Gradually, with increasing gestational age, movements become more coordinated and more like conscious. When the baby grows up, the pregnant woman begins to feel his movements.

When does fetal movement begin during the first and subsequent pregnancies

It is generally accepted that during the first pregnancy, the expectant mother feels the first fetal movements at 20 weeks of pregnancy, with repeated pregnancies - at 18 weeks. This is not entirely true. A mother who is expecting her first child, indeed, most often begins to feel the movements of the fetus a little later than a multiparous woman. This is due to the fact that "experienced" mothers know how the movements of the crumbs are felt at first and what they should feel. Some primigravidas perceive the first movements of the fetus as an increase in intestinal peristalsis, “gaziki”. Many women describe the first movements of the fetus as a feeling of fluid transfusion in the abdomen, "fluttering butterflies" or "swimming fish."

The first movements are usually rare and irregular. The time of the first sensations of fetal movements naturally depends on the individual sensitivity of the woman. Some future mothers feel the first movements as early as 15-16 weeks, and someone only after 20. Slender women, as a rule, begin to feel movements earlier than full ones. Women who lead an active lifestyle, work hard, usually feel the movements of the fetus later.

By 20 weeks, due to the formation of the spinal cord and brain, as well as the accumulation of a certain amount of muscle mass in the fetus, movements become more regular and noticeable .

From 24 weeks of pregnancy, the movements of the fetus are already reminiscent of the movements of a newborn - the expectant mother feels how the fetus changes position, moves its arms and legs. The motor activity of the fetus increases gradually and its peak falls on the period from the 24th to the 32nd week of pregnancy. At this time, the activity of the baby's movements becomes one of the indicators of its normal development. After 24 weeks, the child begins to "communicate" with the mother with the help of movements, respond to the sounds of voice, music, and the emotional state of the mother. With an increase in the gestational age of more than 32 weeks, the motor activity of the fetus gradually decreases due to the fact that the baby is growing up and he simply does not have enough space for active movements. This becomes especially noticeable at the time of childbirth. By the end of the third trimester of pregnancy, the number of fetal movements may decrease somewhat, but their intensity and strength remain the same or increase.

Fetal movement rate

The baby in the mother's belly moves almost constantly. At the 20th week of pregnancy, the fetus makes about 200 movements per day, and between the 28th and 32nd weeks, the number of movements reaches 600 per day. Naturally, a pregnant woman does not feel all the movements of the fetus, but only a small part of them. So, after 28 weeks, the frequency of fetal movement, according to the sensations of a woman, is usually 4 to 8 times per hour, with the exception of periods of fetal sleep (3-4 hours in a row).

In the third trimester, a pregnant woman may notice that her baby has regular sleep and wake cycles. Children are usually most active from 19:00 to 4:00 in the morning, and the period of "rest" occurs more often from 4 to 9:00 in the morning. Of course, the movements of the fetus depend on the mood of the mother, if the mother is worried or happy, the baby can move more actively, or vice versa, calm down. The fact is that when a mother rejoices, her body significantly increases the amount of hormones of joy - endorphins, which regulate the work of the heart and blood vessels, including the vessels of the placenta. During stress or pronounced negative emotions, biologically active substances are also produced - stress hormones, they also affect the work of the heart and blood vessels. It is thanks to this biological interaction between the organisms of mother and baby that the fetus feels the state of the mother. When the expectant mother is resting, the baby usually becomes more active, if the pregnant woman is active, busy with some kind of work, the child most often calms down. The movements also change depending on the satiety of the expectant mother. Usually the baby begins to move actively after the mother eats, especially something sweet. At the same time, the level of glucose in the blood increases sharply, which causes the fetus to be more active.

Fetal movements are the language in which the unborn child speaks to the mother. Naturally, a pregnant woman should listen to the movements, because in some cases, changes in the movements of the fetus may indicate a violation of its intrauterine state and a not entirely successful pregnancy.

If, after 20 weeks of pregnancy, the expectant mother does not feel the movement of the fetus, it may be worthwhile to see a doctor and make sure that everything is in order with the baby.

Methods for assessing the "sufficiency" of fetal movements

Counting the number of movements

The easiest way to assess fetal movements is to count the number of movements of the pregnant woman herself. Self-assessment methods are very easy to use, do not require additional equipment, the presence of a doctor and are easily reproducible by any woman. Their disadvantages are that each woman has different thresholds of susceptibility.

Count to ten

The most common method for assessing fetal movements is called count to ten . It can be carried out after 28 weeks of pregnancy, when the fetus is mature enough for active movements. Its essence lies in the fact that the expectant mother counts the movements of the fetus for a 12-hour time interval, for example, from 9 am to 9 pm. The time when a pregnant woman catches the tenth movement is recorded on a tablet. If the fetus makes less than 10 movements in 12 hours, this is a reason to consult a doctor for an additional examination.

Sadowski method

In the evening after dinner (approximately between 7until 11 p.m.), the woman lies on her left side and counts the movements of the fetus. At the same time, everything is considered, even the smallest movements. If 10 or more movements are noted within an hour, this indicates that the baby is moving quite actively and feels good. If the fetus moved less than 10 times in an hour, then the movements are counted for the next hour. Evening time for this assessment method was not chosen by chance. It is in the evening hours, especially after dinner and the associated increase in glucose, that the greatest activity of the fetus is noted. If the number of fetal movements during this test is less than 10 per two hours, this should be considered as a sign of a violation of his condition and additional studies should be carried out.

For an obstetrician-gynecologist, fetal movements are also an important diagnostic criterion for some deviations in the course of pregnancy from the norm. Too active, violent, painful fetal movement or weak, rare movements may indicate its unfavorable condition.

Changes in fetal activity

Changes in fetal activity may be associated with external influences. For example, if a pregnant woman lies on her back for a long time, then the enlarged uterus compresses a large vessel - the inferior vena cava, the blood flow to the fetus is disrupted, which immediately causes its violent reaction - active movements. The same changes in the activity of the baby can occur in any other uncomfortable position of the mother - if she leans forward, squeezing her stomach, sits with her legs crossed, the child forces her mother to change her position with her activity. A similar situation occurs if the baby himself squeezes or presses the loops of the umbilical cord, limiting the flow of blood through it. He begins to move more actively, changes his position and relieves pressure on the umbilical cord. However, in some cases, an increase or vice versa, a subsidence of fetal movements can be a sign of a serious pathology.

After 28 weeks of pregnancy, if your baby does not let you know for 3-4 hours, he may just be sleeping. In this case, the expectant mother needs to eat something sweet and lie down on her left side for half an hour. If these simple manipulations do not lead to a result, it is worth repeating them again after 2-3 hours. If this time the baby does not make itself felt, this is an occasion to consult a doctor. Rare and weak movements can also indicate a fetal problem, most often a lack of oxygen for the baby, that is, fetal hypoxia.

Determining the condition of the fetus

To determine the condition of the fetus, the doctor conducts a series of examinations:

Auscultation (listening)

The simplest is auscultation (listening) with a special wooden tube (obstetric stethoscope) or a special apparatus that captures the fetal heartbeat, doctor listens to the baby's heartbeat. Normally, it is about 120-160 beats per minute. A decrease in heart rate less than 120 or an increase of more than 160 indicates intrauterine suffering of the child.

Ultrasound and dopplerometry

During ultrasound, the doctor visually assesses the size of the fetus, the compliance of the development of the fetus with the gestational age, because with oxygen starvation, the growth rate of the fetus slows down and its size lags behind the norm for each period of pregnancy. Also important is the structure of the placenta, the presence of signs of aging in it, as a result of which the function of transferring blood, oxygen and nutrients to the fetus usually worsens. During ultrasound, the amount and type of amniotic fluid is assessed, which can also change with intrauterine fetal suffering. Dopplerometry of the vessels of the placenta and umbilical cord is a method for studying blood flow velocities in these vessels. With a decrease in the speed of blood flow in any vessel, one can speak of fetal malnutrition of varying severity.

Cardiotocography (CTG)

This is an important method for assessing the condition of the fetus. CTG is performed at a gestational age of 33 weeks or more, since only in this period of intrauterine development of the baby is a full-fledged regulation of the activity of the cardiovascular system of the fetus by the centers of the spinal cord and brain. Recording of fetal heartbeats is carried out for at least 40 minutes, and if necessary, the study can be extended up to one and a half hours. The device registers and records the baby's heart rate. For example, with a decrease in the concentration of oxygen in the blood of the fetus, the supply of oxygen to the cells of the nervous system decreases, which in turn affects the heart rate, especially during the period of wakefulness of the child. The obstetrician-gynecologist evaluates the heartbeat recording curve, episodes of slowing down and a sharp increase in the fetal heart rate, and based on these data, makes a conclusion about how comfortable the baby feels in the mother's stomach.

If during additional methods for assessing the condition of the fetus, initial disturbances in the supply of oxygen to the baby are detected, drug treatment is carried out aimed at increasing the access of blood and oxygen through the placenta and mandatory control examinations against the background of ongoing therapy. If the changes are profound and the baby experiences a pronounced deficiency of oxygen and nutrients, his condition suffers, an emergency delivery of such a patient is performed.

Fetal movements are not only an indicator of his condition, it is a way of communication between the baby and parents. The movements of the crumbs in the mother's tummy are unforgettable sensations that a woman can experience only in this short, but such a happy period of her life.

Center for Fetal Medicine in Moscow:

The main activities of our center are the early detection of congenital malformations in the fetus, prenatal screening for the detection of chromosomal abnormalities in the fetus, as well as pregnancy complications such as preeclampsia, fetal growth retardation and threatened abortion.

Our center is organized in such a way that the whole range of services is concentrated in one place, where a woman receives the results of various types of examinations, including ultrasound, biochemical, and specialist consultation within 1-1.5 hours. In the presence of a high risk for chromosomal diseases in the fetus, invasive diagnostics and genetics consultation are carried out here in the center.

Fetal echocardiography is given special attention in our center, since congenital heart defects in the fetus are increasingly common today, but, unfortunately, are often missed during ultrasound during pregnancy.

In view of the ever-increasing number of multiple pregnancies, which requires more time and a special approach, the observation of women with multiple pregnancies has been allocated to us in a separate clinic for multiple pregnancies.

All examinations in the center are carried out according to the international standards FMF (Fetal Medicine Foundation) and ISUOG (International Society for Ultrasound in Obstetrics and Gynecology). In complex clinical cases, we can consult with specialists from King's College Hospital, King's College Hospital (London, UK).

The team is a special pride of the center. Our doctors are not only one of the leading specialists, professors, doctors and candidates of medical sciences, doctors of the highest categories, they are also a team of like-minded people and real enthusiasts in their field. All ultrasound diagnostic doctors in our center have international FMF certificates. Having extensive experience in prenatal diagnostics, we share our knowledge with our colleagues by conducting training courses.

The Center is equipped with the most modern diagnostic equipment: these are the latest generation ultrasound machines, GE Voluson E8 Expert, with a complete set of modern technologies, including three-dimensional ones, this is a biochemical analyzer, Delfia Xpress, these are workplaces with professional computer programs.

21-24 weeks of pregnancy

21st week of pregnancy

Baby development due to the lack of subcutaneous fat, the body is still very thin, and the head seems unnaturally large. At this time, the formation of eyelashes and eyebrows takes place, the baby learns to blink, and his skin gradually acquires a flesh color, thickens, constrictions appear on it.

At the 21st week, the muscles and skeleton of the fetus are actively developing. The child constantly moves, carefully bends and unbends the limbs, due to its small size it can do somersaults, turns, change the position of its body several times a day, lie transversely in the uterus, turn up or down with its head.

At this stage, the baby hears well, not only distinguishes sharp sounds, but reacts to music, so the expectant mother can listen to classics or favorite songs, contribute to the development of the child. The development of the digestive system continues, taste buds are formed. The fetus is able to distinguish the taste of amniotic fluid.

Pregnant woman

Pregnant woman at 21 weeks feels normal. The expectant mother clearly feels the movements of the fetus; very often, the periods of sleep and activity of the child and the woman do not coincide, so pregnant women do not get enough sleep during this period, they wake up at night due to the intensive movements of the baby. Painful sensations at this time are quite rare, since the child does not have sufficient physical strength, and his movements do not differ in intensity.

A pregnant woman may put on weight as the baby grows, its muscle and fat mass increases. Expectant mothers eat with pleasure. Their appetite increases significantly, morning sickness and general malaise disappear.

At this time, the baby's skeleton is formed, for the development of which calcium is needed. Pregnant women should monitor their health, take calcium supplements as prescribed by a doctor, since if it is lacking, problems with teeth are possible. Calcium is washed out of the tissues, the teeth begin to hurt and crumble. It is important not only to consume vitamins, but also to carefully balance the diet, add calcium-rich cottage cheese, sour cream and other dairy products to the daily menu. The consumption of fish, cereals and legumes, vegetables will help to fill the calcium deficiency.

22nd week of pregnancy

Child development

The body length of the fetus reaches 28-30 cm and its weight is approximately 500 g. The child more and more resembles a newborn, his head no longer looks so big, the length of the limbs increases. The kid no longer keeps his legs constantly bent, he periodically straightens them. Intensively increases the volume and mass of the child's brain.

The baby is in constant motion, he can move his fingers and toes, move his head to the right and left. The child knows how to suck his thumb, he tilts his head forward and accurately puts his finger in his mouth. Such actions indicate an increase in sensitivity and development of the vestibular apparatus, improved coordination; the child already feels the position of his own body in space.

The baby's brain at this time contains a complete set of neurons, the number of which does not change throughout a person's life. With age, only the re-formation of connections between cells and the improvement of the work of the human brain takes place.

Pregnant woman

At 22 weeks, the uterus of a pregnant woman is located 2 cm above the navel. The abdomen is not yet very large, but the internal organs are already beginning to shrink due to the accelerated growth of the uterus. A woman may experience some discomfort, pain between the lower ribs. In order not to suffer from pain, you must constantly monitor your posture, choose a comfortable chair with a solid back for work. Special exercises, periodic changes in body position, turns and inclinations will help to solve the problem. It is necessary to avoid sedentary work, take short breaks and fully relax.

The fundus of the uterus can press on the stomach, so a common problem at this time is a feeling of heaviness after eating and heartburn. The position of the stomach in pregnant women changes to a more horizontal one, the muscle relaxes, which closes the transition from the esophagus to the stomach, as a result of which the contents of the stomach fall back into the esophagus, irritate it, the woman feels a burning sensation and an unpleasant aftertaste. The reason for such changes is not only the pressure of the uterus on the stomach, but also a change in the hormonal background of a woman, an increase in the content of progesterone in the body. To get rid of heartburn, you need to chew food thoroughly, eat often, but in small portions. Do not eat before going to bed, as the food will not have time to be digested. If the symptoms worsen, it is necessary to consult a doctor who will prescribe the necessary medications and help the expectant mother balance her diet.

23rd week of pregnancy

Child development

The 23rd week is an intensive formation of the respiratory system. The fetus begins to gradually make respiratory movements. If earlier the respiratory movements were periodic, now their duration can reach up to 40 minutes. In a minute, the child takes up to 50-60 breaths. The development of the respiratory system does not stop at this time, a kind of breathing exercises continue until childbirth, the baby improves skills and prepares to breathe air.

When breathing in the womb, the baby swallows a small amount of amniotic fluid and then pushes it out. In this case, the epithelium is washed. When amniotic fluid is swallowed, part of it is absorbed by the blood vessels, and the original feces, that is, meconium, are formed from the remnants.

If the baby is very active and swallows water very intensively, diaphragm irritation and contractions, also called "fetal hiccups", may occur. These rhythmic movements are not abnormal; such hiccups pass in a few minutes, does not pose a threat to the expectant mother and child. If the contractions do not stop within a few hours, you should go to the hospital, as a more serious problem, including hypoxia, can be the cause of hiccups.

The 23rd week is an important stage in the intrauterine development of a person. It is at this time that the formation and improvement of the main components of the circulatory and immune systems, including the liver, lymph nodes, spleen and bone marrow, continue. At this time, the thymus gland (or thymus) develops, which plays an important role in the functioning of the human endocrine system. It is in the thymus that lymphocytes mature. After a kind of "training" in the thymus, the cells enter the bloodstream and can resist infection, neutralize foreign cells in the body.

During pregnancy, the fetal immune system goes through several stages of formation and cannot provide full protection against diseases. The baby is protected by maternal antibodies, while its own immune system learns to recognize potential threats, remember bacteria and viruses, and defend itself against their harmful effects.

Pregnant woman

At 23 weeks' gestation, the uterus rises even higher and is located at a height of 4 cm from the woman's navel. The volume of the uterus increases significantly not only due to the growth of the child, but also due to an increase in the mass and volume of amniotic fluid and the placenta. At this time, the weight gain of a pregnant woman of 5-7 kg is optimal. The expectant mother should carefully monitor the daily diet, do not overeat, since excessive weight gain can pose a threat not only to her health, but also to the baby.

Intensive growth of the uterus causes a shift in the center of gravity. A woman becomes awkward, may feel discomfort in the joints and pain in the spine while walking or sitting for a long time. At this time, the doctor may recommend that a pregnant woman wear special supportive underwear made from natural materials or a bandage.

24th week of pregnancy

Child development

At 24 weeks of gestation, the baby continues to grow rapidly, he weighs already 600 g, and his height is approximately 33 cm. The fetus occupies the entire uterine cavity, so its movements become less impulsive, but more distinct; sharp movements are replaced by smaller ones. The baby can still radically change the position of his body, but prefers to sort out the umbilical cord, play with it, bend and unbend the arms and legs. The amount of muscle mass, namely the muscle fibers of the child, increases sharply. At this time, this indicator reaches its maximum. At later stages of pregnancy, the muscle mass of the fetus increases due to an increase in the volume of each muscle fiber.

This week the child's senses are being improved. He knows how to distinguish tastes, hears perfectly and orients himself in space, the baby's skin has a high sensitivity. The fetal brain continues to develop, connections with the senses are formed, so the child's behavior is characterized by a high degree of complexity. Studies have shown that the child reacts to external stimuli: if a bright light hits his mother's stomach, he turns his head away, closes his eyes or covers his face with his hands. A woman should be calm and peaceful, because her fear, excitement is transmitted to the child, he begins to move intensively or freezes abruptly. The baby may react to harsh sounds, noise, or other stimuli.

Pregnant woman

The weight of the pregnant woman continues to increase, the increase this week is about 500 g. The belly is growing, the uterus is not only increasing in size, but also stretching. A woman may notice pain in the abdomen, but they do not differ in intensity and do not last long.

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