Pregnancy Week By Week (Week 16)

Some Basic Pointers (Week 16)

Quickening

Fetal movements are called quickening and is usually first felt between weeks 16 and 20 of pregnancy. The time varies from woman to woman. It can also be different from one pregnancy to another. One baby more active than another and move a lot. The size of fetus and the number of fetuses can also affect what you feel.
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Triple Screen Test

Tests are now available that go beyond AFP testing in helping your doctor determine if you might be carrying a child with Down syndrome. With this test, your alpha-fetoprotein level is checked along with amounts of human chorionic gonadotropin (HCG) and unconjugated estriol (a form of estrogen produced by the placenta). The levels of these three chemicals in your blood may indicate an increased chance your baby has Down syndrome. For older mothers rate of the problem is better than 60% with a false positive of nearly 25%. If you have an abnormal result with a triple screen test, an ultrasound and amniocentesis may be recommended. An elevated alpha-fetoprotein level can indicate an increased risk of a neural-tube defect (e.g., spina bifida). HCG and estriol are normal in this case. These blood tests are used to detect possible problems. They are screening tests. A diagnostic test will usually confirm any diagnosis.


Amniocentesis

If it is necessary, amniocentesis is usually conducted for prenatal evaluation around 16-18 weeks. By this time your uterus is large enough and the amniotic fluid is sufficient for testing. A procedure at this time gives a woman enough time to decide on terminating the pregnancy if she desires. Ultrasound is used to locate a pocket of fluid where the fetus and placenta are not in the way. The part of the abdomen above the uterus is cleaned; skin is numbed and a needle is passed through the wall into the uterus. Fluid is withdrawn from the abdominal cavity (area around the baby) with a syringe. About an oz (30ml) of amniotic fluid is required to perform the various tests. Fetal cells that float in the amniotic fluid can be grown in cultures and can be used to identify fetal abnormalities. There are about 400 abnormalities a child can be born with - amniocentesis identifies about 40 (10%) of them, including the following:

• Chromosomal problems particularly Down syndrome

• Fetal sex, if sex specific problems such as hemophilia or Duchenne muscular dystrophy must be identified

• Skeletal diseases

• Fetal infections such as herpes or rubella

• Central nervous system diseases

• Hematologic (blood) diseases

• Inborn errors of metabolism (chemical problems or deficiencies of enzymes)


Risks from amniocentesis include injury to the fetus, placenta or umbilical cord, infection, miscarriage, or premature labor. The use of ultrasound to guide the needle helps prevent such complications but doesn't guarantee to eliminate all risk. There can be bleeding from the fetus to the mother, which can pose a problem because it is hard to tell fetal blood from maternal blood and both blood types may be different. This is a particular risk to an RH-negative mother carrying an RH-positive baby. An RH-negative mother should receive RhoGAM at the time of amniocentesis to prevent bleeding. Fetal loss from this procedure is estimated to be less than 3%. The procedure should be done by someone qualified and with the necessary experience. Read Full Article


Don't Lie on your Back

Week 16 is a turning point - no more lying flat on your back in bed while resting or sleeping or lying flat on the floor while exercising or relaxing. This position puts extra pressure on the aorta and vena cava and this reduces blood flow to your baby. Blood flow from mother to baby supplies all the nutrients the fetus needs to develop and grow. Don't endanger your baby's health by forgetting this important action. Reclining on a chair or propped against pillows is OK. Just don't lie on your back flat!

Your Nutrition (Week 16)

The good news is - pregnant women should snack more, more so during the second half of pregnancy. You should have 3 to 4 snacks a day in addition to your regular meals. There are a couple of catches though. Firstly snacks must be nutritious. Secondly your meals must be smaller and only then snacking makes sense. Your goal should be eating enough so important nutrients are always available for your body's use and for use to your growing fetus. Quick and easy snacks are preferable, especially now. Planning and effort will be necessary to make your snacks healthy and easily. Preparation in advance is the key. Cut up fresh vegetables for later use in salads and for munching on low-cal dip. Peanut butter, pretzels, popcorn (low salt/sugar variety) are good choices. Low fat cheese, yoghurt is another one to go for. Fruit juices and fresh cut fruits are good and refreshing. If fruit juice is high in sugar, cut it with water.

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