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24 Weeks Pregnant

24-weeks-baby

Image: Fetal Development At 24 Weeks

Your baby now weighs over 1 lb and is around 32 cm long! If you could see her you’d notice the skin is still rather translucent and thin, with little visible veins running through.

At this point, baby’s face looks very close to how it will at birth. Her eyes are close at the front of her face and her ears are in their at-birth position. Even eyelashes are highly developed. Somersaults and cartwheels are a thing of the past now though – with all the growing your baby’s doing, space is at a premium inside you!

You might a feel stitch-like pain in your side sometimes. Stay calm, this is usually nothing to worry about – it’s just your womb muscles stretching (rather than contracting, as in Braxton Hicks).

Sometime soon you’ll have a glucose tolerance test . Your midwife will also check for signs of pre-eclampsia. Indicators include swelling (because of fluid in the body tissue), high blood pressure and protein in your urine. Pre-eclampsia can be serious so if your midwife has any concerns it’s important to follow it up with regular appointments.

Have you found out about paternity pay? Don’t forget that it’s not just mums that are entitled. Some companies have more generous policies than the statutory entitlement so it’s worth your partner reviewing his contract ahead of time. After all, you’ll need him there to help with the nappies and fetch you the ice-cream…

 
Why might I need a Glucose Tolerance Test?
Around 24-28 weeks, you will be given a fasting blood sugar test or a Glucose Tolerance Test, depending on the clinic you are attending. This is to check for signs of gestational diabetes, a condition that affects between 2% and 14% of women in pregnancy. It’s caused when the pancreas fails to produce enough of the insulin hormone. Insulin regulates your blood sugar levels and helps your body to store sugar that will be needed for energy later.

During pregnancy your body requires more insulin to meet your baby’s needs, particularly after the 5 month mark, when your little one grows rapidly. If your body isn’t able to keep up with the extra insulin needs, you are likely to develop gestational diabetes.

In order to grow, your baby needs glucose (sugar), but too much might cause abnormal levels of growth, particularly around his chest, abdomen and shoulders. This problem is known as macrosomia – literally meaning “of large body”. Sometimes in cases of macrosomia, caesarean section becomes the only birth option because the baby’s large shoulders may get stuck.

What does a Glucose Tolerance test involve?
It is possible to pick up gestational diabetes from a simple urine test but this is no longer considered the most reliable way. If sugar is picked up in your urine, you will then be scheduled for an Oral Glucose Tolerance Test (OGTT), usually at a special clinic.

In the three days leading up to the test Oral Glucose Tolerance Test you will be asked to eat in a normal way. The night before the test you should stop eating by 10pm and not eat or drink anything (except for water) until the test the following day. Check with your doctor about any medications you are taking and whether it’s safe to keep to your dose without food.

A nurse will take a blood sample from you so be sure to bring a friend to hold your hand if you don’t like needles! This first sample measures the blood sugar levels when you’ve been fasting and is known as a baseline test. Next you will be asked to drink a very sweet, sugary drink which contains the equivalent of 75 grams of glucose. Two hours later your blood will be tested and compared with the levels from your baseline test. During this 2 hour wait, you will need to sit quietly and not smoke.
 
Am I more at risk of gestational diabetes?
There are a number of factors that can increase your risk of developing gestational diabetes. For example if you:

  • Are obese – with a BMI greater than 30
  • Have previously given birth to a baby weighing 4.5 kg or more
  • Have had gestational diabetes in the past (in which case you will be screened for the condition at 16 to 18 weeks)
  • Have diabetes within your immediate family
  • Have an ethnic origin associated with high diabetes prevalence (for example if you are of Middle Eastern, African Caribbean or South Asian descent).

Keep in mind that having some of these risk factors doesn’t automatically mean you’ll get gestational diabetes, but there is a 20 to 50 % chance that you will be affected. Remember that most women who have sugar in their urine are later cleared of gestational diabetes in the OGTT test – so try not to worry about it too much.

I have been diagnosed with gestational diabetes – what next?
During pregnancy you will be given a special diet and exercise programme to manage the condition. About 10-20% of women are advised to inject themselves with insulin. Thankfully, in the majority of cases, women with gestational diabetes give birth to healthy babies and their blood sugar levels normalise after the birth.

That said, it’s estimated that around 20% of women with the condition actually had undiagnosed Type 2 diabetes before pregnancy. Also, some women who develop gestational diabetes will go on to develop Type 2 diabetes after pregnancy. In order to minimise this risk, it is advised that you stay on the special diet prescribed for you during pregnancy for the rest of your life. You may also be tested at regular intervals to check that you aren’t developing the condition.

Possible Scan at Week 24
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 24
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.