Your pregnancy: 24 weeks

How your baby's growing:

Your baby's growing steadily, having gained about 4 ounces since last week. That puts him at just over a pound.

Since he's almost a foot long (picture an ear of corn), he cuts a pretty lean figure at this point, but his body is filling out proportionally and he'll soon start to plump up. His brain is also growing quickly now, and his taste buds are continuing to develop. His lungs are developing "branches" of the respiratory "tree" as well as cells that produce surfactant, a substance that will help his air sacs inflate once he hits the outside world.

His skin is still thin and translucent, but that will start to change soon.


How your life's changing:

In the past few weeks, the top of your uterus has risen above your belly button and is now about the size of a soccer ball.

Most women have a glucose screening test (also called a glucose challenge test or GCT) between now and 28 weeks.

This test checks for gestational diabetes, a pregnancy-related high-blood-sugar condition. Untreated diabetes increases your risk of having a difficult vaginal delivery or needing a cesarean section because it causes your baby to grow too large, especially in his upper body.

It also raises your baby's odds for other complications like low blood sugar right after birth. A positive result on your GCT doesn't mean you have gestational diabetes, but it does mean that you'll need to take the glucose tolerance test (GTT) to find out for sure.

Finally, if you don't already know how to spot the signs of preterm labor, now's the time to learn. Contact your caregiver immediately if you notice any of the signs mentioned below.

3 Questions About...Preterm labor

More than 12 percent of babies in the United States are born prematurely (before 37 weeks). About a quarter of these births are intentional, meaning that the medical team decides to induce labor early or perform a c-section because of a serious medical condition such as severe or worsening preeclampsia or because the baby has stopped growing.

The rest are known as spontaneous preterm births. You may end up having a spontaneous preterm birth if prior to 37 weeks you go into labor, your water breaks, or your cervix dilates with no contractions.

While there are some known risk factors for preterm labor, such as having certain genital tract infections, placental problems, or cervical insufficiency, in many cases no one knows what causes a woman to go into labor before term.

So it's important for all pregnant women to learn the signs of premature labor and what to do if it happens to you.

Q1.
What are the signs of preterm labor?

Call your midwife or doctor right away if you're having any of the following symptoms before 37 weeks:

• An increase in vaginal discharge
• A change in the type of discharge — if it becomes watery, mucus-like, or bloody (even if it's pink or just tinged with blood)
• Any vaginal bleeding or spotting
• Abdominal pain, menstrual-like cramping, or more than four contractions in one hour (even if they don't hurt)
• An increase in pressure in the pelvic area (a feeling that your baby is pushing down)
• Low back pain, especially if you didn't previously have back pain


These symptoms can be confusing because some of them, such as pelvic pressure or low back pain, occur during normal pregnancies too, and early contractions may just be harmless Braxton Hicks contractions. But it's always better to be safe than sorry, so call your midwife or doctor right away if you're experiencing anything unusual.

Q2.
What should I do if I think I'm going into labor prematurely?

If you have signs of preterm labor or think you're leaking amniotic fluid, call your practitioner, who'll likely have you go to the hospital for further assessment.

Once there, your medical team will monitor your contractions, watch your baby's heart rate, and test your urine for signs of infection.

A doctor or midwife will do a speculum exam to see whether your membranes have ruptured. She may swab your cervix and vagina and send one sample to the lab to check for an infection and another for a fetal fibronectin (fFN) test.

This test analyzes your cervical and vaginal fluid for the presence of a protein that helps bind the amniotic sac to the lining of your uterus. Between 24 and 34 weeks, elevated levels of fFN mean that this "glue" is disintegrating ahead of schedule (due to contractions or injury to the amniotic sac).

A negative result means that it's highly unlikely that you'll give birth in the next week or two, which can set your mind at ease and allow your practitioner to hold off on treatments that may prove to be unnecessary.

Q3.
Will my baby be okay if he's born early?

The closer your baby is to full term at birth, the more likely he is to survive and the less likely he is to have health problems. Premature babies born between 34 and 37 weeks generally do fine, although they are still at higher risk for short- and long-term problems compared to babies born full term.

On the other end of the continuum are babies who are extremely premature: These days, some babies born as early as 24 weeks (or even a bit earlier) may survive thanks to advances in neonatal care, but these extremely preterm infants require significant medical interventions and long stays in neonatal intensive care units (NICUs), and the survivors often have serious long-term problems.

The best thing you can do to reduce your risk of preterm birth is to avoid known dangers to your baby like smoking, drinking, and illicit drug use. Eat a nutritious diet, keep all of your prenatal appointments, and report any symptoms or problems to your caregiver promptly.

This Week's Activity:

Tackle your home improvement projects. Sit down with your partner and take stock of the things you'd like to fix around the house before your little one arrives. Then let your partner handle them. (You shouldn't be exposing yourself to chemicals or getting up on ladders.) Some things for the list:


• Install or check smoke detectors, get a fire extinguisher for each floor of your house, and plan a fire escape route.
• Fix or remove any broken furniture or fixtures.
• Paint the nursery, hang curtain rods, assemble new furniture.