Expectant Mother at 21 Weeks: Symptoms, Hormonal Changes, and Genetic Examinations
At the **21st week of pregnancy**, both mother and baby undergo significant changes. The baby is growing rapidly, and the mother may experience various symptoms as a result of hormonal changes.
### Baby's Development at 21 Weeks
By the 21st week, the baby is approximately the size of a carrot, measuring around 10.5 inches (26.7 cm) in length and weighing around 12.7 ounces (360 grams). The baby's ears begin to respond to sounds, and eyebrows and eyelashes develop. The digestive system starts functioning, and the baby begins swallowing amniotic fluid. The skin is covered with a protective waxy coating called vernix and fine hair called lanugo. Internal organs such as the liver and spleen are actively producing blood cells, and the bone marrow takes part in blood cell formation. The baby's kicks become stronger, and movements are constant. Other developments include the growth of taste buds, the swallowing of amniotic fluid, the start of circadian rhythms regulating heart rate and breathing patterns, and the gender can often be determined via ultrasound by this stage.
### Common Symptoms for the Mother
Hormonal changes during pregnancy can cause the skin to look pinker, plump up, and lead to spots, acne, sensitivity and itchiness, rashes, red veins on the cheeks, dark patches on the skin, and puffiness due to water retention. Other typical second-trimester symptoms may include heartburn and indigestion, leg cramps, dizziness, nasal congestion, breast and abdominal growth, and Braxton-Hicks contractions as the pregnancy progresses.
### Genetic Testing Options Available at This Stage
Genetic testing and prenatal screening for conditions like Down syndrome, Trisomy 18, and spina bifida are offered to women during their pregnancy. Non-Invasive Prenatal Testing (NIPT) is a blood test analyzing fetal DNA circulating in the mother's blood, usually done as early as 10 weeks but still relevant in the second trimester for screening genetic disorders. NIPT is safe, painless, and highly accurate (over 99% for Down syndrome detection). An anatomy ultrasound scan, typically performed around 18-22 weeks, checks fetal organ development and can detect major congenital abnormalities. Earlier genetic screenings, such as cell-free DNA tests and carrier screenings, are also informative in the second trimester.
It is essential to maintain a balanced and healthy diet during pregnancy, avoiding raw or undercooked food, uncooked, smoked, or pickled fish, unpasteurized soft cheese, refrigerated pâté, raw or undercooked meat and poultry, foods containing raw eggs, unpasteurized juice, milk, eggnog, and caffeine in excess of 300 milligrams per day. If eating fish from a non-commercial source, check with local health authorities that the waters in which it was caught are safe. A test for gestational diabetes may be recommended during the second trimester, and a serum integrated screen is typically carried out in cases where a nuchal translucency ultrasound cannot be performed. Between weeks 10 and 13, and again during weeks 15 to 20, a sequential integrated screen is recommended to test the blood for fetal proteins and identify 92 percent of pregnancies that result in Down's Syndrome.
Always consult your healthcare provider with any questions or concerns about your pregnancy or symptoms of an ectopic pregnancy or miscarriage, such as vaginal bleeding or passage of tissue, leaking vaginal fluid, feeling faint or dizzy, low blood pressure, rectal pressure, shoulder pain, severe pelvic pain or cramping. Pregnancy increases the risk of urinary tract infections (UTIs) from week 6 to week 24, so it is crucial to stay hydrated and practice good hygiene.
[1] American Pregnancy Association. (2021). Week by Week Breakdown: 21 Weeks Pregnant. Retrieved from https://americanpregnancy.org/week-by-week/21-weeks-pregnant/ [2] Mayo Clinic. (2021). Noninvasive prenatal testing (NIPT). Retrieved from https://www.mayoclinic.org/tests-procedures/noninvasive-prenatal-testing/about/pac-20395272 [3] Genetics Home Reference. (2021). Carrier screening. Retrieved from https://ghr.nlm.nih.gov/primer/geneticinfo/carrier [4] March of Dimes. (2021). Ultrasound. Retrieved from https://www.marchofdimes.org/complications/ultrasound-during-pregnancy.aspx
The healthcare provider may recommend a test for gestational diabetes during the second trimester, as early detection can help manage the condition. The science behind such tests involves measuring blood glucose levels to determine if the mother's body can produce and regulate insulin effectively.
In the context of prenatal care, they may also suggest various genetic testing options, such as Non-Invasive Prenatal Testing (NIPT) or anatomy ultrasound scans, to screen for potential genetic disorders. These tests help parents make informed decisions about their baby's health-and-wellness.
A balanced and healthy diet is crucial during pregnancy. To maintain a healthy lifestyle, it is advisable to avoid certain foods and beverages, such as raw or undercooked food, unpasteurized juice, milk, eggnog, caffeine in excess, raw eggs, and certain types of fish, to reduce the risk of foodborne illnesses and other potential health complications.
