. It doesn't cause any inconvenience yet, but it already has volume. Toxicosis has already passed by this period, but new sensations appear.

1. At this time, the little one begins to move actively. Often this happens while the mother is sleeping. Therefore, changes in the baby's position in the womb may wake you up unexpectedly. Doctors recommend monitoring the frequency of movements, since the activity of the embryo directly depends on its condition:

• if you feel the baby moving at least ten times during the day, rest assured, everything is fine with the baby;
• an excess of movements may indicate that the mother is uncomfortable or nervous;
• a small number of movements may indicate fatigue, but also signals that it is necessary to consult a doctor.

1. It is at this time that a woman begins to notice large weight gains. This is absolutely normal. The child begins to accumulate subcutaneous fat, gains weight and increases in height. Mom's appetite also increases. But experts do not advise gaining too much weight, as this can lead to stretch marks and weakening the tone of the uterus.
2. The expectant mother's breasts also continue to change in volume. The sensitivity of the nipples increases, the halo around them becomes a little larger and changes color to a darker one. Pregnancy at 21 weeks is accompanied by the release of a small amount of colostrum, this is associated with the development of the fetus. Doctors recommend placing wipes in your bra to avoid irritation and infection.
3. There may be slight pain in the abdominal muscles. This is due to active growth and does not pose a problem. At 21 weeks of pregnancy, you can already clearly see what is happening to the baby. From the side you can clearly see the baby's leg or butt.
4. At this stage, the uterus rises three centimeters above the navel, its distance to the pubis will be approximately 21 centimeters. This position slightly compresses the woman’s internal organs. The result may be slight shortness of breath when walking or heartburn. To avoid unpleasant phenomena, you need to master breathing techniques that will come in handy later.
5. Changes also occur with the skin; it acquires a slightly bluish tint. This is due to the high quantitative level of estrogen in the blood. Do not be alarmed, this manifestation is considered absolutely normal for the gestation period; after childbirth, the skin color will return to normal.
6. The 21st week of pregnancy is accompanied by pain in the uterus, often the woman gets scared, not understanding what is happening. In medical practice, this phenomenon is known as “training” Breston-Hicks contractions. It is not at all dangerous either for the mother or for the unborn child, and speaks of the correct development of the fetus, rather than of any pathologies. The pain may be concentrated in the abdomen or radiate to the lower back. In the second case, you should bring this to the attention of a specialist. You should also be wary if your stomach begins to pull down or burst from the inside. At the same time, the stomach itself becomes very hard, as if it is starting to turn to stone. Pain in the legs or back may also occur. This happens due to the excess weight of the pregnant woman.
7. At this time, slight vaginal discharge is characteristic, due to the influence of progesterone. It is important to ensure that they do not change their concentration, do not have a curd base, and do not look like flakes. In all these cases, you must consult a doctor. This is especially important if there are signs of bleeding.
8. Various digestive disorders are possible: constipation or bloating. This is due to the pressure of the uterus on the internal organs. The gynecologist will recommend a remedy to solve this problem.
9. Insomnia often accompanies weeks 21-22; this condition can be caused by various reasons:

• frequent urination associated with pressure of the uterus on the bladder;
• unusual position during sleep;
• a psychological factor that is periodically present during pregnancy.

1. Hormonal changes in the body lead to increased growth of hair and nails. Hair growth may also occur in a place other than its intended location.
2. Often during this period, cramps appear at night, often due to a lack of calcium. Heavy stress on the legs can lead to varicose veins. To avoid this, pay attention to comfortable shoes and try not to overload your feet.
3. Fetal pressure often leads to the appearance of hemorrhoids, which are not serious and go away on their own after childbirth.

How the fetus develops at 21 weeks

It is important to remember that at 21 weeks of pregnancy the baby is only 19 weeks old, at this age the fetus begins intensive development and is very similar to a real baby. You can already sing songs and tell stories. It has been proven that children perfectly hear everything that is happening outside and are very fond of classical music.

Intensive weight gain occurs, but growth slows down a little. The baby receives nutrition from amniotic fluid, drinking up to 500g per day.

The child's eyes are still hidden behind his eyelids, and his entire body is covered with hair. At 20-21 weeks he is quite comfortable and spacious in the womb. Therefore, the baby loves to change positions, although he sleeps for almost twenty hours.

At this time, the child’s nervous system is already fully formed, many blood cells are working. The first taste preferences appear due to the taste buds on the tongue. The digestive organs are developing.

The average weight of a child at 21 weeks is 340 g. This is an approximate parameter, since during pregnancy each fetus develops individually. Its size from crown to heels reaches 25 centimeters.

Nutrition for pregnant women

During this period, it is important to avoid overeating, since the baby is rapidly gaining weight and the mother’s appetite increases. It is better to diversify your diet with fish, meat, vegetables and fruits. There are dietary features during this period:

• freshly squeezed juices will provide maximum vitamins for a developing baby;
• to avoid constipation, introduce coarsely ground foods into your diet;
• to avoid heartburn, use fractional portions;
• try to avoid salty, smoked and fried foods;
• try to cook only by steaming;
• give up fast food products.

During this period, the child’s digestive system is actively developing; it cannot be harmed.

Sex at 21 weeks

During a normal pregnancy, there are no contraindications for sex. It all depends on the woman’s well-being.

During this period, the sensitivity of the erogenous zones intensifies, so sex can bring many pleasant sensations. The only thing you will have to experiment with a little is the appropriate poses, since the tummy already has quite noticeable volumes.

Possible risks of 21 weeks

The most undesirable symptoms of pregnancy at 21 weeks are considered to be the appearance of edema and colds, since these factors affect the development of the fetus.

The first problem can be dealt with by following simple rules:

• periodically lie with your legs up;
• take care of comfortable shoes;
• take contrast foot baths.

It’s more difficult with a cold, since this stage of pregnancy implies unwanted medication:

• The main thing is not to panic; 80% of women suffer from a cold during pregnancy. This is due to a decrease in immune functions.
• You definitely shouldn’t self-medicate. At the first symptoms, consult a doctor, warning him about your situation.
• If you do not have edema or a doctor's prohibition on drinking too much, try to drink as much tea with honey as possible.
• Do not use nasal drops, the principle of which is based on vasoconstriction. This will have a negative impact on the uterus and can cause miscarriage.
• During the onset of a cough, it is permissible to use inhalations. However, under no circumstances should you steam your feet or take hot baths. This is a direct threat of pregnancy failure at this stage.
• If you develop a fever, consult your doctor about which medication you can take.
• Do not stop taking your prescribed medications immediately after your symptoms stop. It is important to complete the entire course of treatment to avoid relapse of the disease. The doctor decides how much and when to take the medicine.

Examinations at 21 weeks of pregnancy

At this time, the expectant mother must undergo clinical blood and urine tests to monitor kidney function and detect anemia.

At 21 weeks of pregnancy, a second planned ultrasound is performed, which allows:

• determine gender;
• examine the quality of amniotic fluid;
• fix the position of the placenta;
• identify fetal diligence;
• determine the possible expectation of twins.

At each visit, the doctor should listen to the fetal heartbeat.

Ultrasound examination can make mistakes in determining the sex of the child. The main objective of this study is to agree on mass norms corresponding to the current month.

There are several moments that do not threaten the health of mother and baby, but are unpleasant.

1. Signs of anemia often appear during this period. To avoid this, add foods high in iron to your diet.
2. Try to avoid large numbers of people and avoid going to places that are potentially dangerous from the point of view of infection. Having caught even a simple cold, you will be significantly limited in treatment options.
3. At this stage of pregnancy, the belly is actively growing, as a result, the navel may prolapse, and the pregnant woman may also feel that the belly begins to periodically itch. You need to consult with a specialist, he will select a solution to the problem.
4. Often at this time moles appear on a pregnant woman. Do not rush to panic, it is possible that they will disappear after childbirth. Seek advice from a specialist.
5. Do gymnastics. Starting from the twentieth week, the stomach will actively grow, stretching the muscles. It is important for you to prepare for childbirth.
6. To avoid stretch marks, watch your diet. It is important at this stage to avoid overeating. You need to understand how much you will weigh after a week's time.

At 21 weeks of pregnancy, you need to reconsider your wardrobe:

• choose comfortable shoes, taking into account swelling;
• from now on, the belly will increase, consider options for loose clothing;
• pay attention to the bra, it should not tighten the chest;
• take care of sanitary pads, colostrum will soon begin to flow.

The following can help relieve back pain:

• contrast compresses;
• massage for pregnant women;
• compression stockings for legs;
• physical therapy for pregnant women.

You can ease the load on your legs:

• without straining too much during defecation, keep your feet on a small stand to relieve tension;
• Learn Kegel exercises to stimulate circulation;
• Warm sitz baths help a lot;