The third trimester covers the period from the 27th to the 40th week of pregnancy. This is the time during which the body of the expectant mother will fully prepare for childbirth and adapt to the needs of the baby. In the last three months, there has been a dynamic change in the figure - every week the belly becomes bigger and bigger. The third trimester is the time when all the unpleasant symptoms of pregnancy intensify, and new ailments also appear. Emotions begin to dominate common sense - the first fears associated with the birth of a child and motherhood appear. The third trimester of pregnancy is a good time to find a suitable maternity hospital, purchase all the necessary things for the baby and arrange a room for a new family member, as well as attend courses in preparation for childbirth and life with a child.
Changes in the body in the third trimester
In the third trimester, the child grows especially intensively, which affects not only the general condition of the mother, but also the functioning of internal organs, in particular the gastrointestinal tract. The child is less and less able to move freely, so all his “acrobatics” are especially clearly felt. Its mass also increases, which increases the load on the spine, and a significantly stretched uterus causes compression and stagnation of blood in the pelvic veins. This leads to the appearance or worsening of pain in the lumbar region, varicose veins, and can also cause hemorrhoids and swelling of the ankles. Changes also affect the organs of the genitourinary system. During this period, an exacerbation of infections is possible, which should be diagnosed and eliminated as early as possible.
In the last trimester of pregnancy, the uterus begins to prepare for childbirth, and training contractions called Braxton-Hicks contractions appear. These are uterine contractions that can be noticed after 20 weeks of pregnancy. Contractions usually last about 30-45 seconds.
Symptomatic therapy
Episodic nausea that occurs with mild toxicosis or due to physiological reasons does not require drug correction. To reduce painful sensations, pregnant women are advised to eat small meals up to 5-6 times throughout the day. The diet should consist of easily digestible foods. After eating, it is undesirable to be in a horizontal position, so as not to provoke the reflux of contents from the stomach into the esophagus.
If nausea during pregnancy is constant, makes it much more difficult to eat, or is accompanied by headaches, repeated vomiting, severe pain in the stomach and intestines, you should consult a specialist as soon as possible. Before establishing a clinical diagnosis, prokinetics, antacids, and sedatives can be used to alleviate the condition. Psychotherapy methods are effective for functional digestive disorders.
Possible problems in the third trimester
Unfortunately, in the third trimester of pregnancy, many ailments can occur, which are mainly caused by the growing uterus and the active enlargement of the fetus. For many women, the third trimester is a rather tiring time.
Tachycardia
Tachycardia is an increase in heart rate above 100 beats per minute.
During this period, blood volume increases significantly - by about 40-50%, and in pregnant women with increased body weight this value can reach 80-90%. This means the heart must beat faster to pump the right amount of blood to maintain adequate blood pressure. Another cause of heart palpitations may be hyperthyroidism or anemia. Pregnancy can also worsen pre-existing arrhythmia.
Heartburn
If there was no heartburn before, then in the third trimester it is almost impossible to avoid. Constant heartburn in the last weeks of pregnancy is due to the fact that the enlarging uterus puts pressure on the stomach. As a result, the contents of the stomach are pushed into the esophagus, causing unpleasant discomfort.
Low water
A decrease in the amount of amniotic fluid can develop against the background of infectious pathologies or fetal malformations. Intrauterine infections of the fetus that develop as a result of diseases of the genitourinary system of the expectant mother can also provoke oligohydramnios. Another provoking factor for the anomaly is considered to be diseases of the respiratory system, in particular influenza.
Insomnia
Insomnia in the third trimester is a common condition for expectant mothers. Spinal pain, a large belly, frequent visits to the toilet and cramps do not naturally contribute to quality sleep. In addition, psychological factors also influence the onset of insomnia, especially during the first pregnancy. The closer the expectant mother gets to her due date, the more fears and anxiety she has. In this case, you should talk to your doctor and perinatal psychologist and try to solve the problem of insomnia.
Edema
Swelling during this period of pregnancy is physiological (a consequence of increased blood volume and pressure from the enlarged uterus on the vein that drains blood from the lower body to the heart) and is not something to worry about. But if swelling is accompanied by increased blood pressure or the presence of protein in the urine, a doctor’s consultation is required.
Diarrhea
Diarrhea in the third trimester of pregnancy can be caused by the body's reaction to hormonal changes, an enlarged uterus and the development of the fetus. Diarrhea in the 9th month can be caused by increased stress due to the approaching due date. Diarrhea is also a signal of impending labor.
If diarrhea is accompanied by general weakness, fever, or abdominal cramps that gradually become painful and severe, this may indicate placental abruption. An ambulance is required.
Lower back pain
A change in the center of gravity, extra pounds, and lack of movement increase pain in the spine. In addition, when the body prepares for childbirth, it produces more relaxin, a hormone responsible for weakening the pelvic ligaments.
Spinal exercises during pregnancy are the most effective way to get rid of back pain. If the expectant mother feels well and the doctor has not identified any contraindications, starting from the second trimester, you can do pregnancy fitness, following the principle that prevention is better than cure.
Bleeding from the nose
In the third trimester, nosebleeds often indicate an exacerbation of chronic diseases. It can also be caused by blood pressure problems and anemia, which are often diagnosed at the very beginning of pregnancy, so the doctor applies appropriate countermeasures or prescribes the necessary medications.
Signs of thrush
Thrush, or vaginal candidiasis, develops in almost half of women during pregnancy. Unpleasant itching, burning in the vagina and white, curd-like discharge are typical symptoms of infection that require treatment under the supervision of a gynecologist.
You should be aware that in the third trimester of pregnancy, heavy clear or clear white vaginal discharge may appear, which is not associated with infection and is not accompanied by the above-mentioned symptoms.
Polyhydramnios
Polyhydramnios (polyhydramnios) affects approximately 1.5% of pregnant women, often in multiple pregnancies. Polyhydramnios is diagnosed when the amount of fluid in the third trimester of pregnancy exceeds 2000 ml or when the AFI index is > 25 cm. The amount of amniotic fluid is assessed by a doctor based on an ultrasound examination.
The prognosis for pregnancy complicated by polyhydramnios depends on the cause of the increase in amniotic fluid.
Dizziness
During the third trimester of pregnancy, dizziness is associated with pressure from the uterus on important blood vessels and increased energy needs. You should also monitor your iron levels, as iron deficiency increases drowsiness and can cause dizziness.
At all stages of pregnancy, dizziness can be a result of gestational diabetes or gestational anemia.
Cloudy urine
In the last stage of pregnancy, a change in the color of urine may be associated with infectious and inflammatory processes of the pelvic organs or late gestosis. The presence of kidney stones or sand in the bladder will also affect the clarity of the urine.
Temperature
A slightly elevated body temperature during pregnancy is normal and very common and, as a rule, does not affect the health of mother and baby. However, a high temperature in the last trimester may indicate the presence of a viral infection, intoxication, urinary tract infection, toxoplasmosis and chickenpox. If fever develops, you should call a doctor at home, a specialist will select treatment tactics that will minimize the risk of possible complications.
Treatment
If all of the listed dangerous conditions develop, the pregnant woman is subject to immediate hospitalization, where the question of the advisability of prolonging pregnancy or delivery is decided.
If chronic fetoplacental insufficiency occurs, they are prescribed
- agents that improve uteroplacental blood flow (actovegin, vitamin E, hofitol, instenon, piracetam, etc.),
- antispasmodics (papaverine, aminophylline, no-spa),
- drugs that normalize blood rheology: antiplatelet agents (chimes, aspirin) and anticoagulants (trental, troxevasin),
- Tocolytics (ginipral, partusisten, magnesium sulfate) are also indicated to relax the uterus and normalize blood circulation in it,
- in case of detected intrauterine infection, antibiotics (macrolides: erythromycin, sumamed) and other anti-inflammatory drugs (metronidazole, antifungals, etc.) are prescribed.
For gestosis, therapy begins with the creation of a therapeutic and protective regime and the prescription of a diet (food rich in proteins, moderately under-salted, moderate or reduced fluid intake), fasting days once a week, herbal teas.
Gestosis requires the prescription of antihypertensive drugs (nifedipine, methyldopa, labetolol), reducing the tone of the uterus and lowering blood pressure (ginipral, magnesium sulfate), normalization of uteroplacental circulation (chimes, trental, piracetam, actovegin, etc.).
Also, in case of gestosis, infusion therapy is indicated to restore the volume of circulating blood and normalize its rheology (infucol, rheopolyglucin, albumin, fresh frozen plasma). Additionally, antioxidants are prescribed (tocopherol, glutamic and ascorbic acid). In case of development of preeclampsia during full-term pregnancy, the issue of labor induction or surgical delivery is decided; eclampsia at any stage is an indication for cesarean section.
Moderate or severe placental abruption is a direct indication for surgical delivery, regardless of the duration of pregnancy (in the interests of the mother). In mild cases, treatment is prescribed for fetoplacental insufficiency, intrauterine fetal hypoxia, anemia and uterine hypertonicity.
Observation by a doctor in the third trimester
From the 30th week of pregnancy, prenatal care begins, which should include an appointment with an obstetrician-gynecologist and a third ultrasound examination. In addition, appropriate tests and consultations with specialized specialists, usually a hematologist, ophthalmologist, or ENT doctor, are prescribed.
From the 30th week of pregnancy, working women are entitled to maternity leave; the doctor will issue all the necessary documents for its registration.
After the 36th week, it is recommended to visit the obstetrician weekly in order to timely identify the possibility of premature birth.
Tests in the third trimester
In the third trimester of pregnancy, each expectant mother must pass the following laboratory and instrumental tests:
- general urine analysis;
- detailed blood test;
- Hbs antigen testing (hepatitis B);
- detection of antibodies to toxoplasmosis;
- cardiotocography (CTG);
- obstetric examination;
- Ultrasound.
Other control tests in the third trimester of pregnancy:
- checking fetal heart function (auscultation);
- assessment of vaginal discharge;
- woman's weight control;
- assessment of fetal mobility;
- Wasserman reaction to detect syphilis, which is carried out at the beginning and end of pregnancy;
- determination of vaginal cultures for the presence of type B streptococci (can be localized in the genital tract).
Baby development in the third trimester
Now the elements of the child’s spine are beginning to form - 33 vertebrae, 150 joints and more than 600 muscles. Blood vessels and alveoli develop and the nostrils open. From the 28th week of pregnancy, the baby recognizes his mother’s voice - so you need to try to talk to him as much as possible. At the 29th week the nervous system is already developed, the child reacts very quickly to stimuli.
Between the 29th and 33rd weeks of pregnancy, the baby's brain enters a phase of rapid development and is able to control breathing and regulate body temperature. His body has already acquired basic immunity, thanks to which the baby can fight mild infections.
During the last two months of pregnancy, the baby's weight doubles, and in the last four weeks the baby gains 50 g per day.
Useful tips in the third trimester
In the third trimester of pregnancy, it is recommended to visit an obstetrician-gynecologist every two weeks. Around the 30th week, it is recommended to start searching for a suitable maternity hospital and attend antenatal classes.
Advice! Make a list of necessary items for the hospital in advance, do not leave it until the last minute.
Exercises for pregnant women: preparing for childbirth
At this stage of pregnancy, the most important are relaxation exercises, which will help relax the muscular corset and reduce the severity of back pain. Any physical activity during pregnancy should only be done under the supervision of an experienced professional.
Back pain and muscle spasms are considered an inevitable part of pregnancy, although it's worth knowing that expectant mothers can effectively counteract them with regular, low-intensity exercise.
Nutrition for pregnant women: features of the third trimester
The diet for pregnant women should consist of proteins, dairy products, fruits, vegetables and carbohydrates present in every meal. In the third trimester, calcium is extremely important, which is necessary for the formation of the baby's bones. Also in the third trimester, a woman should consume at least 2,300 calories per day.
What vitamins should I take?
Due to the fact that in the third trimester the fetus needs more calcium to build bone mass, it is advisable to take it as a dietary supplement, in addition to vitamin D3.
There are a variety of vitamins intended specifically for pregnant women; your doctor will help you choose the best one.
Childbirth preparation courses
One of the important components of successful childbirth and comfortable motherhood is the information and physical preparation of a woman. Every antenatal clinic has courses for expectant mothers, where they will tell you the following:
- Stages of the birth process. Possible medical interventions are caesarean section, epidural anesthesia.
- How to relieve pain during childbirth using breathing, massage and comfortable birth positions.
- The first days of caring for your baby - basic hygiene and daily routine.
- Breastfeeding - how to establish breastfeeding and what options for assistance are available (pacifiers, specialized formulas).
Preparing to move to the maternity hospital
The main preparation is to collect things for the maternity hospital. Usually, the doctor can provide a ready-made list of items needed for mother and baby in the hospital. The standard things you will need are the following:
- Children's bodysuits (with short or long sleeves depending on the season), socks, hats, envelopes.
- Disposable diapers, wet wipes, anti-irritation cream, personal hygiene products.
- Baby bottles, pacifiers, specialized formulas if breastfeeding is not possible.
The main causes of dizziness during pregnancy
Main sources:
Transformation in the circulatory system. Pregnancy is accompanied by a redistribution of blood, as a result of which the uterus begins to be actively supplied with blood. In the first trimester, these mechanisms are not yet perfect, so the body’s needs are not fully met. Because of this, there is an unsatisfactory supply of oxygen to the brain.
Reduced blood glucose levels. Dizziness often occurs due to a lack of sugar supply to the brain. A decrease in glucose levels is provoked by breaks in meals or by eating too many carbohydrates, such as sweets and baked goods.
Very rapid changes in body position. Red blood cells are the most numerous type of human blood cell. They contain hemoglobin, which carries oxygen and carbon monoxide to other organs.
Expecting a baby is accompanied by an increase in blood volume and a lack of red blood cells. Hence the conclusion: insufficient oxygen supply.
But the reasons described above are not the only ones that serve as a source of dizziness.
Rotation of your own body and surrounding objects can also occur due to:
- toxicosis;
- psychosomatic diseases;
- osteochondrosis;
- hypotension;
- cardiovascular failure;
- disturbances in the functioning of the vestibular apparatus;
- damage to the inner ear;
- sclerotic changes.
In addition to medical indicators, women during their miraculous situation should also monitor external environmental factors that may be the causes of ailments.
- strong stuffiness;
- being outside in the heat;
- pungent odors;
- eaten dish.
Attention! Dizziness should not be ignored or attributed to pregnancy. But there is no need to panic either. You should sit or lie down with your head down so that blood is forced to flow to your head, which will improve your condition. And then be sure to consult a doctor.
