28th – Twenty-eighth week of pregnancy

In the seventh month of pregnancy, two-thirds of the way is already done for you to meet your baby. The child’s development is now in its final stage. Those born prematurely at the 28th week have a more than 90% chance of surviving without major neurological or physical defects.

As the third trimester sets in, you’ll likely experience a host of new symptoms along with any you’re already experiencing.

The joy of finally being able to hold the baby in your arms makes you feel more alive. At the same time it is normal that you also have fears, which can be constituted, for example, by the fear of complications for you or for the unborn child, by the concern of not being completely “adequate” to give birth, by the fear that labor may come earlier than expected.

If you would like to learn more about these issues, I refer you to the article published on this site: Tocophobia: the fear of childbirth, written by the psychotherapist Dr. Caterina Laria.

During this week you could also contact the hospital where you intend to give birth, to find out about the pre-natal courses held by the facility’s midwives and gynecologists.

Usually the first preparatory meeting in the hospital takes place around the 32nd-34th week of pregnancy. However, each hospital has its own procedures and, therefore, I advise you to move a few weeks in advance.

One very useful thing about these pre-natal courses – both on a practical and psychological level – is that, among other things, they often also include a visit to the delivery/labour room.

Baby’s development at the 28th week of pregnancy

The development of brain activity

Its brain structure continues to become more and more complex, with characteristic indentations and grooves developing on its surface.

The increase in her brain tissue during the twenty-eighth week results in a greater level of activity of the fetus.

When the baby is sleeping, fetal brain waves begin to show sleep cycles that are now clearly discernible.

The rapid eye movement (REM) phase may also be identified, indicating that the child may already have started dreaming.

As the third trimester progresses, her sleep cycles continue to be more and more discernible.

The development of the lungs

The child is still continuing to practice breathing. His blood vessels are still developing in both of his lungs.

A chemical agent called surfactant is produced: after birth – when your lungs have started to absorb oxygen – it is used to prevent the air sacs from sticking together.

During this week, its (maturing) bronchi begin to divide into smaller branches.

During the seventh month the primitive alveoli allow gas exchange in the lungs, and therefore autonomous respiration.

The development of the sensory organs

His eyes, which opened last week, are now quite sensitive to bright light. If you shine a bright light from the outside at your belly, the baby may even blink or turn its head in the womb.

This is also the week in which the irises become pigmented: however their color is not yet permanent and could change until the first year of age.

The development of reflexes

The fetus is practicing itself by doing several activities: sucking harder than ever, grabbing whatever is within reach (usually the umbilical cord), and blinking. This will help him survive in the outside world once he comes out of the womb.

After the 28th week, fetuses can often be found sticking out their tongues: the reasons are not yet known but undoubtedly this allows the baby to taste the amniotic fluid, as its taste buds are now quite mature .

The outward appearance

Its fat layers are still developing, giving the fetus a dull, plump appearance.

During this period, nails also begin to appear.

Another notable change is the disappearance of the hair (lanugo) that covered the fetus, and now the task of regulating its body temperature is taken over by the subcutaneous fat.

The teeth of the fetus

The first sketches of milk teeth (which began to form as early as the sixth week of pregnancy ) are now well formed.

During the fetal period, permanent teeth will also begin to form.

Wisdom teeth, on the other hand, will only form in the third year of life.

Beware that we are talking about the formation of teeth, not their appearance: the teeth will appear in the child’s mouth between the 6th month and the 33rd month of age.

The movements of the fetus

Most fetuses, in their period of optimal activity, move about twenty times within half an hour.

Therefore, try to take into account how much your little one moves, so as to be able to identify any anomalies in his sleep-wake rhythm early. In any case, consult your doctor to find out what is (in your case) the normal “amount” of fetal movement in this stage.

To prepare for birth, babies usually position themselves head down during this week; but, most likely for yet another couple of weeks they will keep capsizing.

Fetuses in twin pregnancies

In twin pregnancies, the twenty-eighth week represents an important stage, as the twins born – before the term – in this week, have the same chance of survival as single babies (about 90%).

However, the twins are still at risk of long-term complications: cerebral palsy, vision problems and chronic respiratory problems.

how big is it now

Now the baby is almost the size of a Japanese pumpkin: from head to toe it is about 38 centimeters long and weighs almost a kilogram.

Weight gain and bump and body changes

At this week, the top of your uterus is approximately 3.5 inches above your belly button, while your fundal height (the distance from the top of your uterus to the top of your pubis) should be between 8 and 10 inches. 29cm.

In this period, either due to the effect of relaxin  (a hormone that facilitates the progression of the fetus in the birth canal during childbirth) which loosens your joints, or due to the belly that is shifting your center of gravity, you could drop things, you could bump into furniture and you may trip more often.

it is however advisable that you wear flat and comfortable shoes that allow you to move comfortably, and that you move slowly to avoid falling and hurting the child too.

You have now probably gained between 8 and 12 pounds in the previous quarters. The ideal weight gain for the third trimester is about 2.5 kilograms.

As your body prepares to breastfeed, you may see a thick, yellowish fluid (colostrum) leak from your nipples.

Test and ultrasound at the twenty-eighth week

A 2D ultrasound done during this week shows the baby to be quite active, moving his arms and legs a lot, grabbing the umbilical cord and sucking his thumb.

If you want to have the first photo of the album dedicated to your baby, you could also opt for a 3D ultrasound at this stage.

Your doctor may order a blood test to evaluate your hemoglobin levels and to detect anemia. As with every prenatal visit, your blood pressure will also be measured.

If you haven’t already,   you may need to take a glucose tolerance test to determine if you have gestational diabetes .

Rh negative women are given an injection of Rhogam (an Rh antibody) to prevent – ​​in the event that the baby’s blood contains the antigen – the mother’s sensitization to the rhesus factor.

Symptoms in the twenty-eighth week

In this week it is normal to have,

  • pain in the round ligament of the uterus;
  • joint, hip and back pain;
  • leg cramps;
  • Braxton Hicks contractions
  • indigestion, bloating, and heartburn ;
  • constipation;
  • varicose veins and hemorrhoids;
  • frequent urination;
  • shortness of breath and chest pain (from the baby putting pressure on your ribs and lungs);
  • swelling or edema of the arms and legs;
  • stretch marks, especially on the belly, hips, and thighs;
  • pain in the pelvis and tailbone;
  • symphysis pubis dysfunction;
  • acute pain in the sciatic nerve (sciatica);
  • swollen or bleeding gums;
  • itchy skin (around the belly, sides, and breasts);
  • sleep disturbances (insomnia);
  • restless legs syndrome;
  • congested nose (due to high levels of pregnancy hormones, which increase blood flow to the nasal mucosa, causing it to swell);
  • headache or migraine;
  • fatigue and dizziness;
  • mood swings and depression.

When it is appropriate to call the doctor

The doctor should be consulted in the case of,

  • contractions that become more frequent, associated with vaginal bleeding, loss of mucus plug or any change in secretion, a feeling of pelvic pressure, copious watery secretions and menstrual-like cramps: things that could indicate a premature birth;
  • pain or burning when urinating, copious secretions (gelatinous, yellowish or greenish in color, or thick and white), kidney pain, nausea, and an abnormal and urgent urge to urinate: these could indicate a urinary tract infection, a kidney infection, or candidiasis;
  • extreme fatigue and excessive thirst, accompanied by an increased urine flow, intense nausea, dry mouth, and sudden vision changes, which could indicate the existence of gestational  diabetes
  • severe and persistent diarrhea or vomiting for more than 24 hours;
  • when – during the period of activity of the baby, usually between 9 in the evening and 1 in the morning – within 2 hours you feel less than 10 fetal movements;
  • persistent headaches and lightheadedness, together with extreme fatigue, blurry vision, upper abdominal pain, rapid heartbeat, sudden swelling of the hands and face: could be due to hypertension or preeclampsia;
  • swelling in one foot or ankle (not the other foot or ankle): This could indicate a serious complication, such as a bleeding disorder.

Some useful tips for pregnancy and baby

Also for this week some advice may be useful:

  • during prenatal visits – which will probably be more frequent now (twice a month) – tell the doctor any possible doubts or concerns about your baby’s growth, or about labor and delivery;
  • Include plenty of iron-rich foods in your daily diet, such as spinach, tofu (a curdled soy derivative), beans, whole grains, beef and chicken, as your child now needs iron levels iron even higher than last trimester: to prevent gestational anemia, your doctor may also recommend an iron supplement;
  • for a few minutes, stretch your legs or massage them;
  • reduce your caffeine intake to better manage restless legs syndrome;
  • now that your appetite has probably increased, eat a diet rich in fruits and vegetables, whole foods, unsweetened fruit juices, and lean meats—all foods that contain fiber, essential vitamins, and minerals vital to correct fetal growth;
  • attend prenatal yoga classes , and do physical exercises to strengthen the pelvic floor muscles.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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