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Week 24
MDAdvice.com Home > Health Library > Your Pregnancy: Week by Week > Previous Week > Contents > Next Week

How Big Is Your Baby?

By this week, your baby weighs about 1.2 pounds (540g). Its crown-to-rump length is about 8.4 inches (21cm).

How Big Are You?

Your uterus is now about 1.5 to 2 inches (3.8 to 5.1cm) above the bellybutton. It measures almost 10 inches (24cm) above the pubic symphysis.

How Your Baby Is Growing and Developing

Your baby is filling out. Its face and body look more like that of an infant at the time of birth. Although it weighs a little over 1 pound at this point, it is still very small.

Role of the Amniotic Sac and Amniotic Fluid

By about the 12th day after fertilization, there is an early beginning of the amniotic sac, where the fetus grows and develops during pregnancy. The baby rests inside the amniotic sac in the amniotic fluid. See the illustration on page 203. Amniotic fluid has several important functions.

ò It provides an environment in which the baby can move easily.

ò It cushions the fetus against injury.

ò Amniotic fluid regulates temperature for the baby.

ò It provides a way of assessing the health and maturity

of the baby.

Amniotic fluid increases rapidly, from an average volume of 1.5 ounces (50ml) by 12 weeks of pregnancy to 12 ounces (400ml) at midpregnancy. Following the 24th week of pregnancy, the volume of amniotic fluid continues to increase as your due date approaches. There is a maximum of about 2 pints (1 liter) of fluid at 36 to 38 weeks gestation.

Composition of amniotic fluid changes during pregnancy. During the first half of pregnancy, amniotic fluid is similar to maternal plasma (the fluid in blood without blood cells), except it has a much lower protein content.

Amniotic fluid contains old fetal blood cells, lanugo hair and vernix. As pregnancy advances, fetal urine makes an increasingly important contribution to the amount of amniotic fluid present.

The fetus swallows amniotic fluid during much of pregnancy. If it can't swallow amniotic fluid, you will develop a condition of excess amniotic fluid, called hydramnios or polyhydramnios. If the fetus swallows but urination does not occur (for example, if the baby lacks kidneys), the volume of amniotic fluid surrounding the fetus may be very small. This is called oligohydramnios.

Amniotic fluid is important. It provides the baby space to move and allows it to grow. If there is an inadequate amount of amniotic fluid, the baby usually shows decreased growth.

Changes in You

An Incompetent Cervix

This term is applied to the painless, premature dilatation of the cervix, which usually results in delivery of a premature baby. It can be an important problem during pregnancy.

Dilatation or stretching of the cervix goes unnoticed by the woman until the baby is delivering; it often occurs without warning. Diagnosis is usually made after one or more deliveries of a premature infant without any pain before delivery.

The cause of cervical incompetence is usually unknown. Some medical researchers believe it occurs because of previous trauma to the cervix, such as dilatation and curettage (D&C) for an abortion or a miscarriage. It may also occur after cervical surgeries.

Usually the cervix doesn't dilate like this before the 16th week of pregnancy. Before this time, the products of conception are not large enough to cause the cervix to dilate and to thin out.

A pregnancy that is lost from an incompetent cervix is completely different from a miscarriage. A miscarriage during the first trimester is common. Incompetent cervix is a relatively rare complication early in pregnancy.

Treatment for an incompetent cervix is usually surgical. The weak cervix is reinforced with a suture that sews the cervix shut.

If this is your first pregnancy, there is no way you can know whether you have an incompetent cervix. If you have had problems in the past or have had premature deliveries and have been told you might have an incompetent cervix, share this important information with your doctor.

How Your Actions Affect Your Baby's Development

Eating Out during Pregnancy

Many pregnant women share a common concern related to eating out. Trish called my office because she wanted to know if she should avoid certain types of food, such as Mexican, Vietnamese, Thai or Greek food, when dining out. She was concerned that spicy foods could be harmful to her baby or her pregnancy.

I told her it's OK to eat out, but she might find certain foods wouldn't agree with her. And of course, if you don't do well eating certain foods anyway, it doesn't make a lot of sense to go out and eat those foods frequently during pregnancy.

The best types of food to eat at restaurants are those you tolerate well at home. Fish, fresh vegetables and salads are usually good choices. Restaurants that feature spicy foods or unusual cuisine may cause you distress. You may even notice an increase in weight from water retention after visiting these restaurants.

During pregnancy, avoid restaurants that serve highly salted foods, foods high in sodium or foods loaded with calories and fat, such as gravies, fried foods, junk food and rich desserts. It is difficult to control your calorie intake at specialty restaurants.

You Should also Know

When You Feel "Under the Weather"

It's possible you could have diarrhea during pregnancy as well as viral infections, such as the flu. These problems can raise concerns for you.

ò What can I do when I feel ill?

ò What medication or treatment is acceptable?

ò If I'm sick, should I take my prenatal vitamins?

ò If I'm sick and unable to eat my usual diet, what should I do?

If you become sick during pregnancy, don't hesitate to call your doctor's office. Get your doctor's advice about a plan of action. He or she will be able to advise you about what medications you may be able to take to help you feel better. Even if it's only a cold or the flu, your doctor wants to know you're feeling ill. If any further measures are needed, your doctor will recommend them.

Is there anything you can do to help yourself? Yes, there is. If you have diarrhea or a possible viral infection, increase your fluid intake. Drink a lot of water, juice and other clear fluids, such as broth. You may find a bland diet without solid food helps you feel a little better.

Going off your regular diet for a few days won't be harmful to you or your baby, but you do need to drink plenty of fluids. Solid foods may be difficult for you to handle and can make diarrhea a bigger problem. Milk products may also make diarrhea worse.

If diarrhea continues beyond 24 hours, call your doctor. Ask which medications you can take for diarrhea during pregnancy.

Don't take any medication without consulting your doctor first. Usually a viral illness with diarrhea is a short-term problem and won't last more than a few days. You may have to stay home from work or rest in bed until you feel better.

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From Your Pregnancy Week by Week by Glade B. Curtis, M.D., OB/GYN. Copyright by Fisher Books. Electronic rights by Medical Data Exchange.

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