Whether the belly is 4 months pregnant. Feelings of a woman in the fourth month of pregnancy, the size of the abdomen and the development of the fetus, possible complications. Why the belly does not grow during pregnancy

13 (15) weeks

The child has a thin, transparent skin, through which myriads of blood vessels are visible. Hair on the head continues to grow, eyebrows thicken. If a child is destined to be dark-haired, his follicles will begin to produce a special pigment. The child becomes very mobile and flexible. The handles are bent at the elbows and wrists, he is able to clench his palms into fists. The formation of the skeleton and bone marrow continues.
Through the transparent skin on the forehead, you can see the smallest network of blood vessels. Previously, the yolk sac was the blood factory for these vessels: now it has dried up, and the fetal bone marrow has taken over this function.
Fruit length and weight
The length from the crown to the sacrum is 93-103 mm.
Weight - about 70 g.
The baby grows and gains weight very quickly, so that the fetal bladder does not keep up with its development in the same proportions. The first hairs begin to grow on his head.
His organs, muscles, tissues and bones are developing. His heart is beating faster. The skin is still very thin, so the future baby looks more red than pink.
It floats in a 100 ml IAF (Amniotic Fluid Index) table of norms, which is fully updated every 3 hours.
He easily moves in this “warm bath” (about 37°C), which has the same density as his body, and floats as if in weightlessness. Amniotic fluid is not just "pool water":
* it does not allow the unborn child to come into contact with the walls of the uterus;
* it protects his organs (all together) and tissues from concussions and blows to which the maternal abdomen may be subjected and which may be transmitted to it, as well as from the pressure of the uterine muscles;
* she models his body with the help of undulating movements of the type of inflow and outflow;
* she massages his body, preventing the blood from stagnating in his limbs;
* it regulates the temperature and protects it from external influences;
* it provides respiratory, after his chest begins to "breathe";
* in it, the fetus actively moves, developing its joints; without these movements, it would be doomed to stiffness or immobility of the joints and even deformation of the bones.
Psychologists agree that the fetus, floating in the uterus in the amniotic fluid, experiences very pleasant sensations, and the memory of this period remains with a person forever.

You yourself
The placenta at the moment has a semicircular shape.
Very often it is attached next to the cervix, and it happens that it covers it. At this stage, there is nothing to worry about, the placenta will move and clear the way for the baby ... in 5 months.
Looking in the mirror, you may notice a dark line stretching in the middle of the abdomen from the navel to the pubis. These are deposits of a pigment called "melanin", after childbirth this line will disappear without a trace.

14(16) weeks.

Eyebrows and eyelashes appear. The body and face are covered with a gentle fluff (lanugo).
The baby's skin is so thin that a network of blood vessels can be seen through it.
The joints of the arms and legs were formed, hardening of the bones began.
By the genitals it is already possible to recognize the sex, although this is not always possible with ultrasound.
The chest makes breathing movements.
He can already suck his thumb.
He moves a lot, but you probably don't feel it yet.
Your heart beats twice as fast as yours. After the 14th week, a doctor or nurse can listen to it with a special stethoscope.
This month, the fetus is growing rapidly.
Its legs lengthen and become longer than the handles, which have also grown to such an extent that the brushes touch each other.
He uses the new possibilities of his body to work out swallowing and sucking movements, puts his fingers and toes in his mouth.
He trains in this way to suck and swallow without choking. These skills will be useful to him immediately after birth, when his mother will attach him to her breast.
The grasp reflex is manifested in the fact that it grasps everything that is within reach: the other arm, leg, umbilical cord. As for the latter, you don’t have to worry about it: the umbilical veins and arteries are surrounded by a strong mucous membrane that protects them from possible damage from the unborn child.
The umbilical cord is very strong and can withstand a weight of 5 to 6 kg! At the same time, it is very flexible and adapted to all the research manipulations of the unborn child. Nature made it so that the place where the cord is attached to the fetal abdomen is covered with a few millimeters of denser skin: this is his future navel. And finally, to allow the child to move freely in the amniotic fluid, this elastic cord lengthens every month and reaches 40-50 cm in length with a thickness of about 2 cm in diameter.
Nerve cells (neurons) began to form as early as the 5th week, and now their production is in full swing. Every second, 5,000 neurons are formed! By the end of the 6th month, with a doubling of efforts, there will be one hundred billion!
The head is disproportionately large compared to the body.
The baby has a neck.
The fingers already have their own unique skin pattern.
The nails are already fully formed, they are very long and sharp.
The baby empties his bladder every 40-45 minutes.
Important news - with the help of ultrasound you can find out the sex of your child!
Fruit length and weight:
length: 16 cm;
weight: 85 g.

15(17) weeks
The fetus develops rapidly, the placenta does not lag behind. If in the first weeks it is a thin shell with choral villi, then by the end of the period it is already a dense (about 2.5 cm thick) mass, weighing 480 g. At the 17th week, the placenta is already fully formed, with a dense network of blood vessels, through which nutrients are supplied and waste products are discarded. This week, the so-called "brown fat", a special type of adipose tissue, is deposited, which is vital for the body's heat exchange.
During this period, the entire body of the embryo is covered with a delicate fluff - lanugo, which repeats the microscopic pattern of the skin, the only one of its kind in every person. The skin of the embryo is still thin, without subcutaneous fat. But the subcutaneous fat layer is already beginning to accumulate in the baby. He will help him maintain normal temperature body after birth. The baby now weighs more than the placenta. No new structures and bodies have been formed. Loud noises outside the uterus surprise the baby.
The brain is fully developed, the fetus can make sucking, swallowing movements with irregular breathing movements, feel pain. Intrauterine "respiration" cannot be compared with extrauterine respiration. During respiratory excursions, the lungs of the fetus do not expand, and the glottis is in a semi-closed state. These respiratory movements are very important - they contribute to the flow of blood to the fetal heart, the entry of amniotic fluid into tracheobronchial tree and lungs of the fetus, which is one of the important mechanisms for the exchange of amniotic fluid
The skin of the fetus is almost transparent. In most bones, the first ossification nuclei appear. Eyebrows and eyelashes appear. The fetus makes active movements, including kicks and even somersaults.
The gestational age of 16 weeks is the optimal time for ultrasound to exclude possible heart pathology.
Fruit length and weight
Length from crown to sacrum - 15-17 cm.
Weight - about 142 g.

16(18) weeks
Your child in the womb is already beginning to perceive the outside world and makes itself felt by pushing in your stomach with a foot. The child even hears you: the auditory ossicles, through which sound passes to the middle ear, have already grown stronger, and the part of the brain responsible for receiving auditory signals is working. The child is not afraid of neither the noise of the blood flow through the umbilical cord, nor the beating of your heart: but loud sounds frighten him. Gradually becomes sensitive and the retina. At this stage, while there is still "free space" in the uterus, the embryo is very active, often changing position. He can either cross his legs, then lean back, sucking his thumb on his hand, or even do somersaults!
Although it seems to you that your child is sleeping, in fact he is responding to everything that happens outside. For example, if you expose your bare belly to the bright rays of the summer sun, your child will see a soft pink glow...
From this week, start talking to your child, sing songs to him - he listens to you attentively!
Fruit length and weight
Length from crown to sacrum - 20.5 cm.
Weight - about 198-200 g.
16 (18) week
As soon as he opens his mouth, he swallows some amniotic fluid. In this, he is helped by the lungs, performing pseudo-respiratory movements (at this period they do not function, since during the “aquatic” life there is no need for this). As a result of these movements, fluid enters and is expelled through the mouth. These movements of fluid due to the lack of air for inhalation and exhalation play a huge role in the growth and development of the structure of the lungs.
Part of the amniotic fluid is ejected through the mouth, part is swallowed and filtered by the kidneys, and then returned to the amniotic cavity in the form of urine. Amniotic fluid that enters the digestive tract contributes to the development digestive system fetus. Thanks to this preparatory stage, the gastrointestinal tract of a newly born baby is able to absorb colostrum and then milk.
The bone marrow was formed during the third month of pregnancy, soon after the replacement of cartilage with bone tissue began. Now he has the structure that will remain until the moment of birth. The bone marrow provides the formation of erythrocytes and leukocytes.
In parallel, at the end of organogenesis, a thymus (thymus, or goiter) gland appears at the base of the neck. This gland produces its own lymphocytes and "teaches" them to recognize and destroy the aggressor.
By the time of birth, blood cells will be produced only by the bone marrow and thymus, the liver will soon “leave the game”.
You yourself
The uterus reaches the level of the navel (about 16 cm in height). It resembles a coconut - a more harmonious form, which is conveniently located on the pelvic floor in its entirety, is impossible to imagine.
The tummy can no longer be hidden.
In order to continue to properly supply the unborn child with oxygen and essential nutrients, the blood must receive more air from the lungs than at normal times. For this reason, your breathing becomes faster. When these efforts deplete your supply of oxygen, you experience shortness of breath.
This week you can feel your baby's first movements! This is most likely if you are not expecting your first child or have a thin physique.
in the fourth month of intrauterine life, the body length of the fetus reaches 14 cm, and the weight is 200 grams (this is a significant jump compared to 40-45 grams, which he gains by the end of the third month!). Such fast growth associated primarily with the intensive development of the skeleton, as well as a significant development of organs abdominal cavity.
Judge for yourself: in the fourth month of intrauterine life, the body length of the fetus reaches 14 cm, and the weight is 200 grams (this is a significant jump compared to 40-45 grams, which he gains by the end of the third month!). Such rapid growth is associated primarily with the intensive development of the skeleton, as well as the significant development of the abdominal organs.
During this period, all organs and systems of the fetus, which previously performed temporary duties, acquire their main “specialties”. For example, the liver, which for all the previous months was the organ of hematopoiesis, is now becoming the organ of the digestive system. And hematopoietic functions are taken over by the red bone marrow. It is gaining strength more and more, and almost all cells can be found in the blood of the fetus during this period: erythrocytes, lymphocytes, leukocytes ... And although there are still a lot of immature ones among them, nevertheless, the blood type, as well as the Rh factor, can already be determined.
If a woman has Rh-negative blood, and the fetus is Rh-positive, a serious immunological conflict can develop. After all, fetal red blood cells containing Rh-positive protein begin to enter the mother's bloodstream. For her body, this protein is foreign, so antibodies begin to be produced against it. Passing through the placenta, they penetrate the blood of the fetus, attack and destroy its erythrocytes - a hemolytic (hemolysis is destruction, dissolution) disease develops. And the longer the gestation period, the more toxic decay products accumulate in the blood and, in particular, bilirubin, which has a harmful effect on the entire body, but especially on the fetal brain. That is why the expectant mother should see a doctor as soon as possible about pregnancy. This is especially important if the woman has Rh-negative blood and the baby's father is Rh-positive. The doctor will be able to determine if antibodies have appeared in the pregnant woman's blood, and if they are found, he will take the necessary measures.
In the fourth month, the kidneys of the fetus also begin to function. I must say that this paired organ goes through a very difficult path of development. First, the pronephros is laid, in the second month the primary kidney appears, but it does not work as an excretory organ, but participates in the formation of the reproductive system. The complexity of the development of this organ to some extent explains why congenital pathology of the kidneys is so common: mobile, ever-changing structures, as you know, are the most vulnerable, they are easily amenable to any damaging effects.
By the end of 4 months, the kidneys take their final position, are included in the metabolism and begin to excrete urine. This urine constantly increases the volume of amniotic fluid, which is the habitat for the developing child until birth. By the way, it is with the amniotic fluid that the fetus swallows that liquid enters its body. But the placenta continues to perform the main excretory function. Therefore, even if the kidneys develop incorrectly and do not work at full strength, this has almost no effect on the development of the fetus. But after birth, when the kidneys no longer have anyone to “shift” their duties, the problem of their insufficiency can become very acute.
The organs of the digestive tract also learn to work: the stomach, intestines, and gallbladder begin to perform their specific functions. The first contents appear in the intestines: for the time being, it mainly consists of bile and is called meconium.
For 4 months, daily, hourly, the formation of the most complex organ - the cerebral cortex - takes place. Nerve cells are intensively dividing, their number is constantly growing, and, as if under the hand of an invisible sculptor, furrows and convolutions appear. The central nervous system more and more confidently takes the reins of the body in “its own hands”. It connects to the endocrine system.
During this period, the largest endocrine gland is the adrenal glands, with about 80% of the mass of the organ falling on the cortex. In the previous three months, there was a preparatory work, which now allows the adrenal glands to produce the required amount of hormones. By the 16th week, the supreme endocrine gland, the pituitary gland, also begins to function; its connections are established with another important brain center - the hypothalamus.
And only the respiratory system is in no hurry to get involved in the work. But the fetus does not need lungs yet, because it breathes through the placenta.
The fourth month is just the time when you can no longer delay contacting a medical genetic consultation. An indication for treatment may be the presence in the family of the mother or father of the unborn child of relatives suffering from any hereditary disease, the birth of a previous sick child.
The age of the pregnant woman is also considered a risk factor: either younger than 18 years or older than 35 years. In these cases, it is extremely necessary to conduct research and listen to the forecast of geneticists about the possibility of having a healthy child.
A huge help in identifying fetal malformations that cannot be detected using other methods in this period is ultrasound diagnostics. In the same period, you can find out whether one fetus or twins develops.
Amniocentesis - the study of amniotic (amniotic) fluid. If necessary, it is usually carried out in the 4th month of pregnancy. 8-10 milliliters of amniotic fluid allow us to evaluate the hereditary apparatus of the fetus. You can set the sex of the fetus, determine how it develops.
Amniocentesis is a rather complicated study and is performed strictly according to indications.

Based on the materials of the book by Professor A.I. Brusilovsky "Life before birth".

The 4th month of pregnancy is the beginning of the most pleasant, safe period.

First movements Eat tasty close by
occurrence of phase pain
changes how much water

For women, things begin best time bearing a baby: the symptoms of toxicosis are replaced by increased appetite.

Feelings of the expectant mother

The belly in the 4th month of pregnancy is gradually rounded, and the waist is smoothed out, as you can see in the photo. As a rule, this time is characterized by a significant improvement in the well-being of pregnant women, as well as an increase in appetite. At the same time, expectant mothers gain 1-4 kilograms, what kind of belly and how it looks at the 4th month of pregnancy largely depends on the lifestyle of the future mother.

Due to the rapid increase in the uterus, its ligamentous system is stretched, which can manifest itself in the form of sharp pain in the lower abdomen. Such pains, although they appear very suddenly, but also quickly disappear.

By the end of this period, the mother can feel the baby move.

Due to the significant amount of fluid in the body, sweat may increase in the 4th month of pregnancy, as well as vaginal discharge. It is perfectly safe, although they entail additional hygiene procedures.

Another unpleasant surprise that a future mother can expect during this period is the appearance of constipation. Due to hormonal changes and the growth of the uterus, intestinal motility slows down, which causes delay and compaction of feces in it. Not only is constipation unpleasant, it can cause the development of hemorrhoids - varicose veins of the rectum.

Manifestations of hemorrhoids are venous nodules that are located in the anus or directly in the rectum. Under the condition of constant tension in the process of constipation, inflammation may occur, as well as swelling, bleeding of nodules. If it is possible to successfully deal with constipation, then such complications can be easily avoided.

It is necessary to pay attention to the diet, some foods are undesirable

However, all of the above inconveniences that may arise are nothing compared to the fact that it is at the end of the fourth month that thin girls, as well as women who become mothers again, can feel their baby moving.

What can and cannot be a future mother?

Pregnancy is, although truly wonderful, an unforgettable period of time, however, at the same time, it is quite vulnerable. That is why there are certain actions that are categorically not allowed, and, on the contrary, it is recommended to carry out during the 4th and 5th months of pregnancy, in other words, while waiting for the baby.

Can	It is forbidden
Having sex (during a normal pregnancy)	Consume alcoholic, carbonated drinks and coffee
Use cosmetics (provided that there are no harmful substances)	smoke
Do certain sports (swimming, water aerobics)	Walk in heels
Sleep on your back	Take a number of medications
Cut hair	Overheat
Drink plenty of water, natural juices	lift weights
More likely to be on fresh air	Perform x-rays, x-rays
Subject to certain rules - visit the solarium	Do active sports
Staying at the computer for a short time	experience stress
Walk at a moderate pace	Eat certain foods: raw eggs, meat, milk, sausages, blue cheeses, oily fish, mushrooms, sushi

Future baby and his feelings

Due to the fact that by the end of this period the placenta is already fully formed, the fetus is supplied with absolutely all the necessary substances. At the same time, for future mother a very favorable period is coming.

The function of the placenta is not only to transfer food and oxygen from the mother to the fetus. It also removes harmful elements, waste products of the embryo along with venous blood, acts as a reliable protection of the fetus from bacteria, viruses, harmful chemical substances, and also, is a chemical laboratory that synthesizes hormones and proteins that are necessary for the development of the baby.

During this period, the baby begins to appear sucking, as well as swallowing reflexes. The arms of the embryo can bend at the wrist and elbow, he can already grab something and squeeze his hand into a fist - this may be one of the signs of pregnancy at 4 months.
At 4 months, the baby is very flexible, he can swim, as well as suck his thumb. The child begins active motor activity.
This month, the baby's skin is covered with lanugo - the so-called germinal fluff. It is a protective layer that is necessary to retain the waxy substance secreted by the skin. At 4 months, hair growth on the baby's head begins, nails begin to form, and cilia and eyebrows appear.
Scientists are still debating about the origin of amniotic fluid. According to their assumption, it is formed by cells of the fetal bladder. A complete renewal of the waters is carried out at intervals of several hours, which ensures proper sterility and the necessary chemical composition.
It is the waters that are the first "habitat" of the child at 4 months of pregnancy, and many functions are assigned to it. The main one is reliable protection against mechanical damage. In addition, thanks to her, the baby gets freedom of movement.
At this stage, a very important process takes place - in boys, the prostate is formed, and in girls, respectively, the ovaries, which contain many eggs that descend from the tummy to the hip space. At the same time, in accordance with the external genitalia, it is often already possible to conclude who will be born - a girl or a boy.
During this period, the formation of the face of the unborn baby continues. The ears rise from the side of the neck to the proper level. Despite the fact that the ears are not yet fully formed, the baby can react to noise with body movements.
At the end of 4 months of pregnancy, as seen in the video, the baby can open his eyes, and the retina becomes quite sensitive. During this time, the embryo grows up to 20 centimeters, and its weight by the end of this period can reach 200 grams.

So, at 4 months, important changes in the development of the fetus occur:

the end of the formation of the placenta;
formation of the reproductive system;
the appearance of the germinal cannon;
the appearance of the main reflexes;
the ability to open your eyes;
the occurrence of a reaction to external stimuli;
appearance of motor activity.

Is it possible to have sex?

If the expectant mother and baby feel well, you can safely enjoy every second, because the most difficult trimester is left behind.

In the absence of contraindications, making love can even be beneficial for the expectant mother.

Thanks to a surge of new strength and energy, sex at 4 months of gestation has a positive effect on the girl's mood, you can resume sexual relations. During orgasm, special substances are released that have a positive effect on the fetus.

Subject to certain contraindications, which are voiced by the doctor, as well as the appearance of bloody discharge, damage to the amniotic bladder, the appearance of infections, or the low location of the placenta, it is better to postpone sex. In addition, due to excessive mechanical impact on the cervix, certain adverse effects may occur.

Discomfort and unpleasant pain belly

With such a problem as abdominal pain at 4 months of pregnancy, for sure, most women who carry a baby under their hearts face. However, before you get upset, you should find out the cause of the pain. They can be of a different nature, they can be strong or not very strong, and also vary depending on the accompanying symptoms.

So, the main causes of discomfort are:

the threat of termination of pregnancy;
placental abruption;
problems with the gastrointestinal tract;
stretching of the ligaments and abdominal muscles;
acute surgical pathology;
uterus growth.

Under the condition of a normal pregnancy, a woman only needs to visit a doctor once. He will talk about what the tests have shown, appoint a planned ultrasound for 4 months of gestation, and thus the expectant mother will have the opportunity to see what she looks like future baby.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Behind the difficulties and anxieties of the first trimester, early toxicosis of pregnancy is gone, you have visited many doctors, passed tests. Embryogenesis has almost ended - the development of the embryo and the formation of the placenta. Harmful factors environment not so scary anymore. It's time to breathe and enjoy, especially since you feel more energetic.

What happens in the body of a future mother at 4 months of pregnancy?

From this month, the uterus extends beyond the small pelvis and grows quite quickly in the abdominal cavity. At the beginning of the month, the bottom of the uterus barely shows above the pubic joint, and by its end it is almost at the level of the navel. To help the placenta in nourishing the growing fetus, your body increases the volume of circulating blood. An increase in blood volume by 30-40% adds work to the heart. If the heart is healthy, then such a load will be invisible to you. Many specific skin and hair changes occur during pregnancy. Moles and freckles darken, hyper- and hypopigmented spots appear on the skin, as well as a dark line running from the navel to the pubic bone. All of these phenomena are associated with another "trick" of hormones - the deposition of a special pigment substance called melanin. After giving birth, they go away on their own. In order to reduce the likelihood of such troubles, use sunscreens for the face (at any time of the year) and body (when you plan to stay in the sun). To slightly lighten existing spots, you can use whitening masks based on fermented milk products and lemon juice.

The increase in the mammary glands continues, especially the areolas - dark areola.

Future baby at 4 months pregnant

By the end of the fourth month, the fetus is fully supplied with everything necessary thanks to the already formed placenta. There is a relatively quiet period for you. The placenta not only transfers food and oxygen from the mother to the fetus - it also performs the function of removing harmful substances, fetal waste products with venous blood flow, protects the fetus from the penetration of viruses, bacteria, harmful chemical compounds, and is also a chemical laboratory synthesizing the necessary for the fetus proteins and hormones.

The child has the first reflexes - sucking and swallowing. His arms bend at the elbows and wrists, he is able to clench his palms into fists and grab something. He becomes very flexible, can swim, suck his thumb. The baby moves a lot, but the vast majority of expectant mothers will feel the first movements only in the next month of pregnancy.

This month, the embryonic fluff - lanugo - appears on the skin of the baby. It performs a protective function - it delays the waxy substance secreted by the skin. Even during pregnancy, lanugo will be replaced by thicker and longer vellus hair. Already in this month, hair on the head begins to grow, eyebrows and eyelashes appear, nails form.

The baby produces urine and releases it into the amniotic fluid every 40-45 minutes. However, the baby's urine is not the main component of amniotic fluid. The origin of the waters is still a mystery to scientists; it is assumed that their main producer is the cells of the fetal bladder. The amniotic fluid is completely renewed every 2-3 hours, which maintains their sterility and constant chemical composition. This is the first "habitat" of the child, and it performs many functions, including protection from mechanical damage, provides freedom of movement, and is involved in metabolism. In addition, by drawing amniotic fluid into the lungs and pushing it back, the baby trains in breathing.

This month, boys-to-be develop a prostate, and girls' ovaries, containing millions of eggs, descend from the abdomen to the hips. It is already possible to recognize the sex by the external genital organs, although this is not always possible with an ultrasound examination at this time.

Your child's face continues to take shape. The ears from the side of the neck rise to the right place. Although the ear is not yet fully formed, the child may respond to external noises with changes in motor activity.

By the end of the month, the baby's eyes open, the retina becomes sensitive. During this month, the baby grows from 12 to 20 cm, its weight reaches 200 g by the end of the month.

Feelings of the expectant mother at 4 months of pregnancy

Your stomach gradually begins to slightly round and the waist is smoothed out. Feeling better, appetite increased. It is better if the weight gain for 4 months of pregnancy is from 1 to 4 kg. Tight clothes can become tight, but you can still get by with the usual “non-pregnant” wardrobe.

A rapid increase in the uterus causes stretching of its ligamentous apparatus, which many pregnant women perceive as a sharp pain in the lower abdomen and in the inguinal regions. Such pains come on suddenly and pass quickly.

More fluid in the body causes increased sweating and vaginal discharge. These phenomena are safe, although they require additional hygiene procedures. Sometimes small blood vessels do not withstand the additional load, so nosebleeds are frequent in pregnant women and bruises are easily formed. For recurring nosebleeds, make sure that the air in the apartment is humidified, besides, be sure to tell your doctor about bleeding.

There is also an unpleasant surprise, which prepares you for a "calm" month. Just at this time, constipation may appear. Hormonal changes in the body and the growing uterus slow down intestinal motility, which causes a delay and compaction of food masses in it. Constipation in itself is unpleasant, besides, they can provoke the development of hemorrhoids - varicose veins of the rectum. Hemorrhoids appear in the form of nodules of veins located in the anus or inside the rectum. With constant tension during constipation, such nodules often become inflamed, swell, and bleed. If constipation can be dealt with, then such complications do not happen.

By the end of the fourth month, multiparous or thin women may feel the movement of the fetus.

Psychology 4 months of pregnancy

Many women claim that they realized their impending motherhood just at the border of the third or fourth month of pregnancy, when the first difficulties of the “interesting situation” receded. This is not surprising: during this period, you increasingly begin to experience joyful excitement, enjoy and take care of it. This amazing feeling will help to cope with any difficulties better than any medicine.

Possible deviations from the norm at 4 months of pregnancy

Now one of the main causes of miscarriage can be isthmic-cervical insufficiency (ICI). The bulk of the muscle bundles of the cervix is located around the internal opening (pharynx) of the cervical canal. These muscle fibers normally tightly compress the internal os, holding the fetus inside the uterus. With unsuccessful births, miscarriages, abortions, hormonal disorders, muscle fibers are destroyed, scar tissue comes in their place, which cannot play the role of a “lock”. Then, as the pregnancy grows, the fetal bladder protrudes into the cervical canal, its membranes become infected, and a miscarriage occurs. The doctor can suggest the presence of ICI with a manual examination, but the final diagnosis is made by ultrasound. Treatment may include surgical suturing of the cervix or/and placement of a special plastic ring around the cervix. With such a diagnosis, you should be very careful, lie more and give up homework.

As mentioned above, at this time the placenta completes its formation, so right now it is possible to form primary placental insufficiency - a condition in which the placenta does not provide the fetus with oxygen and nutrients properly. Primary (early) insufficiency occurs during the formation of the placenta during implantation, early embryogenesis and the formation of the placenta under the influence of genetic, endocrine, infectious and other factors up to 16 weeks of pregnancy. It is manifested by a picture of a threatening abortion (the appearance of pain in the lower abdomen, in the lower back, spotting from the genital tract), the development of congenital malformations of the fetus. For early diagnosis, the determination of the level of placental hormones in the amniotic fluid, blood and urine of pregnant women is used. The change in these levels occurs long before the first symptoms, which allows timely treatment. Such a course may include antispasmodics (NO-SHPA, PAPAVERIN), vitamins, herbal sedatives, COCARBOXYLASE, TRENTAL, METIONIN, ACTOVEGIN.

In addition to taking medication, a woman should eat well, sleep a lot and walk in the fresh air (3-4 hours a day).

Necessary medical measures at 4 months of pregnancy

In this month of pregnancy, in its normal course, you will visit the doctor once. The doctor will talk about the results of the tests, explain the parameters ultrasound. Perhaps he will prescribe an additional examination for infections.

If any of the sexually transmitted infections that adversely affect the development of the fetus are detected during the initial examination, it is now advisable to conduct a full course of treatment, including antibacterial drugs. After treatment, be sure to undergo a follow-up examination.

Between 15 and 20 weeks of pregnancy, a test is done for alpha-fetoprotein (AFP), human chorionic gonadotropin (CG), and unconjugated estriol (NE). In some congenital anomalies (for example, Down's syndrome, craniocerebral hernia, splitting of the anterior abdominal wall of the fetus), the levels of these substances in the blood of pregnant women may deviate from the norm. If the risk of such anomalies is high, it is advisable to do an analysis at the 15-16th week of pregnancy in order to have time to repeat it if necessary. Risk factors for congenital anomalies include: age over 35 years, the presence of children with malformations in the family, recurrent miscarriage, exposure to radiation, harmful production factors, and certain medications.

If, according to the results of a double test, which a pregnant woman takes at 10-12 weeks (we talked about it last month), and a triple test, there is reason to assume the presence of some kind of pathology, then the pregnant woman will be offered to undergo additional studies.

Women who are at risk of giving birth to a child with malformations are offered to do an amniocentesis at this time - in this case, a needle is passed through the uterine wall under ultrasound control and the required amount of amniotic fluid is taken for examination. They determine the genotype, including sex, fetus, AFP level (an indicator by which one can assume the presence of malformations of the central nervous system), bilirubin (a marker of hemolytic disease), hormones, and proteins. This study allows you to exclude many diseases, accurately diagnose, in the fourth month it is the safest.

From about 13-14 weeks of pregnancy, if the fetus is in a position convenient for examination, ultrasound can determine its gender. However, it is not worth doing an ultrasound only for this reason, especially since at such a time the results may be erroneous. It is better to keep your curiosity until next month, when the second scheduled ultrasound will be performed.

Visit the dentist in the fourth month. Tell him about your pregnancy. The fourth to fifth month is the optimal time for dental treatment, if necessary. At this time, you can already use some anesthetics - the doctor will select the safest for you and the baby. X-rays are also acceptable if needed.

Under the influence of hormones, your gums become sensitive and may bleed. Brush your teeth regularly, rinse your mouth with a decoction of chamomile. An infection in the oral cavity is as dangerous for the unborn baby as any other.

Behavior rules

It's time to rethink your vitamin preparations. If until the fourth month folic acid, vitamin E and iodine were the main ones, now it is necessary to take B vitamins, macroelements (calcium, phosphorus, magnesium) and microelements (iron, zinc). At this time, it is best to take special "prenatal" vitamin complexes. Prenatal vitamins differ in composition from conventional multivitamins in the increased content of iron, zinc and folic acid. Their composition is optimal for a pregnant woman.

Vitamins are usually well absorbed when taken with food or at bedtime. Multivitamins, like other drugs and foods, can cause an allergic reaction, in which case you can try to replace the drug with another one. If, for some reason, you cannot take a multivitamin complex, then iron supplements must be added to the list of monopreparations for this period to prevent anemia in pregnant women. Anemia is a decrease in the concentration of hemoglobin in the blood (a substance that carries oxygen) below 110 g / l. Iron is one of the constituents of the hemoglobin molecule. The daily requirement for iron at this time is 2-4 mg per day. However, iron is very poorly absorbed from both food and medicines. If iron is taken in tablet form, the recommended prophylactic dose is 60 mg per day. The same amount of iron is found in pre-natal vitamins. A lot of natural iron is found in buckwheat, beef, liver, green sour apples, dried apricots, cherries, pomegranates.

At this time, it is permissible to increase the number of calories consumed with food by about 300 per day. These "extra" calories will be spent on the growth of tissues of the mother and baby. If there are not enough calories, then the necessary proteins will be processed in the metabolic process as a source of energy, instead of being spent on growth and development. Expand your diet with protein foods (meat, cottage cheese, fish, poultry, cereals). In addition, the diet of the fourth month must necessarily include fresh vegetables, greenery, vegetable oil, cereals (all cereals are useful, except for semolina - it contains a lot of easily digestible carbohydrates and few useful substances), dried fruits, sour-milk products.

If 10 years ago, pregnant women were advised to move less and rest more, now sports are considered very useful for both mother and unborn baby. Check with your doctor before hitting the gym, especially if you're at risk or have had a miscarriage. You should not engage on an equal footing with your non-pregnant girlfriends. Even if you have an ideal pregnancy, you have become much heavier, you get tired faster, and besides, you have to “breathe for two”, supplying yourself and the baby with oxygen. Best Views sports for pregnant women - walking, swimming. The "forbidden" include extreme and game sports, skiing, cycling.

Household chores at 4 months pregnant

Use the temporary lull of the fourth month to resolve accumulated domestic issues. And if you have a personal car, then it helps a lot to do everything quickly. However, decide whether it is really necessary now to drive a car on your own. Remember that pregnancy affects concentration, you get tired faster, and most often the cause of an unpleasant accident on the road is fatigue. If you continue to use the car, it is important to buckle up correctly: to do this, place the lower section of the belt under the abdomen across the hips, and the upper one above the abdomen, you can also purchase a special seat belt designed for pregnant women.

Many women are worried about whether it is possible to dye their hair and nails. Of course, paint and solvents are not very useful for inhalation. However, if the refusal of cosmetic procedures causes fear of looking in the mirror, then it is better not to refuse them. In the end, the harm from constant dissatisfaction with oneself can be equated with chronic stress. Alternatively, you can dye your hair once in your natural tone - and solve the problem until the very birth. You can use tinted shampoos or coloring balms: they are safe.

You may already feel tight in your trousers and skirt, so it's time to think about special clothing. Comfortable, comfortable maternity clothes are what you need right now. It's also time to buy a couple of pillows. From the fourth month, the most comfortable and safe sleeping position is on the left side with one leg bent and a thin pillow between the legs. Recommendations to sleep on the left side are due to the fact that in this position the pregnant uterus does not put pressure on large vessels, does not interfere with blood circulation in the placenta. You can attach another pillow to the lower back so as not to “roll” onto your back. This position helps the blood supply to the placenta and improves kidney function.

How to deal with constipation during pregnancy?

Drink more pure still water, at least 1-1.5 liters per day. Drink a glass of water in the morning before breakfast. You can replace morning water with a glass of kefir.

The fourth month of pregnancy is obstetric 13-16 weeks inclusive. Manifestations of early toxicosis disappear, and the tummy begins to grow quite quickly, in some women it is already becoming noticeable to people around.

The fetus has completed the formation of internal organs, the placenta is functioning, and it is more protected from various adverse factors. It's time to enjoy your pregnancy!

What happens to the body of the expectant mother in the 4th month of pregnancy, what she feels and notices

1. Growth of the abdomen. The uterus is growing rapidly, and doctors have the opportunity to control the development of pregnancy by measuring the length of the uterus and the girth of the abdomen at the navel. Normally, both the length of the uterus and the girth of the abdomen increase by a centimeter every week. And the height of the fundus of the uterus is equal to the obstetric week of pregnancy. At the beginning of the fourth month, the uterus only slightly shows above the pubic joint, and closer to the fifth month it approaches the navel.

2. Mom's heart. The amount of circulating blood in the mother's body increases up to 40%, and this puts a lot of stress on her heart. For this reason, many mothers from the fourth month of pregnancy periodically suffer from shortness of breath and tachycardia. The pulse can increase to 100 beats per minute and even higher (at a rate of up to 80 beats). However, although this symptomatology is considered a variant of the norm, it is a reason for a deeper examination of the heart. We need to do an ECG, possibly a Holter study of the heart rhythm and an ultrasound of the heart. There are drugs for tachycardia, but their expectant mothers are prescribed only when absolutely necessary, as they reduce the heart rate and the child. You can fight tachycardia with physical rest, valerian and motherwort - natural sedatives, safe for the fetus.

3. Skin changes. Increases pigmentation. New age spots, moles, freckles appear. Therefore, you should try not to be in the open sun, especially during the warm season and during the time period from 10 am to 5 pm.

A new sign of pregnancy appears - a strip in the middle of the abdomen. During pregnancy, it will darken, possibly become wider. Pigmentation on the abdomen will remain after childbirth, for about a year. Trying to wipe it off with a washcloth is not worth it, it's useless, just hurt the skin.

The nipples and the area around them, the armpits are subjected to pigmentation. But all this too shall pass.

Many expectant mothers develop acne on their face and body. To avoid the spread of acne throughout the body, do not pick them, do not provoke the transfer of infection to other areas of the skin. And wipe the acne itself with an aqueous solution of chlorhexidine - this is an excellent antiseptic that is safe for expectant mothers.

And another skin problem that occurs in most pregnant women is the appearance a large number small papillomas. Apparently, this is due to a decrease in immunity and the HPV virus, which, perhaps, we all have. Trying to tear them off, pull them off, should not be. This will lead to infection of the wound, which is very dangerous for you and the unborn child. After childbirth, the papillomas themselves will begin to dry out and fall off, even medical intervention will not be needed.

4. Weight. By the end of the fourth month, the total weight gain should be no more than 4 kilograms. If you have more - try to find errors in nutrition and normalize your menu. Excess weight provokes the development of diabetes mellitus, leads to the birth of a large fetus (and hence birth injuries in him) and generally complicates the birth process.

If weight gain is normal, then outwardly the woman does not seem fuller than she was before pregnancy. But the waist begins to slowly round.

5. Sprain. Since the uterus is growing rapidly, the load on the ligamentous apparatus becomes stronger. Sometimes for this reason, expectant mothers experience sharp pains lower abdomen, inguinal region. This is not dangerous for the child, although it is unpleasant for mommy.

6. Nosebleeds. Due to the increase in the volume of blood in the mother, her vessels are under load. Moreover, blood clotting is somewhat reduced. All this provokes bleeding. Not only the nose, but also the gums, for example. If you want to avoid nosebleeds, carefully humidify the air in your home, do not allow the mucous membranes to dry out.

7. Constipation and hemorrhoids. The growing uterus and the relaxing effect of the hormone progesterone cause slow intestinal motility and constipation. Also, the intake of certain medications, for example, magnesium and iron preparations, has an adverse effect in this regard. You need to stay as mobile as possible, drink plenty of water and eat fiber-rich vegetables.

Remember that frequent constipation, coupled with uterine pressure on the rectum, provokes hemorrhoids. And if he appeared, then for life. You can't get rid of it without a major operation.

8. Movement of the child. Some women begin to feel them as early as 14-15 obstetric weeks.

What happens to the fetus in the fourth month

The baby completely becomes dependent on the placenta. It is through it that the body is supplied with oxygen and nutrition. Through it, toxic substances are removed from his body.

In addition, the placenta is a defense against viruses and bacteria, not all, but very many.

The baby already has reflexes, which will remain with him for a long time after birth, and some for life. Swallowing and sucking first.

The baby is very active and moves often, but is still very small, so most expectant mothers will feel the presence of a new life in themselves only in the next four weeks.

The baby has fluff all over his body - lanugo, a small amount of it will remain with him until the very moment of birth. These fluffy hairs have a certain function - they help the protective lubricant to linger on the child's body, without it it is impossible to live constantly in the water.
But in addition to lanugo, real hairs on the head, cilia and eyebrows are already appearing. There are nails on the fingers.

The baby has a functioning urinary system, and he urinates into the amniotic fluid at least once an hour. But this is not scary, since the amniotic fluid tends to be completely renewed once every 2-3 hours. Thus, their sterility is maintained, and nothing threatens the baby. The chemical composition of the waters is the same. Amniotic fluid plays a multifaceted role - it protects the child from mechanical damage, expands the uterus so that it is convenient for the fetus to move in it, nothing limits its development. Water is also involved in metabolism.

Now the prostate gland is formed in boys, and the ovaries in girls. However, the doctor with an ultrasound examination is still unable to accurately determine the sex of the child by appearance his genitals.

The face of the child becomes more and more formed, close to the ideal. However, the ears are not yet fully formed on the outside. But the baby already hears and reacts to loud sounds.

At the end of the fourth month, the little one sometimes opens his eyes, his retina becomes sensitive to light. Weight is about 200 grams, and height is 20 cm. Still a baby.

2 common and dangerous problems of the fourth month

The first is isthmic-cervical insufficiency or ICI. A pathology in which the cervical os is unable to remain closed throughout pregnancy. The fetus grows, and the fetal bladder begins to protrude into the neck, which leads to its gradual shortening and opening. It is the main cause of preterm birth and miscarriage later dates pregnancy. The cause of ICI is surgical interventions in which the mechanical opening of the cervix was performed (for example, abortions), hormonal disorders, trauma during childbirth.

Treatment - suturing or wearing an unloading obstetric ring on the cervix. The first method is considered more effective and safer.

The second problem is disturbances in the placenta. Placental insufficiency begins to form. As a result, the fetus receives less nutrition, oxygen, and in the second half of pregnancy, it begins to lag behind in development. These problems arise due to infectious diseases transferred during pregnancy, violations of the formation of the placenta in the early stages of pregnancy. And it's not curable. Doctors can only observe the condition of the fetus and, if necessary, give birth to a woman ahead of schedule to try and save the fetus.

Other problems may arise with the placenta - this is its presentation, that is, being too close to the cervix. It threatens with detachment, severe bleeding and fetal death. With increasing gestational age, the placenta almost always rises to a fairly high level in the uterus. Until then, you need to take care of yourself.

New tests and examinations

At the end of the fourth month, namely at 16 obstetric weeks of pregnancy, a woman takes a blood test for alpha-fetoprotein (AFP), human chorionic gonadotropin (CG) and unconjugated estriol (NE). This is the second screening. It is necessary for the diagnosis of some congenital abnormalities in the development of the fetus. And if the result of the analysis is unimportant, and the results of the ultrasound are also suspicious for malformations, doctors may recommend an invasive study - to pass amniotic fluid for analysis. This procedure is called amniocentesis. Since miscarriages sometimes occur after it, you need to carefully weigh the pros and cons before agreeing to it.

The fourth month opens the second trimester - the most calm and comfortable period of pregnancy. By this time, the manifestations had almost disappeared, the woman underwent an initial examination at the antenatal clinic, the recently formed placenta reliably protects the fetus from negative impact external environment. The unborn child has already formed all the organs, and the baby's life support system has begun to function.

During the fourth month of pregnancy, the uterus grows very rapidly in size. If by the beginning of the first week of this month it barely rises above the pubic joint, then by the end of the fourth month the bottom of the uterus approaches the level of the navel. Another significant change is an increase in blood volume by 30-40%. This increase in circulating blood volume puts more stress on the heart muscle. A healthy heart copes with it, and in case of pathology of cardiovascular activity, these changes can affect the work of the heart in a bad way.

An increase in the level of melanin in the blood affects the condition of the skin and hair - moles darken, age spots appear on the skin, the strip of skin between the navel and the pubic bone, the skin of the perineum darkens. These changes will disappear some time after childbirth. To reduce the intensity of the appearance of spots, you need to actively use sunscreen for the face.

The stomach at 4 months of pregnancy may be completely absent, and most pregnant women still use the usual clothing models. However, an increase in waist volume is already noticeable, and in some women, a rounding of the abdomen. Since the uterus is growing intensively, pronounced pain in the groin and lower abdomen. They pass as quickly as they appear.

Due to the increase in the total volume of fluid in the body, a woman feels. The volume of vaginal discharge also increases. The load on the circulatory system causes a violation of the integrity of small vessels, bruises and nosebleeds. They may appear less frequently if the air is intensively humidified in the dwelling.

Due to frequent constipation, prerequisites for - varicose veins of the rectum may appear. Outside and inside the anus, venous nodules appear, which bleed when straining, become inflamed and swell.

A pleasant sensation for women undergoing a second and subsequent pregnancies, and for slender thin women, is the feeling of the first movements of the unborn child.

The placenta is a universal organ - it protects the fetus from pathogenic bacteria and viruses, synthesizes the necessary proteins and hormones, removes the waste products of the unborn child with venous blood, filters out harmful substances, delivers oxygen and nutrients from the mother's body. Thanks to her, a woman manages to avoid accidents and not be afraid of abortion due to the negative impact of the external environment.

The baby's waste products are urine, which the fetus releases every 40-45 minutes into the amniotic fluid. The amniotic fluid is renewed every 2-3 hours, it is sterile and has a constant chemical composition. Amniotic fluid protects the fetus from damage, stimulates the baby's metabolism, and allows him to move freely. At the 4th month of pregnancy, the fetus imitates respiratory movements, drawing water into the lungs, training the respiratory system.

The weight of the fetus by the end of 4 months, and its height increases from 12 to 20 cm.

The unborn child has already formed a swallowing and sucking reflex - from time to time he sucks his finger. The arms are bent at the elbows, the palms and fingers can fold into a fist, the fetus can grab the umbilical cord, touch its face. Despite the fact that the baby moves a lot and willingly in the uterine cavity, these gentle movements are not yet fully felt by the woman, they can easily be mistaken for sensations from intestinal motility.

A light and thin fluff appeared on the skin of the child - lanugo. It covers the entire body of the fetus, and will disappear only after childbirth. The fluff helps to keep the original lubricant on the body, which protects the skin from the action of amniotic fluid. Eyebrows, hair, eyelashes are outlined on the head and face of the fetus. On the fingers, the formation of nails begins.

The genitals of the child are in the process of formation, but its gender can already be determined. When conducting an ultrasound, it is still very difficult to distinguish a boy from a girl. In the male fetus, the prostate begins its development, in future girls, the ovaries already contain eggs, and have descended into the small pelvis from the abdominal cavity.

The baby's ears gradually take their permanent place, rising from the side of the neck to where they should be. The formation of the inner ear is not yet complete, but the baby is already reacting to strong noise. The sensitivity of the retina increased, and the fetus was able to raise and lower the eyelids.

The psychological state of the pregnant woman

Women undergoing their first pregnancy, at the fourth month, finally realize that expecting a baby can bring positive emotions. They begin to feel that they have an extremely important mission to perform, and they anxiously await the first movements of the fetus. Those who already have children know that in the second trimester of pregnancy they will enjoy the joyful excitement during a kind of communication with an unborn child, from his first gentle, and then more and more tangible movements and movements.

During the fourth month of pregnancy, if there are no deviations from the normal course, the woman visits her doctor once. The obstetrician-gynecologist will evaluate the results of previously passed tests, ultrasound data. If the results of a smear test for urogenital infections are unfavorable, a course of treatment with antibacterial drugs should be completed within the fourth month. After a course of therapy, a control examination of a smear from the vagina is prescribed.

At the end of the fourth month, the doctor may order tests related to screening for the second trimester of pregnancy. It is carried out from 15 to 20 weeks of the gestational period. This screening includes a blood test, or “triple test,” and another ultrasound.

Analysis of the concentration in the blood of the hormone hCG, or chorionic gonadotorpin;

Analysis for ?-fetoprotein (AFP);

Analysis for unconjugated (free) estriol.

If the level of these markers deviates significantly from the norm, the risk of having a child with congenital pathologies is high:

craniocerebral hernia;

Cleavage of the anterior abdominal wall of the fetus.

Risk factors:

The woman's age is over 35;

Radiation impact;

Harmful Conditions labor;

Side effects drugs;

The presence in the family of children with pathologies;

History of habitual miscarriage.

An increased content of markers indicating a high risk of anomalies in the results of screening of the first and second trimester is a reason for amniocentesis. This study is voluntary, it consists of a puncture of the uterus under ultrasound control to collect amniotic fluid. This is an extremely informative analysis, which is performed only with significant indications for it. One procedure out of 200 ends with spontaneous abortion.

According to the results of the study of amniotic fluid determine:

Genotype and sex of the fetus;

The level of ?-fetoprotein, indicating malformations of the central nervous system;

Since nausea no longer accompanies meals, a pregnant woman's appetite increases. You should not thoughtlessly eat various dishes, because there is a danger of weight gain in excess of the permissible norm. If you count from the initial weight before pregnancy, at this time the increase should be no more than 2-2.5 kg.

The optimal diet is to eat often, but little by little, without overeating. Most of the diet is consumed in the morning, during lunch and breakfast. In the morning they mainly eat cereals, dairy products, at lunch - hearty meals, and in the evening it is better to leave easily digestible foods. For snacks, it is better to use not cookies and sandwiches, but fruits and vegetables.

The use of salty foods is limited, it is better not to salt food in order to avoid edema. Smoked meats, fatty and fried foods, semi-finished products are banned. Sweets, rich pastries can lead to an increase in excess weight.

Very helpful products. containing protein - meat, fish, cottage cheese, cheese. Dairy products will not only make up for the lack of calcium in the body, but also help to improve digestion and bowel function. Recommended for the use of beef, liver, apples, dried apricots. In practice, the doctor will recommend supplementing such a diet with iron supplements.
Problems 4 months - the threat of miscarriage and constipation

Despite the fact that the threat of miscarriage is no longer as great as in the first trimester, it still exists. The main reason is cervical insufficiency. It occurs due to the weakness of the muscle bundle, which normally holds the internal os of the cervix tightly compressed. The pharynx of the cervix does not hold the fetal bladder for the following reasons:
The diagnosis of "istvico-cervical insufficiency" threatens with infection of the membranes and death of the fetus. It is put on palpation, confirmed by ultrasound. Treatment is a surgical suture on the cervix or a ring on the cervix. A woman with such a diagnosis is categorically not recommended to strain, do housework.

Primary placental insufficiency is another risk factor for maintaining pregnancy. In this condition, the fetus does not receive the right amount of oxygen and nutrients due to endocrine disorders, the action of an infection, or due to a genetic factor that manifests its effect before the 16th week of pregnancy.

Symptoms of placental insufficiency are similar to those of a miscarriage:
Due to insufficient supply of nutrients to the fetus, congenital malformations may occur. Diagnosis - a study of the level of placental hormones in the urine, blood and amniotic fluid.

Treatment of placental insufficiency:
- Methionine;
  
  Soothing herbal preparations.
Bleeding

The appearance of bloody discharge, accompanied by pain in the abdomen and lower back - this is very dangerous symptom, talking about the onset of spontaneous abortion. The discharge is bright red and may contain blood clots. If these symptoms occur, seek immediate medical attention emergency care. If timely measures are taken, miscarriage can be prevented.

Minor painless discharge that appeared after an intimate relationship may be a sign of cervical erosion. This condition should be treated after childbirth.
intimate relationship

The well-being of a pregnant woman at 4 months improves significantly, she becomes more active and energetic. If the doctor sees no contraindications for intimate relationships, you should not refrain from them.

Possible contraindications:
In addition, for many women, under the influence of hormones, libido only increases, and positive emotional experiences will benefit them.

Video about the rules of conduct and features of the course of the fourth month, mandatory examinations:

Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.