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Week 35
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How Big Is Your Baby?

Your baby now weighs over 5.5 pounds (2550g). Crown-to-rump length by this week of pregnancy is about 13.2 inches (33cm). Its total length is 20.25 inches (45cm).

How Big Are You?

Measuring from the bellybutton, it is now about 6 inches (15cm) to the top of the uterus. Measuring from the pubic symphysis, the distance is about 14 inches (35cm).

By this week, your weight gain should be between 24 and 29 pounds (10.8 and 13kg).

How Your Baby Is Growing and Developing

What Is Placenta Previa?

With placenta previa, the placenta lies close to the cervix or covers the cervix. The illustration on page 293 shows placenta previa.

Placenta previa is serious because of the chance of heavy bleeding. Bleeding may occur during pregnancy or during labor. This problem is not common; it happens about once in every 170 pregnancies.

The cause of placenta previa is not completely known. Risk factors for an increased chance of placenta previa include previous Cesarean delivery, many pregnancies and increased maternal age.

Symptoms of Placenta Previa

The most characteristic symptom of placenta previa is painless bleeding without any contractions of the uterus. This doesn't usually occur until close to the end of your second trimester or later when the cervix thins out, stretches and tears the placenta loose.

Bleeding with placenta previa may occur without warning and may be extremely heavy. It occurs when the cervix begins to dilate with early labor, and blood escapes.

Placenta previa should be suspected when a woman experiences vaginal bleeding during the latter half of pregnancy. The problem cannot be diagnosed with a physical exam because a pelvic examination may cause heavier bleeding. Doctors use ultrasound to identify placenta previa. Ultrasound is particularly accurate in the second half of pregnancy as the uterus and placenta get bigger.

If you know you have placenta previa, your doctor may tell you not to have a pelvic exam. This is important to remember if you see another doctor or when you go to the hospital.

The baby is more likely to be in a breech position with placenta previa. For this reason, and to control bleeding, a Cesarean delivery is almost always performed. Cesarean delivery with placenta previa offers the doctor the advantage of delivering the baby, then removing the placenta so the uterus can contract. Bleeding can be kept to a minimum.

Changes in You

Emotional Changes in Late Pregnancy

As you reach the last trimester and come closer to delivery, you and your partner may become more anxious about the events to come. You may even have more mood swings, which seem to occur for no reason. Many women and their partners report a woman may become more irritable, which can place a significant strain on a relationship.

You may be concerned about insignificant or unimportant things. Your concern about the health and well-being of the baby may also increase during the last weeks of your pregnancy. This can include concern about how well you tolerate labor and how you will get through delivery. You may be concerned about whether you'll be a good mother or be able to raise a baby properly.

While these emotions rage inside you, you'll notice you're getting bigger and aren't able to do things you used to do. You may feel more uncomfortable, and you may not be sleeping well. These things can work together to make your emotions swing wildly from highs to lows.

How Can You Deal with These Changes?

Changes are normal; don't feel as though you're the ôLone Ranger.ö Other pregnant women and their partners have the same concerns.

Talk with your partner about your concerns. Tell him how you feel and what's going on. You may be surprised to find out the concerns your partner has about you, the baby and his role during labor and delivery. By talking about these things, your partner may find it easier to understand what you're experiencing, including mood swings and crying spells.

Discuss emotional problems with your doctor. He or she may be able to reassure you that what you're going through is normal. Take advantage of prenatal classes and information available about pregnancy and delivery.

Emotional changes can occur, so be ready for them. Ask your partner, the nurse in the doctor's office and your doctor to help you understand what is normal and what can be done about mood swings.

How Your Actions Affect Your Baby's Development

Can Your Baby Get Tangled in the Cord?

You may have been told by friends not to raise your arms over your head or reach high to get things because it can cause the cord to wrap around the baby's neck. There doesn't seem to be any truth to this theory.

Some babies do get tangled in their umbilical cord and can get the cord tied in a knot or wrapped around their neck. However, nothing you do during pregnancy causes or prevents this from happening.

A tangled umbilical cord isn't necessarily a problem during labor. It only becomes a problem if the cord is stretched tight around the baby's neck or is in a knot. (Also see Week 30.)

Will Working at a Computer Terminal Hurt Your Baby?

Lots of my patients are concerned about working in front of a computer screen (at a computer terminal). Currently nothing suggests that working at a computer terminal is likely to harm your unborn baby.

If you work at a computer terminal (or at a typewriter), you probably should be concerned about the way you sit and how long you sit. Sit in a chair that offers good support for your back and legs. Don't slouch or cross your legs when sitting. Be sure to get up and walk around at least once every 15 minutesůyou need to keep good circulation in your legs.

You Should also Know

Fetal Monitoring before Labor Begins

The biophysical profile (discussed in Week 34) evaluates the well-being of your baby inside your uterus. One part of the biophysical profile is fetal monitoring, commonly called a nonstress test.

A nonstress test is performed in your doctor's office or in the labor and delivery department of a hospital. While you are lying down, a technician attaches a fetal monitor to your abdomen. Every time your baby moves, you push a button to make a mark on a strip of monitor paper. At the same time, the monitor records the baby's heartbeat.

When the baby moves, its heart rate usually goes up. Doctors use the findings from fetal monitors to help them evaluate how well a baby is tolerating life inside the uterus. Your doctor will decide if further action is necessary.

Getting Ready for the Birth

At this point, you may be feeling a little nervous about the birth. You might be afraid you won't know when it's time to call the doctor or go to the hospital. Don't hesitate to talk to your doctor about it at one of your visits. He or she will tell you what signs to watch for. Prenatal classes teach you the signs of labor and when you should call your doctor or go to the hospital.

Ask your doctor what the signs of labor contractions are. Labor contractions are usually regular. They increase in duration and strength over time. You'll notice a regular rhythm to real labor contractions. You'll want to time them so you know how frequently they occur and how long they last. (See Week 33.) When you go to the hospital depends in part on your contractions.

Your bag of waters may rupture before you go into labor. In most cases, you'll notice this as a gush of water followed by a steady leaking. (See Week 33.)

During the last few weeks of pregnancy, have your suitcase packed and ready to go. That way, you'll have the things you wanted with you in the hospital ready to go.

If you can, tour the hospital facilities a few weeks ahead of your scheduled due date. Find out where to go and what to do when you get there.

Talk with your partner about the best ways to reach him if you think you've gone into labor. You might have him check with

you periodically. It's common for a partner to wear a pager if he is often away from a phone, especially during the last few weeks of pregnancy.

Ask your doctor what you should do if you think you're in labor. Is it best to call the office? Should you go directly to the hospital? Should you call the answering service?

By knowing what to do, and when, you'll be able to relax a little and not worry about the beginning of labor and delivery.

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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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