Third trimester of pregnancy ( IV )

• Hemorrhoids. Hemorrhoids are varicose veins in the rectum. Although they may occur at any time during pregnancy, they are most common during the third trimester due to the increased pressure of the growing fetus on the veins in the rectum. Constipation may also contribute to their development. Hemorrhoids can cause itching, soreness and bleeding. Women may benefit from drinking a large amount of fluids, increasing fiber consumption and eating whole grains, fruits and leafy green vegetables. Women should also avoid straining during bowel movements.

• Stretch marks. Stretch marks are red, pink, or purple streaks in the skin caused by the stretching of the skin. These scars, which usually appear over the thighs, buttocks, abdomen and breasts, most often develop in the second half of pregnancy. According to the National Women’s Health Information Center, approximately half of all pregnant women get stretch marks. Following delivery, most stretch marks fade to light lines.

• Rashes. During late pregnancy, some women may develop itchy red bumps on the abdomen. Although they are harmless, these bumps can spread to the buttocks, arms and legs, causing discomfort. The rash normally disappears following delivery.

By the 26th week of pregnancy, the fetus is about 13 inches (330 millimeters) long and weighs approximately 1 ¾ pounds (794 grams). It will continue to grow and move, however, activity may be decreased due to the fact that the fetus now has less room. During this trimester, the expectant mother’s body will begin preparing for labor and delivery and the fetus will start moving down into the birthing position. As a result, the woman may notice the fetus moving down (dropping or a process called lightening) in the abdomen. By the end of the trimester, the average fetus is about 20 inches (508 millimeters) long and weighs about 7 pounds (3 kilograms).

Third trimester of pregnancy ( III )

• Increased perspiration. Pregnant women often experience increased perspiration. This is the result of growth and movement by the fetus. During hot weather, pregnant women may benefit from resting, drinking cold liquids and taking cool showers. This can prevent overheating.

• Shortness of breath. Pregnant women may experience shortness of breath, as the result of the uterus expanding beneath the diaphragm (the muscle below the lungs). Patients may benefit from taking long, deep breaths. Maintaining good posture is also beneficial because it gives the lungs room to expand. At night, women are encouraged to use an extra pillow or sleep on their left side. Pregnant women should contact their ObGyn when they experience shortness of breath accompanied by chest pain or a cough.

• Continued breast growth. Most women experience breast growth throughout pregnancy. During the late stages of pregnancy, hormones cause the breasts to grow even larger in preparation for breastfeeding. By the third trimester, a woman may have an additional one to three pounds (1.4 kilograms) of breast tissue. This may result in tenderness and discomfort. Women may benefit from wearing a more supportive bra, such as a nursing or maternity bra.

• Changes in skin color. During the second half of pregnancy, hormonal changes may cause the skin to darken. Some woman may develop darker nipples or a dark line running from the naval to the pubic hairline (linea nigra). Pregnancy may also cause blotchy brown pigmentations to appear on the nose, forehead or cheeks. They may also appear over the eyes. Known as melasma or chloasma (mask of pregnancy), these changes are particularly common among women with dark hair and pale skin. Most of these skin changes fade or disappear following delivery.

Third trimester of pregnancy ( II )

• Swelling. The body produces and retains additional fluid during pregnancy. As a result, many woman experience slight swelling. It is especially common in the last few months of pregnancy. Swelling most often occurs in the legs, feet and ankles, but also may occur in the hands and face. Pressure from the uterus on the veins that return blood from the feet and legs may also cause swelling in the feet and legs. Swelling may be more severe in warmer seasons or climates.

Women may benefit from drinking fluids and placing a cold compress on affected areas. Patients with swollen legs or ankles may benefit from wearing a larger shoe size and resting whenever possible with their feet elevated. Women experiencing sudden or extreme swelling of the feet, ankles, hands and face, or sudden weight gain, should immediately contact their ObGyn. It may be a sign of preeclampsia, a serious pregnancy complication.

• Aches and pains. Expansion of the uterus and the abdomen may cause pains in the abdomen, groin or thighs. Pressure from the fetus’s head, increased weight and loosening joints can also cause backaches or aching near the pelvic bone. Backaches may also result from strain on the muscles that support the spine. Women may benefit from lying down, resting, sitting in chairs with good back support and applying heating pads or ice packs to the affected area. In addition, some gentle stretching of the muscles or massage may help ease the discomfort.

Women should contact their ObGyn when pains do not improve after resting or when back pain is accompanied by fever (a sign of infection and other complications). Physicians should also be immediately notified when a patient experiences moderate or severe pelvic pain or any degree of pelvic pain that lasts more than four hours.

Third trimester of pregnancy ( I )

• Hair changes. Pregnancy can cause changes in the texture and growth rate of hair. In many cases, pregnant women develop thicker hair during pregnancy. This is the result of hormones causing hair to grow faster and fall out less. Others notice that their hair changes color, or that it is drier or oilier than normal. In addition, some women grow hair in unwanted places, such as the face, abdomen and around the nipple. These changes usually disappear after delivery.

• Spider veins. The increased blood circulation during pregnancy can lead to the development of small reddish spots on the face, neck, upper chest or arms. These spots are commonly referred to as spider veins because they appear to sprout tiny blood vessels that resemble the legs of spiders. These marks, which are especially common among women with fair skin, usually fade or disappear after delivery.

• In addition, changes in hormone levels may slow the digestion process and relax the muscles that keep the stomach acids in the proper place. As a result, stomach acids reflux, causing a burning sensation in the throat and chest. Women may benefit from avoiding spicy, fried or fatty foods and eating smaller, more frequent meals. In addition, remaining upright for a period of time following a meal may decrease the heartburn and reflux. Women should contact their obstetrician–gynecologist (ObGyn) when they experience severe or persistent heartburn that does not respond to these treatments.

• Varicose veins. During pregnancy, pressure is placed on the large veins located behind the uterus. This slows the return of blood to the heart and puts pressure on the veins, causing them to swell. As a result, varicose veins may develop. These veins look swollen and cause pain. They may appear to be twisted, bulging and dark purple or blue in color. During pregnancy, varicose veins most often develop on the back of the calves, thighs and vagina. Women may benefit from avoiding long periods of standing, lying on their side and sitting with their legs and feet raised whenever possible.

Third trimester of pregnancy

The third trimester of pregnancy lasts from week 25 to delivery. During this time, many of the discomforts from the second trimester may remain. As the result of a growing fetus placing additional pressure on the maternal organs, existing conditions may worsen and new conditions may develop. In addition, the fetus’s size and position may make it difficult for a woman to get comfortable. Most of these conditions, however, disappear or lessen after delivery. Common changes and symptoms of the second trimester include:
- Expanding abdomen. The uterus is continuing to enlarge. By the 36th week of pregnancy, the uterus extends to the lower edge of the rib cage. The expanding abdomen often causes the naval to bulge.

- Changes in nail condition. During pregnancy, hormones can cause nails to grow faster and become stronger. In some women, however, the nails may become more prone to breakage and splitting. These changes usually disappear after delivery.

- Heartburn and indigestion. Heartburn and indigestion are common during pregnancy, even for those who have never experienced these conditions before. Although they can occur at any time during pregnancy, they typically occur during the third trimester. As the fetus grows, it causes the uterus to push on the stomach. This can result in acid reflux (backflow of stomach acid into the esophagus) and heartburn, particularly after a meal.

- Leaking breasts. As the breasts continue to prepare for breastfeeding, an expectant mother may begin to leak colostrum (a type of milk) in the third trimester. Colostrum is an early rich precursor to the normal breast milk that the body produces. Women with leaking breasts may benefit from placing disposable or cloth nursing pads in their bras.

Second trimester of pregnancy

• Vaginal discharge. Pregnant women may produce a thin, white vaginal discharge (leukorrhea). Consisting of cells from the vaginal lining and normal vaginal moisture, this type of discharge is not a cause for concern although the amount may be greater than before pregnancy. Women, however, should contact their ObGyn if they produce a strong-smelling green or yellowish vaginal discharge or any vaginal discharge accompanied by redness, itching or irritation. These symptoms may indicate a vaginal infection.

• Glowing skin. Pregnant women may experience a “healthy glow” resulting from the increase of blood circulation.

• Dizziness. A woman may experience dizziness, lightheadedness or fainting at any time during her pregnancy. These symptoms may be especially noticeable early in the second trimester. This is due to the additional blood heading toward the uterus and legs and the dilation of blood vessels in response to hormones. Occasional dizziness may occur until the volume of blood expands to fill the vessels. Women may benefit from avoiding prolonged standing, lying on their left side (to relieve pressure on blood vessels) and rising slowly after sitting or lying down. In addition, women should avoid sitting or standing in one position for an extended period of time.

• Nasal problems. During pregnancy, the lining of the nose and airway may swell as more blood flows to the mucus membranes. This can result in restricted airflow. In addition, hormones affect the tissues of the throat, mouth and nose. As a result, pregnant women may experience snoring, congestion and nosebleeds. Women may benefit from drinking water, sleeping on their sides and using a cool mist humidifier in their bedroom. Although these conditions are typically harmless, women should contact their ObGyn when nosebleeds occur often or continue longer than a few minutes.

Second trimester of pregnancy

• Tingling. Many woman experience tingling and numbness in the fingers during
pregnancy. This is due to swelling of tissues in the narrow passages in the wrists. These sensations often disappear after delivery.

• Leg and foot cramps. It is common for pregnant women to experience leg cramps during the second and third trimesters. Frequently occurring at night, these cramps may result from the pressure the uterus applies to the veins which return blood from the legs. Changes in circulation and stress on the leg muscles due to carrying additional weight may also be to blame. In addition, cramps may also be due to changes in the way the body metabolizes (processes) calcium. Women may benefit from stretching the affected muscle or walking, and consuming an adequate amount of calcium.

• Braxton Hicks contractions. During the second trimester, the uterus may begin flexing to build up strength. As a result, a woman may feel contractions in her lower abdomen and groin. These contractions, known as Braxton Hicks contractions, are usually painless and unpredictable. Women should immediately contact their ObGyn when contractions become painful or regular. This may be a sign of premature labor.

• Itchiness. Many women experience itchiness as their pregnancies progress. This is due to hormones and stretching skin in areas such as the abdomen. Some women also develop itchiness and redness on their palms and the soles of their feet. These symptoms usually vanish after delivery. Women may benefit from moisturizing and using soaps for sensitive skin. In addition, women should avoid taking hot showers or baths, which can cause dryness. Since heat rash can worsen itching, women should also avoid becoming overheated. Women experiencing itching in combination with nausea, vomiting, loss of appetite, jaundice (yellowing of the skin and eyes) or fatigue should contact their obstetrician-gynecologist (ObGyn) immediately. This may be a sign of cholestasis, a condition that indicates a serious liver disorder.