Pregnancy management: 2nd trimester

Why does nervousness increase during pregnancy?

During pregnancy, as mentioned above, the hormonal background of the expectant mother changes greatly. Hormonal changes occur in any organism in which a new life is born, so any woman in one way or another becomes vulnerable psychologically. During the period of bearing a baby, people around you, and especially relatives and friends, need to be very sensitive towards the woman.

Already at the moment of fertilization, the value of the hormone gonadotropin jumps sharply. Its indicator reaches its maximum at 7-10 weeks. Increased concentration greatly affects a woman’s physical condition and changes her psychological background, making her mood changeable. Many people feel nauseous and their taste preferences change.

Reference! The hormone progesterone has a great influence on the mood of the expectant mother. Its level fluctuates from low to high at high speed, which dramatically affects mood. An important role is played by estriol, a natural antioxidant produced throughout the entire period of gestation.

How does the fetus develop in the 2nd trimester of pregnancy?

The period from 13 to 28 weeks of pregnancy (fetal, fetal) is characterized by the fact that the active growth of the baby continues, whose internal organs are already partially formed. Following the nervous system, the endocrine system begins to develop: the thyroid gland, pituitary gland, adrenal glands. The fetus noticeably increases in size, so the woman’s tummy becomes rounded. If previously it was possible to notice the baby’s movements only on an ultrasound, now his movements and tremors become noticeable in everyday life.

Also, if in the 1st trimester of pregnancy a woman experienced toxicosis (nausea), then in the 2nd trimester the symptoms become less noticeable. The tone of the autonomic nervous system changes. At the same time, the expectant mother may notice mood swings: most often this manifests itself in drowsiness, tearfulness, dizziness and even headaches. In the 2nd trimester of pregnancy, the risk of miscarriage decreases. If all recommendations of specialists are followed, and there are no deviations, this is a relatively calm period of fetal development, so there is no need for a large number of examinations.

A weight gain of 300-400 grams per week is considered normal weight gain.

Due to the fact that a woman’s uterus continues to grow, her gait and posture change. Due to the increasing load, problems may arise with the veins of the lower extremities (varicose veins) and joints (symphysiopathy - separation of the pelvic bones). Due to changes in the functioning of the adrenal glands, brown pigment may appear on the areolas, linea alba, and facial skin.

How the fetus itself develops in the 2nd trimester of pregnancy (by week):

13th week of pregnancy

- the fetus develops a digestive system, and its own red blood cells appear in the blood. The baby begins to move more actively and can already make swallowing movements.

16th week of pregnancy

- approximately by the end of the 18th week, the organs of the reproductive system are formed in the fetus. Also at this stage, facial expressions develop and improve (the baby can already blink). The child's immune system is strengthened.

Week 19

- most often, the fetal growth already exceeds 25 cm. The cerebral cortex is formed. The slightest exposure to alcohol, nicotine or toxic substances can lead to a child's mental retardation and other irreversible consequences.

21st week

— the fetus’s respiratory system is already practically formed. Around the end of the 23rd week, the formation of the baby’s body is completely completed.

Week 24

- Doctors often talk about physiological arrhythmia of the fetus due to the fact that its heartbeat increases.

Week 28

- the fetus completes the formation of the organs of vision and hearing.

The baby’s growth and development may vary from mother to mother, so an obstetrician-gynecologist can best tell you about it at the stage of prenatal diagnosis, which includes ultrasound, biochemical screening, ECG and other studies.

Causes of increased irritability:

- in the 1st trimester

In the first trimester of pregnancy, women are the most whiny and irritable. This is due to a sharp jump in hormonal levels and adjusting it to the most acceptable one. Frequent predetermining factors of bad mood during this period include:

• Peculiarities of the woman's psyche. If the expectant mother, before the period of conception, had a tendency to unexpected changes in mood, then she will bring this state into her beginning pregnancy. The psyche of such young ladies is quite resistant to stress, therefore it is not so dangerous for emotional health in general.
• Previous bad pregnancy experience. If a woman has previously experienced miscarriage, then the stress received during this period automatically turns into a new pregnancy. In this case, coping with the emotional fear of loss becomes very difficult. A woman listens to her body every minute in order to avoid previous sensations.
• Unexpected pregnancy. If conception occurs unplanned, then upon learning about this, the woman experiences stress, either joy or panic. It’s good if the baby is long-awaited. In this case, the emotional background quickly returns to normal and the stress disappears. But if the child is unexpected, then a storm of emotions simply covers the confused mother. Here you need to quickly decide to accept the situation, otherwise you can cause irreparable harm to the child.
• The role of a strong personality. If a woman is accustomed to hard work and solving independent problems, then the understanding that she will have to wait a while causes her a slight psychological shock. To cope with emotions, you should get used to the idea of ​​motherhood and your feminine essence: softness and weakness.

- in the 2nd trimester

By mid-pregnancy, women tend to calm down a little. They are already fully aware of the role of the expectant mother and their psyche returns to normal. However, in the second trimester of pregnancy there are very frequent emotional breakdowns, which are accompanied by irritability on the part of the expectant mother.

Attention! A woman may begin to be offended by everyone around her. She is literally hurt to the core by the words of her colleagues that she is absent-minded or has put her coffee cup in the wrong place. Even if there was no reproach, the woman will still find a hint of resentment in the advice or hint.

Sounds and smells can suddenly begin to irritate, and even quiet noises cause great bewilderment, even to the point of hysteria. If in the second trimester a woman continues to be bothered by toxicosis, then irritability intensifies against this background. At the same time, vomiting can lead to a constant feeling of hunger, which mom tries to eat with something tasty and satisfying. In turn, an addiction to sweets and starchy foods significantly adds pounds to the scale, which also adversely affects a woman’s well-being and her emotional background.

- in the 3rd trimester

The third trimester is quite a difficult test for a woman. Her weight noticeably increases, and her stomach begins to pull down, it becomes difficult to stand on her feet for a long time, and she feels the urge to lie down more. It is precisely because of excess body weight and the enormous load on the legs that a woman experiences severe discomfort and leads to irritation.

Quite severe swelling is inevitable, especially in cases where a woman is forced to spend time at sedentary work, and there is no opportunity for physical exercise. At the same time, after work, a pregnant woman is burdened with household responsibilities (cleaning, cooking), which put emotional pressure on the psyche and provoke reasonable nervous breakdowns. It is important for men to support their loved one, help her with household chores, and even transfer some functions onto their shoulders.

An early meeting with the baby adds a note of apprehension to the mother’s mood: she is worried about the normal process of childbirth and the successful birth of the child. Every day, worries accumulate, and the closer the period of childbirth comes, the more stress and worries a mother has in her head.

Changes in the female body and possible pathologies

Mid-pregnancy is a period of relative physical well-being.
During the first trimester of gestation, the woman’s body has already adapted to new conditions, nausea and emotional stress rarely occur, and the pregnant woman feels a surge of strength and energy. However, even during this period, changes occur in the body that can cause discomfort and negatively affect health. These include:

1. Lack of calcium in the body. Calcium is used for the growth and development of the fetus. An insufficient level of this element can lead to fragility of tooth enamel, cause a decrease in immunity, cause inflammatory processes and metabolic disorders. To avoid such problems, it is important to enrich your diet with dairy products, legumes, cabbage, and seafood.
2. Enlargement of the mammary glands and increased sensitivity of the nipples. Such physiological changes are caused by hormonal changes and a rush of blood to the mammary glands. When the nipples come into contact with the surface of clothing, a woman may experience discomfort. The optimal solution in this situation is a supportive bra made of soft, natural and hypoallergenic material.
3. Abdominal enlargement. The most intense growth of the abdomen is observed from 15-16 weeks of gestation. This can lead to decreased physical activity and, as a result, rapid weight gain. Excess weight is dangerous during pregnancy: it disrupts metabolism, creates additional stress on the organs of the genitourinary system, and increases the likelihood of infections. In addition, obesity can cause the fetus to become too large, develop hypoglycemia (low blood glucose levels) and other complications. Therefore, it is very important during the 2nd trimester of gestation to lead an active lifestyle, eat rationally and weigh yourself regularly.
4. False contractions . They are “training” contractions of the uterus, which can cause discomfort in the lower abdomen. This is a normal phenomenon that should not worry a woman. During such contractions, the cervix does not open, and the unborn child is not in danger. On the contrary, false contractions increase blood circulation in the uterus, and the fetus receives more oxygen and nutrients through the placenta.

In the 2nd trimester of gestation, intense white vaginal discharge may be observed. As a rule, such discharge is not pathological and is caused by increased production of estrogen. To avoid the development of itching and other uncomfortable sensations, you need to use high-quality panty liners. The reason to contact a specialist is yellow, green, bloody discharge or secretion with an unpleasant odor.

Pathological discharge may indicate inflammatory diseases of the genital area. The mucous membrane of the genital tract during pregnancy is subject to hyperemia and loosening. This reduces its resistance to bacteria and increases the risk of developing infections. For example, every fifth pregnant woman develops bacterial vaginosis, which is accompanied by gray discharge, itching in the vaginal area and pain when urinating.

In addition, women during pregnancy are susceptible to the development of inflammatory processes in the urinary system, especially pyelonephritis. The growing uterus puts pressure on the ureters, which can lead to stagnation of urine in the kidneys. A favorable environment is created for the proliferation of bacteria and the development of pyelonephritis. Signs of the disease - sharp pain in the lower back and lower abdomen, blood in the urine, high fever, symptoms of intoxication (nausea, vomiting, diarrhea)

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During the consultation, you will be able to voice your problem, the doctor will clarify the situation, interpret the tests, answer your questions and give the necessary recommendations.

What to do if a pregnant woman is irritable?

With severe irritation, a woman’s mood changes, fussiness and panic appear, sleep is disturbed and tears appear in her eyes. It is urgent to deal with the symptoms that have overtaken mommy in order to avoid consequences. Experts recommend adhering to the following rules of conduct:

• Relax. You need to take a comfortable position and distract yourself from all thoughts. To do this, you can turn on an interesting film with a positive orientation, go for several sessions of a relaxing massage, take a walk in a nearby park or public garden, and turn on soothing music. You can simply take a warm shower or sit in a bath with your favorite scent of foam.
• Do what you love. This could be a trip to the store or beauty salon. Returning to your hobby can also be considered a useful activity. It is important to find something you like that will completely relax both body and soul, give you harmony and peace.
• Talk it out. It is very important for a woman to tell people around her about all her accumulated fears and assumptions, especially her partner. A man should listen carefully to his wife, without necessarily saying anything in response. It will be enough to nod or console the worried woman. This method works flawlessly. Not a single girl can resist the understanding and attentiveness of her chosen one.
• Try to remember the funniest and most exciting moments from your life. When there is no one to talk to, and melancholy simply fills everything inside, you need to try to take out from your memories the most amazing moments that can immediately correct the “plight.” Sometimes 10 minutes of this process is enough for mommy to calm down and all the functions of her body to return to normal.
• Protect yourself from negative information. Try to react as little as possible to the surrounding space. You cannot watch TV with sad news, or listen to sad music on the radio. It is best to sit in peace and quiet, it is better to turn on videos about animals, birds, small children.

Risks of the 2nd trimester of pregnancy

By the 2nd trimester of pregnancy (18-20 weeks), the placenta is already formed. This is the calm and most favorable stage of pregnancy, during which complications are observed relatively infrequently (for example, non-developing pregnancy). However, this does not mean that there is no need for a high-quality and careful medical examination.

Commentary from the head of the department of gynecology and obstetrics, doctor of the highest category, candidate of medical sciences.
Sciences Troitskaya Olga Georgievna :
“In the 2nd trimester of pregnancy there is a risk of premature delivery (spontaneous abortion). This may be due to premature shortening and dilation of the cervix - with isthmic-cervical insufficiency. The problem is identified precisely at this obstetric period, but prerequisites may arise in the 1st trimester of pregnancy.

Another problem is the presence of foci of chronic infections (infectious diseases), which may be significant for the fetus, including the reproductive system. If they are not detected and treated, signs of infection of the fertilized sac occur. This manifests itself in placental insufficiency, which affects the duration of pregnancy (as a result, birth may be premature) and, in general, the quality of the baby’s health.

Diabetes mellitus in the 2nd trimester of pregnancy can also debut completely unexpectedly. Therefore, at this stage, especially after the 24th week of pregnancy, we conduct a glucose tolerance test.”

In the second trimester of pregnancy, a woman may experience anemia due to the fact that a significant part of the iron is spent on the growth of the baby. The same applies to calcium; in this regard, the expectant mother may notice that the condition of her teeth has worsened. If necessary, the deficiency of certain nutrients that are important both for the mother and for the development of the baby is corrected together with the doctor.

During pregnancy, a variety of diseases can suddenly appear: ARVI, colds, thrush, hemorrhoids. It is important not to panic - the obstetrician-gynecologists of our clinic are always in touch and ready to help.