Update: October 2018
Over the entire period of waiting for a child, a woman visits not just once or twice.
female consultation. Frequent meetings with the doctor allow to observe
течение of pregnancy, своевременно выявлять какие-либо отклонения и
take the necessary measures. In addition to weighing and compulsory
measuring the blood pressure of the expectant mother at each
the abdominal circumference and, most importantly, the height of standing are measured during the visit
the bottom of the uterus, the indicators of which are compared with the rules, which allows
сделать вывод о нормальном течении of pregnancy или заподозрить
Objective examination of pregnant
Examination of the future mother is carried out at the first appearance in the female
консультацию и постановке на учет по of pregnancy. Objective
not only an obstetrician-gynecologist, but also a therapist
with a dentist, an ENT specialist with an ophthalmologist, and according to indications
endocrinologist and surgeon, cardiologist and urologist. If necessary
(presence of children with congenital malformations, hereditary
diseases, etc.) is prescribed medico-genetic
In the course of an objective survey, study and measure:
- female body temperature;
- height and weight of the future mother (it is necessary to predict
weight gain in the future and edema detection);
- blood pressure (measured at each visit to the female
- body type (normostenic, asthenic, or
- the size of the pelvis;
- coloring and condition of the skin and mucous membranes;
- form of mammary glands, their palpation;
- examination of the abdomen and palpation;
- condition of the symphysis joint by palpation (is there
- the state of the organs of the cardiovascular system and
gastrointestinal tract, lungs, nervous and endocrine systems,
as well as excretions;
- the condition of the teeth and so on.
Early turnout for dispensary registration is very important, so
как в небольших сроках of pregnancy можно диагностировать ожирение
and subsequently differentiate it with hidden edema. Also
первое посещение акушера в малых сроках of pregnancy позволяет
to determine the “working” pressure of the woman and to record the deviations of his
from the norm in the later stages of gestation.
The special obstetric examination includes three
- external obstetric examination;
- gynecological examination on the chair (internal
- additional research methods.
External obstetric examination
When conducting this examination, the tasks of the doctors include an examination
abdomen and pelvis (presence of bone curvature and displacement), measurement
pelvis size, measurement of abdominal circumference (the largest size),
palpation of the abdomen and convergence of the pubic bone, listening
(auscultation) fetal heartbeat, which is possible after 20 weeks
Measurement of the pelvis
The measurement of pelvic size is called pelviometry, which
allows you to indirectly assess the internal dimensions of the pelvis.
4 pelvic sizes are determined (using a tazomer):
Distance spinarum (distantia spinarum)
Represents the distance between the front upper spines.
(easily felt in front) of the iliac bones and normal
corresponds to 25 – 26 cm.
Cristarum distance (Distantia cristarum)
The distance that is measured between the most distant ones
other points of the iliac crests (on the bones) and normally reaches
28 – 29 cm
Distance trochanterika (Distantia trochanterica)
This is the gap between the large skewers of bones.
hips (they protrude from the outer surfaces of the thighs). This segment is in
the norm is 31 – 32 cm. If the difference between the listed
transverse dimensions of not more than 3 cm, this indicates
Conjugata externa (outer conjugate)
Refers to the direct size of the pelvis. Measured by the position of a woman
on the side, and the pregnant woman’s lower leg should be bent at the knee and
hip joint. One button of a tazomer is fixed on top
outer edge of the symphysis joint, and the button of another branch
pressed against the supracarpal fossa. The length of the outer conjugates is normal
is in the range of 20 – 21 cm. If the number obtained subtract 9,
then it turns out the approximate value of the true conjugates (11 – 12
Measuring the size of the abdomen
Before measuring the size of the abdomen, the doctor must
feel the anterior abdominal wall. What is it done for? Palpation
anterior abdominal wall provides an opportunity to determine the elasticity
muscles and skin of the abdomen, in what condition are abdominal muscles
press, are there any discrepancies or hernial protrusions, and
to determine the severity of the subcutaneous fat layer, significant
толщина которого can исказить показатели окружности живота
(norms). From anatomical, and especially functional state
(muscle tone) abdomen depends on the course of labor. For example,
women with multiple muscles or pregnant women with overweight muscles
брюшного пресса настолько вялы и ослаблены, что can отрицательно
affect the course of the period of need (weakness of attempts). After all
attempts are provided by contraction and tension of the muscles of the front
After palpation anterior abdominal wall go to palpation
uterus, which is only possible at 13-13 weeks, when the uterus
stands for the limits of the pubic symphysis. Firstly
its tone is determined. Increased tone or hypertonus
indicates the threat of interruption and is determined by palpation as
doctor and the woman herself. The uterus in this case is strained by
touching, moving the fetus or against the background of complete rest. Future
Moms call this state “belly stone.”
Then the obstetrician measures the height of the uterus and
Rules for measuring the abdomen
For the most accurate and reliable results.
measuring the abdomen, you must observe the following rules:
- Measurements are made only by a specialist.
Only a specialist (doctor or
midwife), measurements taken by the husband or even the most pregnant,
can be very different from the true indicators and can be very
upset a woman.
- Empty bladder
Every woman knows that before visiting the gynecologist should
go to the toilet. Empty bladder is relevant not only when
conducting a gynecological examination, but also during a routine
visit to the antenatal clinic pregnant. Filled Urea
приподнимает матку, что can исказить размеры живота (и его
circumference and height of the uterus).
- Use one centimeter tape
Yes, the future mom’s belly is measured by the usual centimeter
ribbon, which is used by tailors. Use of the same
abdominal tapes reduce the likelihood of abnormalities in
indicators (and the doctor, as a rule, has one constant
- The horizontal position of the pregnant
When measuring the abdomen, the future mother is placed on a firm
horizontal surface (couch). A woman should relax and
straighten the legs (bending the legs at the knee joints can not be).
- Gestational age
To measure the belly start with a specific period of pregnancy,
when the uterus has grown enough and stands for the limits of the pelvis,
that is, it “peeps” above the bosom. Accurately name the period when the tummy
in a woman becomes noticeable, difficult. It all depends on the constitution.
pregnant and the number of fetuses in the uterus. So, with multiple fetuses
pregnancy, the uterus rises above the limits of the symphysis joint
from 13 to 14 weeks. Therefore, the gestational periods in which they begin
measure the belly, vary greatly, from 13 to sixteen weeks.
Pregnancy: the growth rate of the uterus
The uterus in the absence of pregnancy does not exceed a length of 7 – 8 cm, and
its mass is not more than 50 grams. But as soon as in the uterus “settled”
germ, it begins to increase significantly in size and grow
(as the fetus grows).
- 5 – 6 weeks of gestation
For a two-handed gynecological examination, a mild
the uterus, and its size is not more than a chicken egg.
- 7 – 8 weeks of gestation
The uterus has already grown and reached the size of a goose egg or
- 10 weeks of gestation
The uterus can be compared with the size of a man’s fist.
- 12 weeks of gestation
Largest uterus corresponds to the head of the newborn. Disappeared
its asymmetry, it is round and soft, centered in the small
pelvis. The uterine bottom reaches the upper border of the pubic symphysis and
it can already be felt above the pubis.
- sixteen weeks – the uterus “left” the pelvic area, and its bottom
located approximately in the middle of the gap between the pubic
symphysis and navel.
Since the beginning of the second trimester of pregnancy (after 12 weeks)
start measuring the abdomen of a woman.
Start measuring the abdomen
Abdominal circumference, as indicated above, is measured
measuring tape, which is placed at the navel
pregnant The tape can not be too hard, and unnecessarily
relax. The measurement of the height of the uterus is
determining the distance between the protruding edge of the pubic symphysis and
the bottom of the uterus.
Abdominal circumference: norms
Abdominal circumference by week of pregnancy (estimated norms
- 20 weeks of gestation – 70 – 75;
- 22 weeks of gestation – 72 – 78;
- 24 weeks of gestation – 75 – 80;
- 26 weeks of gestation – 77 – 82;
- in the period of 28 weeks – 80 – 85;
- in the period of 30 weeks – 82 – 87;
- in the period of 32 weeks – 85 – 90;
- in the period of 34 weeks – 87 – 92;
- in the period of 36 weeks – 90 – 95;
- in the period of 38 weeks – 92 – 98;
- at 40 weeks – 95 – 100.
The height of the bottom of the uterus: norms
After the uterus has grown up and protrudes beyond the pubic
symphysis, begin to determine the height of its bottom, which indirectly allows
judge the normal growth of the fetus and the estimated period
of pregnancy. The height of the uterus floor by weeks can be estimated
in two ways, relating it to anatomical landmarks or
measuring in centimeters.
The height of standing of the uterus is presented in the table:
|Gestational age в неделях||Location of the uterus|
|In relation to anatomical landmarks||Height in centimeters|
|sixteen||Midway between the pubic symphysis and the navel||6, maybe 8|
|20||About 3 to 4 cm below the navel (2 transverse fingers)||11–12|
|24||The bottom of the uterus in the navel||22-24|
|28||3 to 4 cm above the navel or 2 obstetric fingers||28|
|32||Midway between navel and sternal end (xiphoid
|32 – 33|
|36||Corresponds to the level of the xiphoid process and ribs||36 – 37|
|40||Midway between umbilical fossa and xiphoid
As it becomes clear from the presented table, by the end
pregnancy, the uterus begins to descend. Maximum
values are the height of the uterus, however, as well as the abdominal circumference,
in the gestation period, it reaches 9 obstetric months or 36 weeks.
The prolapse of the uterus is attributed to one of the precursors of childbirth and is associated
This feature with the pressing and insertion of the baby’s presenting part in
pelvic cavity. Therefore, the woman feels relief of breathing and
the disappearance of shortness of breath. Delivery after the bottom of the uterus decreases,
forecast in the next 2 – 3 days.
As the belly grows, the expectant mother first smoothes out.
umbilical fossa, and then the navel begins to bulge, which should not
bother the woman.
What determines the size of the abdomen
The size of the belly of the expectant mother depends on many factors and can
be more or less of the norms presented. On belly indicators
pregnant women, as well as his position, are affected by the following
- sizes of the future child;
- fetal position in the uterus;
- constitutional features of pregnancy;
- pelvic shape (various curvatures);
- weight gain during the current period of pregnancy;
- the number of fruits;
- localization and maturity of the placenta;
- genetic predisposition;
- amount of amniotic fluid.
If the stomach is “small”
Reduction in abdominal performance in relation to height standards
маточного дна и объема живота can сигнализировать о следующих
- lack of amniotic fluid or water scarcity;
- placental insufficiency;
- thin placenta or its premature aging;
- intrauterine growth retardation or malnutrition of the fetus;
- severe preeclampsia leading to delayed growth and development of the fetus;
- antenatal death of the fetus, including missed abortion
in the 2nd trimester;
- intrauterine infection.
Small abdomen can be observed with normal
течении of pregnancy. First, when the gestational age was
incorrectly defined, and, secondly, with a wide and capacious pelvis
burly and tall women.
If the stomach is “too big”
Excess abdominal size is possible in the following
- multiple pregnancy;
- large size of the fetus;
- the fruit is located across or obliquely;
- trophoblastic disease (blistering or
- excess amniotic fluid (high water);
- a large weight gain for pregnancy;
- placenta previa (the height of the uterine bottom exceeds
- narrow pelvis;
- thick and swollen placenta (for example,
Measuring the abdomen of the expectant mother “centimeter” is
a mandatory event every time you visit the obstetrician and
позволяет заподозрить возможную патологию в течении of pregnancy.
Trustworthy method to resolve the doubts of the doctor and
identify any irregularities in the gestation period,
is an ultrasound. With the help of ultrasound can
- the most accurate gestational period;
- height and weight of the fetus;
- determine if the embryo / fetus is alive or dead;
- localization of the placenta;
- size and thickness of the placenta;
- Does pregnancy develop in short periods (exclude
- identify trophoblastic disease;
- eliminate ectopic pregnancy;
- determine the position / presentation of the future baby;
- diagnose fetoplacental insufficiency.
Вопрос: Можно ли рассчитать вес будущего малыша по
Ответ: Да, конечно. Abdominal circumference measurement
together with the height of the bottom of the uterus play not the last role to calculate
estimated mass of the fetus. There are many calculation formulas
mass of the fetus. It is especially important to know the intended weight when
admission of women to the hospital for emergency reasons and drafting
birth management plan. It is known that during the course of labor they have
influence of many factors (obstetric complications, maternal and
other), including the mass of the fetus. The most popular formula
is the Jordania formula: the abdominal circumference is multiplied by the height
the bottom of the uterus (in cm). For example: coolant = 90, WDM = 35, estimated weight
child is 3150 grams. Of course, this is not reliable
result, possible deviations in one direction or another by 100 – 200
gram. And, undoubtedly, we should not forget about additional factors
thanks to which both the coolant and the WDM can be more or less
норм, характерных для данного срока of pregnancy.
Вопрос: Влияет ли питание беременной на размеры
Ответ: Да. The size of the abdomen of the future mother in
Much depend on its nutrition. Undoubtedly, during pregnancy
women’s appetite increases – so laid down by nature. Future mom
fat begins to be deposited, including in the abdomen, to
formed the so-called fat pad, whose task
is to protect the fetus from accidental and violent injuries.
Therefore, pregnant women who adhere to the principle “eat for two”
gaining weight very much and quickly, mainly due to
fat formation. Abdominal circumference in such cases can
significantly exceed the norm, which is not good for both mom and
for the baby. Pathological weight gain (meaning the increase
fatty layers, not covered edema) is fraught with the development of preeclampsia,
threatened interruption and preterm labor, premature
placental abruption, placental insufficiency, severity
lower abdomen and lower back, fatigue. And of course not
it should be forgotten that fasting, like overeating in the period
pregnancy is unacceptable. Therefore, all diets should be postponed to
time until the baby is born.
Вопрос: Правда, что по форме живота можно
determine the sex of the child? For example, if the spiky and
�”Looks” up, then a girl will be born?
Ответ: Нет, это миф, не имеющий под собой
no reason. The shape of the abdomen depends on many factors:
the number of genera, the number of bearing fruits, size and shape
pelvis, the dimensions of the unborn child, his position and others. Acute,
�”Looking up” tummy is typical for young primiparas
women with trained abdominal muscles. But possible
the pointed form of the abdomen and in women whose pelvis is significantly
narrowed down. Too big and round belly is found in women
who expect the birth of twins or triplets. Also round and
constantly “gurgling” belly indicates polyhydramnios. Also
живот can иметь круглую или даже квадратную форму, но быть
dense with large size baby. Irregular shape
(asymmetrical) abdomen suggests an incorrect position
fetus (oblique or transverse).
Вопрос: Почему появляются растяжки на животе?
Ответ: Возникновение растяжек of pregnancy
(stri) on the skin of the abdomen is determined by the rate of its growth. Risk
the appearance of stretch marks increases significantly with rapid weight gain
woman (overeating), with an excess of amniotic fluid,
multiple pregnancies or large fetuses (for example,
in diabetes, when the fetus is characterized as gigantic,
there are 5 kg or more). In such cases, the doctor will recommend
use of special cosmetics (lotions and
creams), which, if not prevented, then at least reduce
probability of striae formation. Also для профилактики растяжек
You can massage the skin of the abdomen.
Вопрос: Почему «зудит» и чешется кожа belly?
Ответ: Появившийся зуд, как правило говорит об
excessive stretching of the skin of the abdomen and warns of the appearance
stretch marks. Еще одной причиной can служит повышенное потоотделение
have a pregnant. Special soothing help to cope with itching.
ointment for women in the “interesting” position and funds from