Pregnancy in 27th week

Your baby is now approximately 36.6cm head to toe, which is as large as the vegetable called leek. Your baby’s approximate weight at this point should be around 875g, but not for long, as your baby will continue to gain weight and grow during the upcoming weeks. 

The baby’s nostrils are likely to open up this week, and so will the eyes which basically fused shut in the 11th week of pregnancy. There might even be some blinking involved! It’s also likely that your baby now has a regular sleep-wake cycle, but don’t expect it to match yours until at least six-eight months after delivery. 

You might often feel some rhythmic movements in your womb, especially after a heavy or spicy meal. Don’t worry, it’s just your baby hiccupping. As your baby’s lungs continue to develop, baby hiccups will be quite natural at this stage of your pregnancy.

Trying to get a peek at your own feet may seem impossible now. You might also feel more bloated, short of breath and feel the need to urinate more frequently. This is because your uterus is still growing and applying pressure to various internal organs. (Read more: Frequent urination during pregnancy)

Try not to let these things bother you too much, and focus on the positive changes in your body. Your breasts are fuller. Your hair looks thicker than ever—all those pregnancy hormones actually reduce hair fall! And your belly button may be pushed outwards now—flaunt it in your pregnancy shoot if you're planning to have one.

If you experience belly button pain during pregnancy or chaffing against clothes, you could try a protective shield over the belly button to minimise the discomfort.

This might be a good time to start taking smaller meals with more fibre and sip more water throughout the day, as well as to reduce strenuous activities and exercises. The comfortable second trimester is coming to an end, and your discomfort will increase—some symptoms of your pregnancy, especially those linked to digestion, might get aggravated now. Getting sufficient sleep might also become a bigger issue, so daytime naps might now become a necessity.

The second trimester might have been the most comfortable part of your pregnancy, but it’s almost over now. It’s unlikely that brand new symptoms of pregnancy will show up during the 27th week of pregnancy or after it. But be sure that some symptoms will be more aggravated than before. The following are some of the key symptoms that you should look out for in the 27th week of pregnancy.

• Sciatic nerve pain: As your baby grows in weight, it starts to put extra weight on your sciatic nerve—which is the largest nerve in the body and travels down to your legs from underneath your uterus. This can manifest in the form of pain along the path of the sciatic nerve. The pain can be constant or may occur in bouts, but the best way to relieve it is by taking a hot or cold compress and staying off your feet as much as possible.
• Round ligament pain: A lot of women experience a sharp pain in their groin area or lower abdomen during the second as well as the third trimesters of pregnancy. This pain is called round ligament pain and usually tends to increase on walking or moving. This is one of the most common complaints in the second half of any pregnancy, 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: The growing weight of the baby on the inferior vena cava and hormonal changes during pregnancy may lead to the development of varicose veins in some women. Web-like swollen and inflamed veins come up in the legs, vulva or rectum (also known as haemorrhoids), and can be quite painful. Varicose veins never go away completely and there are chances they can burst during delivery, so ask your doctor about how to manage this condition.
• 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. These false labour contractions usually last for 30 to 60 seconds and can be quite alarming. However, they’re nothing to worry about and are considered a normal part of your body preparing for delivery. (Read more: Contractions during pregnancy)
• Fatigue: You’re carrying a lot of weight around, your internal organs are being squeezed, you might be breathless, in pain and unable to sleep comfortably in any position. If all of these other symptoms don’t make you feel more fatigued than usual, then what will. As you enter the third trimester, fatigue is likely to increase in intensity, so avoid exerting yourself and get enough rest.
• Sleep issues: Getting a good night’s sleep will become even more difficult now that you’re on the verge of entering the third trimester. Sleep during pregnancy is very important, but the other symptoms, your active baby in the womb and getting into a comfortable sleep position can be more difficult than before. Use pillows to get comfortable and take a few naps during the day to make up for lost sleep.
• Digestive issues: As your pregnancy progresses into the third trimester, pregnancy-linked indigestion, pregnancy-linked heartburn, bloating, gas and acid reflux will increase. This is primarily because your growing uterus is pressing into the digestive organs, and your hormone levels make certain types of foods harder to digest. Opt for more water and fiber, less spices, salt and sugar in your diet and make your meals smaller and more frequent, if possible. You can also talk to your doctor about digestive medications or antacids that are safe for consumption during pregnancy.
• Melasma: Also called the "mask of pregnancy", melasma is experienced by a lot of women during the second trimester. It is characterized by the presence of dark and irregular patches on the forehead, cheeks, lips and nose. Melasma occurs due to the hormonal changes during pregnancy, and so, usually, your skin gets back to normal soon after delivery as the hormone levels recede to their normal standards.

While every woman wishes for a smooth pregnancy, some complications are beyond anybody’s control. These complications can show up during the 27th week of pregnancy, and while some are manageable, almost all of them can be best treated if diagnosed early. So, if you observe the symptoms of any of the following, contact your doctor immediately.

• Stillbirth: The sudden loss of a foetus after the completion of the 20th week of pregnancy is termed stillbirth. World Health Organization (WHO) data from 2015 show that 2.6 million stillbirths occur every year. India has among the highest rates of stillbirths in the world, at an estimated 22 stillbirths for every 1,000 births. The causes can vary from complications during childbirth to maternal infections and health disorders like high blood pressure. To try and avoid this, it is important to choose an obstetrician or trained ANM (auxiliary nurse midwife) you trust and plan ahead to identify the hospital or healthcare facility you want to have your baby in.
• Hypertensive diseases: Moms-to-be can get high blood pressure (BP) or gestational hypertension. This needs to be monitored regularly, as it can have a negative health outcome for the mom and baby. For example, 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. Pre-eclampsia and eclampsia are also likely complications arising from hypertension during pregnancy.
• Subchorionic haemorrhage: This type of bleeding occurs when the original connection between the placenta and the uterus is partly severed, though not completely broken (placental abruption). This occurs in over 3% of pregnancies. A routine ultrasound should alert your doctor to this problem, even if you don’t experience any bleeding. You may have to go on bed rest or take hormone therapy if this happens.
• Infections: Pregnant women should guard against infections like bacterial vaginosis and urinary tract infection or UTI. It is important to tell your doctor if you have itching or abnormal discharge from the vagina, for prevention or timely treatment of any infection.
• Obstetric cholestasis: Itchy palms and feet is yet another weird side-effect of pregnancy. The reason: obstetric cholestasis, a condition in which pregnancy hormones affect the liver. This condition usually resolves on its own after delivery. In the meantime, ask your doctor for salves and creams to soothe the itching.
• 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. It’s important to manage gestational diabetes because it can have long-term implications for your health and that of your baby too.

You’re approaching the final trimester of your pregnancy, and this is the time when you should rest more and plan ahead properly. It might seem that your due date is still far away, but time is likely to fly in the coming weeks and you need to be prepared. The following are some of the things you should get done in the 27th week of pregnancy:

• This is the last week when you can take a flight without getting clearance from your obstetrician. After this, you will have to get check-ups done before flying, so ensure that you, your family and employers know this.
• All pregnant women who are working should get their maternity leaves and rights sorted. Your partner or spouse should also apply for paternity leave around this time.
• Get a go-bag with all your hospital essentials ready. Your baby is now viable, and whether you have a premature delivery or a normal one after 10 weeks from now, you should have all the necessities ready.
• Think about baby-proofing options for your house and taking all safety precautions in a few weeks’ time. It's early days, but you may become too busy to do this when the baby arrives.
• Make sure you avoid caffeine, raw fish, undercooked meat, processed foods, excess sugar and salt in your diet. These will ease your digestion issues and keep infections like salmonella and listeriosis at bay.
• Avoid all strenuous exercises and activities, but do get some exercise, yoga and pelvic floor strengthening exercises done every day.

You are about to enter the last phase of your pregnancy, which means that you need to take extra care from now on to ensure that you get through the last trimester without any issues at all. Your doctor and your partner will have a huge role to play here. As some household chores and activities become both difficult and dangerous, your partner will have to take on a more active role around the house and ease it all for you. You could also ask friends and family for help, especially if you also have more children to care for.

Your doctor wants the best outcome for you and your baby, so listen to everything they have to say and follow their recommendations to the T. Don’t take any medications or engage in activities like flying without their say-so. If you have any questions, ask uninhibitedly, because your doctor is the best person to rely on for all types of medical queries.