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20 Weeks Pregnant


Image: Fetal Development At 20 Weeks

Congratulations – you’re halfway through your pregnancy. Your baby is now about 10 inches long but still has a lot of amniotic fluid and space to move in. You should definitely be feeling flutters at around this time and it might feel like she’s turning somersaults! Even though your baby will be born head first, she actually won’t settle in that position for a while yet.

Your baby has grown her very own means of ‘waterproofing’, which is a gooey white coating known as ‘vernix caseosa’. It protects all your baby’s skin while she swims in the amniotic fluid. Clever, isn’t it? This accounts for the white goo that a lot of babies are covered in when they arrive in the world.

As your womb grows, your belly button may flatten or stick out more (so make sure you’ve taken out any tummy button jewellery!)

Don’t worry if you’re feeling a bit breathless going up hills or stairs – your womb is actually pressing against your diaphragm, leaving the lungs less space.

If you haven’t had it already, you are likely to be off for your Anomaly Scan about now. This is a very thorough examination where your baby will be checked and measured in great detail. It is also often the time that many, but certainly not all, couples choose to find out the sex of their baby. Perhaps you want a surprise, or you’ll get the nursery painted!

I’m 20 weeks pregnant and haven’t felt movement from my baby for nearly a day. Should I be worried?
No, try not to worry. At 22 weeks things should be different, and at 24 weeks you will probably be feeling your baby move many times a day. She may even keep you up at night, the cheeky little thing!
What is pre-eclampsia?
Pre-eclampsia is a condition that affects some mums-to-be in the second half of their pregnancy (from about week 20 onwards) or immediately after birth. It is thought to occur through a problem with the placenta. If left untreated it can be dangerous for mother and baby.

What are the symptoms of pre-eclampsia?
Often women with pre-eclampsia don’t recognise it and frequently it is identified in routine antenatal appointments.

Women with pre-eclampsia experience swelling and fluid retention (oedema) and protein in their urine (proteinuria). Other symptoms may include severe headaches, upper abdomen pain, vomiting, excessive weight gain, a general feeling of being unwell, and problems with vision, for example blurring or seeing flashing lights. Signs in the unborn baby mostly relate to slow growth.

Who is affected by pre-eclampsia?
About 10% of first-time mothers experience pre-eclampsia and 1-2% of mums-to-be suffer from more severe pre-eclampsia. If you have had pre-eclampsia in your first pregnancy, you are at greater risk of developing it in following pregnancies, however most do not get it a second time.

Is there anything I can do to prevent pre-eclampsia?
Unfortunately pre-eclampsia cannot be predicted or prevented outright. However, there is some evidence to suggest that taking calcium supplements and aspirin in early pregnancy might be helpful. But remember: always speak to your GP or midwife before taking any medication in pregnancy.

How is pre-eclampsia treated and what should I do if I think I might have it?
Mild pre-eclampsia tends to be monitored with urine and blood pressure checks at your routine antenatal appointments and most of the time it disappears after delivery.

Treatment is often focused on bringing blood pressure down and managing further symptoms, for example with medication. More severe cases may need monitoring in hospital.

Delivery of the baby is the only way to be free of pre-eclampsia. Some women are advised to induce labour to relieve the symptoms, but this depends on how far into the pregnancy they are.

In any case, if pre-eclampsia is not immediately treated, it can lead to a number of severe complications including stroke, eclampsia (convulsions) and HELLP syndrome (a liver and blood clotting disorder).

These complications are rare but if you think you may be experiencing pre-eclampsia symptoms, get in touch with your doctor or midwife straightaway or call NHS Direct on 0845 4647.

Possible Scan at Week 20
Sometimes known as a 20 Week Scan, an Anomaly Scan is your baby’s anatomy is examined in detail. Measurements will be made of the head, brain, abdomen and legs. These will be plotted on a chart. Then your baby’s heart, brain, spine, bowel and limbs are checked to detect any abnormalities. This can never completely guarantee that the baby will be normal, but it gives very strong reassurance. The placenta, amniotic fluid and the umbilical cord are also all checked. If you wish, you can find out the sex of your baby from this scan.

An Anomaly Scan can be performed from 18 weeks but some doctors advise scans between 22-24 weeks. This is because often at that time the images of the baby are clearer. However, it’s not advisable to schedule this scan beyond 24 weeks because after that time the baby is more likely to adopt a position that is unfavourable for clear views.

You’ll be given a few pictures of your baby to keep. Some clinics also offer you a chance to get a glimpse of your baby in 4D (moving film), but this is in addition to the Anomaly Scan and charged accordingly.

Possible Scan at Week 20
A Sexing Scan (also sometimes called a Gender Identification Scan) can be performed to find out the sex of your baby at this stage.

The baby will also be measured and your medical professional will assess his or her wellbeing. Sexing scans are highly reliable but can be more difficult if a woman is very overweight, or if the baby is in an unfavourable position.

Gender Scan or Sexing Scan

Gender Scan (Boy) Picture (Click image to enlarge)

Generally, if a healthcare professional is unsure about the sex of your baby they won’t guess. But thankfully it’s very unusual to be unable to determine the sex of the baby.

Possible Scan at Week 20
A Reassurance Scan can be performed anywhere from 14-22 weeks. It’s not usually necessary but might be advisable if you have had bleeding or have been unwell.

The baby’s head, abdomen, and leg length will be measured. The placenta can be located and the amniotic fluid and umbilical cord assessed. The measurements will be plotted on a graph which you will be given.

Reassurance Scan

Reassurance Scan Picture (Click image to enlarge)

The scan is performed through the tummy (a trans-abdominal scan), and usually takes 15-20 minutes. You don’t need to have a full bladder and no special preparation is needed. You’ll have a few pictures of the baby to take away with you.