Pregnancy in the 24th week

During the 24th week of pregnancy, your baby is likely to be about 30cm from head to toe—that is. roughly the size of an ear of corn—and weigh about 600 grams. Apart from a head that’s a bit larger than the body, and skin that’s a little wrinkly, your baby is now looking pretty much like a newborn. 

Your baby is also considered to be viable now, which means that the chances of survival of your baby have shot up even if premature delivery was to happen. However, you need to fight off infections of all sorts that can endanger your baby’s life during this stage.

This apart, your baby's brain development has quickened. His or her taste buds are forming, and the lungs are improving every day. Pulmonary surfactants, which are lipids and proteins everybody needs in the lungs to enable breathing, are now being produced in your baby’s lungs. The perfect amount of surfactants will, however, only be produced after your baby comes to full term, which is why premature babies have more trouble breathing and require support in neonatal intensive care units (NICU).

There are a number of symptoms of pregnancy that you might not even notice much any more because you’ve learnt to live with them over the first 23 weeks of pregnancy. However, you’re likely to experience some of the common symptoms that occur during the second trimester. The following are some symptoms that are likely to show up in the 24th week of pregnancy.

• Sciatic nerve pain: This periodic type of pain might be occurring in your legs. The sciatic nerve is one of the biggest in the body. It runs under the uterus and all the way down your legs. With the added weight and pressure of the womb on this nerve, sciatic nerve pain is quite normal during pregnancy—especially, in the second and third trimesters. The best thing to do about it is to rest as much as possible.
• Round ligament pain: Round ligament pain is a type of pain that pregnant women experience in the lower belly or groin area, either on one side of these areas or across them. This is one of the most common complaints in the second trimester, so it’s quite normal. However, if you cannot bear the pain or it appears to be too much, do consult the doctor immediately.
• Varicose veins: A lot of women may start noticing varicose veins in their legs, genitals and rectum, which can be a cause of concern and discomfort. Varicose veins during pregnancy usually appear because the growing uterus puts pressure on the large vein known as inferior vena cava, that carries blood back from your legs and feet to the heart. Varicose veins in the rectum are basically the cause behind hemorrhoids or piles, which might be an added symptom of pregnancy during this week.
• Braxton Hicks contractions: Although most commonly experienced during the third trimester of pregnancy, Braxton Hicks contractions can start early and show up in the second trimester as well. When these contractions occur, your uterus muscles can tighten for 30 or 60 seconds—these contractions might even last for two minutes. Although harmless, you should definitely consult your doctor if these contractions show up, intensify in pain and in frequency. (Read more: Contractions during pregnancy)
• Sleep problems: Whether it’s because of all the aches and pains, the leg cramps, indigestion during pregnancy, trips to the bathroom, heartburn or any other symptoms of pregnancy, getting a good night’s sleep might seem like an elusive goal during pregnancy. Not getting enough sleep can lead to stress and other serious issues, so make sure you consult your doctor about it. (Read more: Sleep during pregnancy)
• Fatigue: Your body is pumping more blood, your weight has increased, there’s a life growing inside you and you still have to remain active and make sure your daily chores are performed. Add to that, you might also not be getting enough sleep. Fatigue is quite natural under these circumstances—so don’t beat yourself up about it. Instead, make sure you get enough rest, get undisturbed sleep and eat well.
• Melasma: Melasma, also known as chloasma or the mask of pregnancy, basically refers to the dark patches of skin that might appear on your forehead, cheeks, and other parts of the face during pregnancy. This usually occurs due to hormonal changes during pregnancy, and these dark and symmetrical patches are likely to disappear a month or two after delivery as your hormone levels go back to normal.
• Other symptoms: Apart from the above-mentioned symptoms which are typical in the second trimester, you might still experience some symptoms from the first trimester during the 24th week of pregnancy. These symptoms are heartburn, indigestion, bloating, constipation, sore breasts as your body prepares for breastfeeding, bleeding gums, swollen gums, headaches, nosebleed and mood swings.

Your abdomen and breasts are still growing, and it might start getting difficult to see your toes while standing up straight. Your uterus will continue to grow throughout the rest of your pregnancy, and it might push on both your bladder and rib cage. This can lead to shortness of breath and frequent urination during pregnancy. This apart, your growing breasts might also release some colostrum, which indicates that your body is prepared for breastfeeding.

It’s important to take care when you pee because if you’re accidentally leaking amniotic fluid then that can be a cause of concern. Check yourself when you pee, and in case you are concerned, call the doctor or emergency health services immediately. This is also a good week to get your cervix checked. In case your cervix is weak, you might have to get a cervical cerclage done. It’s also important to start doing pelvic floor strengthening exercises during this week.

Read more: Kegel exercise

Ask your doctor if you should get yourself screened for gestational diabetes. A blood glucose screening should ideally be done between the 24th and 28th weeks of pregnancy. In case your blood sugar levels are high, you’ll have to tailor your diet accordingly and follow the other recommendations given by your doctor.

Most complications of pregnancy have their own risk factors, which is why knowing about them well in advance and avoiding all risky habits and behaviours is very important. The unfortunate thing is, while you can reduce the risk of most complications, some might still occur, especially if you have a history or genetic predisposition for it. The following are some of the complications that might show up during the 24th week of pregnancy.

• Stillbirth: While the loss of a foetus before the 20th week of pregnancy is known as a miscarriage, pregnancy loss after the 20th week is known as stillbirth. If the stillbirth occurs between the 20th and 27th weeks of pregnancy, it’s known as an early stillbirth. There are a number of risk factors associated with stillbirth even though its precise causes are not known yet. Despite being a major risk, development in medicine and medical technologies have made it possible to reduce the risk of stillbirth if caught in time. Hence, if you do see any symptoms like contractions, vaginal bleeding, etc., you should contact emergency health services immediately.
• Gestational diabetes: Hormonal changes during pregnancy can lead to gestational diabetes due to increase in blood sugar levels. This usually occurs between the 24th and 28th weeks of pregnancy. It’s important that you get an oral glucose tolerance test (OGTT) done during these weeks to diagnose the condition, as it can have severe implications for you and your baby. A close observation of blood sugar levels, change in diet and increase in exercise might be recommended if you have gestational diabetes. In some cases, doctors also prescribe drugs like metformin and insulin if the condition is too severe.
• Hypertensive diseases: High blood pressure (BP) is never a good thing to have, but it can pose quite a number of difficulties during pregnancy. High BP in the expecting mom can reduce the availability of oxygen and nutrients to the baby in the womb. It has also been associated with placental abruption, in which the placenta becomes partially or completely detached from the uterus before the due date. Gestational hypertension can also slow down baby development in the womb, and lead to other problems such as going into premature labour and low birth weight (under 2.5 kilograms) of the baby. Pre-eclampsia and eclampsia are also complications that can arise due to blood pressure issues during pregnancy.
• Subchorionic haemorrhage: Since you aren’t supposed to experience any vaginal bleeding during the pregnancy, bleeding due to a subchorionic haemorrhage can be quite alarming. This type of bleeding occurs when the original connection between the placenta and the uterus is affected, though not completely broken (placental abruption). This occurs in over 3% of pregnancies. Usually safe in the early stages of the first trimester, this type of bleeding should not be ignored later in the pregnancy.
• Infections: Unless you’re living in a bubble, you might not be able to completely avoid infections during pregnancy. Pregnant women are more prone to some infections, like bacterial vaginosis and urinary tract infection (UTI). Infections typically cause a fever—a normal occurrence as your body fights the pathogen. A rise in body temperature during pregnancy, however, can be harmful to your health as well as your baby’s. (Read more: How to naturally reduce your body temperature during pregnancy)
• Obstetric cholestasis: Obstetric cholestasis is a type of liver condition that usually shows up during the second or third trimesters of pregnancy. It causes itchiness without a rash (pruritus). There’s no treatment for this condition, and it usually becomes better on its own after delivery. In the meantime, if the itching gets to be too much, ask your doctor for salves and creams to soothe it.

If there’s one thing pregnancy teaches you, it’s to take your health very seriously. Keeping that in mind, there are a number of things you should get done or start doing during the 24th week of your pregnancy. Here’s a list you can use to get these important things done.

• Talk to your doctor about cervical cerclage and check if you need to get it done or not.
• Start doing pelvic floor strengthening exercises.
• Reduce your caffeine intake, and keep a check on your salt and sugar consumption, too.
• Do not consume rare or undercooked meat, raw fish or undercooked or runny eggs, etc., as these can cause salmonella and listeriosis.
• Wear comfortable and loose-fitting clothes, the right maternity bra and avoid high heels.
• Avoid strenuous exercise and activities.
• Follow the prescription of your doctor and do not mess with the dosage of prescribed medications.
• Prioritise your diet and sleep schedule, and try to keep your feet up to avoid bloating and pain.

Read more: Is it safe to eat cheese during pregnancy?

Get to know the things your baby responds to the most and make a note of his or her most active times while in the womb this week. This can help you understand if everything is going well with your baby. Talk to your doctor about these movements and don’t hesitate to air any concerns you may have about anything. Maintaining a good relationship and keeping the channels of communication open with your obstetrician is very important because it can be very reassuring to know how you and your baby are doing.

It’s equally important to find mental and emotional support during pregnancy, whether it’s through conversations with your family and friends or through a maternity support group where you’ll find women experiencing pregnancy and its many issues just like you. Engage with your spouse or partner and make sure that even though they can’t experience pregnancy themselves, they feel equally attached to you and the baby in your womb.