Pregnancy calendar: 24th week of pregnancy
Pregnancy calendar by week. An experienced doctor tells how a child develops in the womb and what changes occur in the pregnant woman’s body. All the most important things about the 24th week of pregnancy
Changes in your body (24th week of pregnancy):
Your uterus is similar in size to a soccer ball, which creates additional pressure on the organs of the pelvic cavity, in particular, on the bladder, due to which you go to the toilet more often; on large vessels that supply blood to the legs, and accordingly it provokes the development of varicose veins in women prone to it, or hemorrhoids. Lying on your side, exercises for the spine, for example: “cat”, can benefit you.
And, of course, don’t forget about swimming.
Tests to detect hidden diabetes (Screening for gestational diabetes or diabetes of pregnant women).
Unfortunately, during pregnancy, such a disease as gestational diabetes, or another name – gestational diabetes, is sometimes detected for the first time. Diabetes mellitus is a disease manifested by a violation of the body’s absorption of sugar (glucose).
Glucose is necessary for the vital activity of any cell of the body, and especially during the growth and development of a new organism inside the uterus. In order for glucose to enter the cell, insulin is needed – a special hormone produced by the pancreas of the human body. Insulin is sometimes compared to a key that brings glucose into the cell. If insulin is ineffective, or there is not enough of it, or the receptors (areas of the cell to which insulin attaches) are insensitive, this condition leads to a violation of the absorption of the necessary glucose or, so-called, a violation of glucose tolerance.
Why is gestational diabetes called hidden? The reason for this is that the baby’s body, namely his pancreas, begins to produce the necessary insulin for two. Children’s insulin replaces, compensates for the lack of effective maternal insulin, and therefore there may not be outwardly characteristic signs of diabetes, namely: unrestrained appetite, thirst and increased urination. However, even compensated diabetes without characteristic symptoms is a serious condition that requires increased attention during pregnancy and childbirth. This is precisely why all pregnant women from 24 to 28 weeks of pregnancy undergo a 2-hour oral glucose tolerance test (ORG).
If a woman has one or more risk factors for gestational diabetes, an oral glucose tolerance test is performed immediately after the first visit to an obstetrician-gynecologist regarding pregnancy. In case of a negative result of the glucose tolerance test, it is repeated at the usual time of 24-28 weeks of pregnancy.
Risk factors for gestational diabetes:
- diabetes in close relatives (father, mother, brothers or sisters).
- obesity (body mass index greater than 28).
- gestational diabetes during the previous pregnancy(s).
- large birth weight of the previous child (macrosomia) (newborn weight over 4000 g).
- cases of stillbirth.
How is the test for latent diabetes (2-hour oral glucose tolerance test (OPTG)) performed?
Preparation for the test:
- The test can be carried out only in the absence of acute diseases, injuries or surgical interventions.
- The test is performed later (after an 8-hour abstinence from food) in the morning.
- You can buy 75 g of glucose at the pharmacy. Also, take a fresh lemon with you, the juice of which can be added to a sweet solution of 75 g of glucose.
Conducting the test:
- Проводиться забір крові з вени натще. Лабораторія визначає рівень глюкози в плазмі венозної крові.
- Після забору крові натще вагітній дають випити упродовж 3-5 хвилин 75 г глюкози, яку розчинено у 300 мл води (можна додати сік свіжого лимона).
- Впродовж наступних 2 години вагітна має перебувати у стані спокою, їй дозволяють пити негазовану воду, не дозволяють їсти і палити.
- Через 2 години проводять повторний забір венозної крові, в якій визначають рівень глюкози (глікемії).
The value of the glucose level in the venous blood plasma (glycemia) during the glucose tolerance test should be:
- fasting less than or equal to 5.1 mmol/l,
- 2 hours after the glucose load <8.5 mmol/l
- The test is considered positive if fasting and/or post-exercise glycemia exceeds the normative values (respectively >5.1 mmol/l and greater than or equal to 8.5 mmol/l).
- In case of a positive PTTG result, it should be repeated the next day.
- If a positive result is confirmed, the diagnosis of gestational diabetes is considered established, and the pregnant woman is followed up by an obstetrician-gynecologist and an endocrinologist.
How does the baby grow?
Your baby is about 31 cm long from head to toe, and can weigh 600 – 750 g. It can be compared to the beginning of corn.
The twenty-fourth week of pregnancy is quite decisive, since the respiratory system, namely the child’s lungs, has developed so much that the child has a chance to survive outside the womb with modern care. Cells in the lungs begin to synthesize surfactant – a substance that helps the lung sacs (alveoli) to open and not collapse. Training of the respiratory system inside the uterus occurs due to the “inhalation” and “exhalation” of amniotic fluid. It must be recognized that different literature gives different levels of survival of children from 36% to 50%. Of course, everything depends on many conditions, but it’s nice to know that there are chances.
Author: Olga Letnyanchyk, doctor