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Week 25
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How Big Is Your Baby?

Your baby now weighs about 1.5 pounds (700g), and crown-to-rump length is about 8.8 inches (22cm). These are average lengths and weights and vary from one baby to another and from one pregnancy to another.

How Big Are You?

Look at the illustration on page 209. By this week of pregnancy, your uterus has grown quite a bit. When you look at a side view, you're obviously getting bigger.

The measurement from the pubic symphysis to the top of your uterus is about 10 inches (25cm). If you saw your doctor when you were 20 or 21 weeks pregnant, you have probably grown about 1.5 inches (4cm). At this point, your uterus is about the size of a soccer ball.

The top of the uterus is about halfway between your bellybutton and the lower part of your sternum. (The sternum is the bone between your breasts where the ribs come together.)

How Your Baby Is Growing and Developing

Survival of a Premature Baby

It may be hard to believe, but if your baby were delivered at this time, it would have a chance of surviving. Some of the greatest advances in medicine have been in the care of the premature baby. No one wants a baby to deliver this early, but with new treatment methods, such as ventilators, monitors and medication, a baby does have a chance of living.

The baby weighs less than 2 pounds and is extremely small. Survival is very difficult for an infant delivered this early. The baby would probably spend several months in the hospital, with risks of infection and other possible complications.

Is It a Boy? Is It a Girl?

One of the most common questions I'm asked is, ôWhat is the sex of my baby?ö Amniocentesis can reveal the sex of the baby by chromosome study. Ultrasound examination can also be used to determine the sex of the baby, but it may be inaccurate. Don't get your heart set on a particular sex if ultrasound is used.

Tammy wanted to know if I could tell her what sex her baby was. Without ordering certain tests, I told her I couldn't predict the sex of her baby. To me, not knowing is part of the fun of having a baby.

Some people believe a baby's heartbeat rate can indicate its sex. A normal heart rate for a baby ranges from 120 to 160 beats a minute. Some believe a fast heartbeat indicates a girl, and a slower heartbeat indicates a boy. Unfortunately, there is no scientific proof of this. Don't pressure your doctor to guess based on this method because it is only a guess.

A more reliable source might be a mother, mother-in-law or someone who can look at you and tell by how you're carrying the baby if it is a boy or girl. Although I make this statement with my tongue placed firmly in my cheek, many people believe it's true. Some people claim they're never wrong about guessing or predicting the sex of a baby before birth. Again, there is no scientific basis for this.

Your doctor is more concerned about your health and well-being and that of your baby. He or she will concentrate on making sure you and your baby, whether it's a boy or girl, are progressing through pregnancy safely and that you both get through pregnancy, labor and delivery in good health.

Changes in You

Your Growing Abdomen

Beginning around week 20 or 21, your doctor began measuring you. You will be measured at every visit from now until delivery. In addition to your uterus growing upward from your bellybutton, you may notice you are also getting bigger on the sides of your abdomen.

Your doctor does not measure you around your waist or around your sides. Many women carry their pregnancies on their sides or low in their abdomen. The appearance or the size of your abdomen may make you look different than a pregnant friend. Don't be concerned; it's just a normal variation from one woman to another.

Thyroid Disease

Thyroid problems and thyroid disease can affect your pregnancy. Thyroid hormone is made in the thyroid gland; this hormone affects your entire body. It is very important in your metabolism.

Thyroid-hormone levels may be high or low. High levels of thyroid cause a condition called hyperthyroidism; low levels cause hypothyroidism. Women who have a history of miscarriage or premature delivery or who have problems around the time of delivery may have problems with their thyroid-hormone levels.

Symptoms of thyroid disease may be hidden by pregnancy. Or you may notice changes during pregnancy that cause you and your doctor to suspect the thyroid is not functioning properly. These changes could include an enlarged thyroid, changes in your pulse, redness of the palms and warm, moist palms. Because thyroid-hormone levels can change during pregnancy (because of pregnancy), your doctor must be careful interpreting lab results about this hormone while you're pregnant.

The thyroid is tested primarily by blood tests (a thyroid panel), which measure the amount of thyroid hormone produced. The tests also measure levels of another hormone, thyroid stimulating hormone (TSH), made at the base of the brain. Another test, an X-ray study of the thyroid (radioactive iodine scan), should not be done during pregnancy.

If you have hypothyroidism, thyroid replacement (thyroxin) is prescribed. It is believed to be safe during pregnancy. Your doctor may check the level during pregnancy with a blood test to make sure you are receiving enough of the hormone.

If you have hyperthyroidism, the medication propylthiouracil is used for treatment. It does pass through the placenta to the baby. Your doctor will prescribe the lowest possible amount to reduce risk to your baby. Blood testing during pregnancy is necessary to monitor the amount of medication needed. Iodide is another medication used for hyperthyroidism. Avoid iodide during pregnancy because of harmful effects to a developing baby.

After delivery, it's important to test the baby and to watch for signs of thyroid problems related to the medications prescribed during pregnancy. If you have a past history of problems with your thyroid, if you are now taking medication or if you have taken medication in the past for your thyroid, tell your doctor. Discuss treatment during pregnancy.

How Your Actions Affect Your Baby's Development

Treating Broken Bones

Sometimes a fall or accident causes a broken bone, which may require X-rays and surgery. Treatment cannot be delayed until after pregnancy; the problem must be dealt with immediately. If you find yourself in such a situation, insist your OB/GYN be contacted before any test or treatment is done.

If X-rays are required, your pelvis and abdomen must be shielded. If they cannot be shielded, the need for the X-ray must be weighed against the risks it poses to the baby.

Anesthesia or pain medications may be necessary with a simple break that requires setting or pinning. It is best for you and the baby to avoid general anesthesia if possible. Pain medication may be needed for pain relief, but its use should be kept to a minimum.

If general anesthesia is required to repair a break, the baby should be monitored closely. You may not have a lot of choice in the matter. Your surgeon and OB/GYN will work together to provide the best care for you and your baby.

Systemic Lupus Erythematosus (SLE)

Some women have conditions before pregnancy that require medication for the rest of their lives. They are often concerned about the effects medication may have on their developing babies. One such condition is systemic lupus erythematosus (SLE).

Many young women have lupus and take steroids to control the problem. They want to know if medication they take can harm their baby. Should they continue to take steroids during pregnancy?

Lupus is a disease of unknown cause that occurs most often in young or middle-aged women. (Women have lupus much more frequently than menùabout nine women to every man.) Those who have lupus have a large number of antibodies in their bloodstream. These antibodies are directed toward the woman's own tissues, which causes problems.

The diagnosis of SLE is made through blood tests, which look for the suspect antibodies. Blood tests done for lupus are a lupus antibody test and/or an antinuclear antibody test.

Antibodies can be directed to various organs in the body and may actually damage them. Affected organs include joints, skin, kidneys, muscles, lungs, the brain and the central nervous system. The most common symptom of lupus is joint pain, which is often mistaken for arthritis. Other symptoms include lesions, rashes or sores on the skin, fever and hypertension.

We don't have a cure for lupus. Systemic lupus erythematosus is generally unaffected by pregnancy. However, miscarriage, premature delivery and complications around the time of delivery are slightly increased in a woman with lupus. If kidneys were involved and there was kidney damage during the flareups, you must be on the lookout for kidney problems during pregnancy.

Steroids, short for corticosteroids, are generally prescribed to treat lupus. The primary medication used is prednisone. It is usually prescribed on a daily basis. It may be unnecessary to take prednisone every day, unless complications from lupus occur during pregnancy.

The many studies that have been done on the safety of prednisone during pregnancy have found it to be safe. If you are taking prednisone when you become pregnant, don't stop. It's important to talk to your doctor early if you have lupus or if you have been treated for the problem in the past.

Other medications are used when a woman is not pregnant. These include many anti-inflammatory medications, such as aspirin. It is best to avoid anti-inflammatory medications during pregnancy.

You Should also Know

Sugar in Your Urine

It is common for normal, pregnant, nondiabetic women to have a small amount of sugar in their urine. This occurs because of changes in sugar levels and how sugar is handled in the kidneys, which control the amount of sugar in your system. If excess sugar is present, you will lose it through the urine. Sugar in the urine is called glucosuria. It is common during pregnancy, particularly in the second and third trimesters.

Many doctors test every pregnant woman for diabetes, usually around the end of the second trimester. Testing is particularly important if there is a family history of diabetes. Blood tests used to diagnose diabetes are a fasting blood sugar and a glucose-tolerance test (GTT).

For a fasting-blood-sugar test, you eat the evening before the test. In the morning, before eating anything, you go to the lab and have the blood test done. A normal result indicates that diabetes is unlikely. An abnormal result is a high level of sugar in the blood, which needs further study.

Further study involves taking the glucose-tolerance test. You have to fast the night before this test. In the morning at the lab, you are given a solution to drink that has a measured amount of sugar in it. It is similar to a bottle of soda pop but doesn't taste as good.

Before you drink the sugar solution, a fasting-blood-sugar test is done. After you drink the solution, blood is drawn at predetermined intervals; usually at 30 minutes, 1 hour and 2 hours and sometimes even 3 hours. Drawing the blood at intervals gives an indication of how your body handles sugar.

If you need treatment, your doctor will devise a plan for you.

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