Mom's calendar.  Intrauterine development of a child by week

Mom's calendar. Intrauterine development of a child by week

1-2 week

A new menstrual cycle begins in the first week, so at this time it is difficult to talk about actual pregnancy. However, obstetricians-gynecologists start counting not from the date of fertilization of the egg, but from the first day of the cycle. Ovulation occurs, then conception occurs, and only from the third week can we safely talk about pregnancy.

It's time to take care of your health and get rid of bad habits, Go to proper nutrition, do some light sports (but only with your doctor’s permission). These measures are very important for the health of the unborn baby, who in nine months will delight the world with his presence.

3-4 week

Child. The fertilized egg has already received all the important information about the future person: eye color, hair, skin, gender. It now travels down the fallopian tube and into the uterus, where the embryo will develop. By the end of the fourth week it will reach a size of 1 mm.

Mother. A woman shows the first signs of pregnancy: increased basal temperature, feeling tired, drowsiness, increased appetite, change in taste preferences, nausea, intestinal upset, frequent urge to urination. Intolerance to hotel odors may occur. Bloody discharge is possible, but you should not be afraid of it. It's time to take a pregnancy test.

5-6 week

Child. At this time, the baby has already formed the main vital organs: heart, liver, kidneys, lungs. And at this time his heart begins to beat! You can hear the heartbeat on an ultrasound. Arms and legs begin to form. The length of the embryo reaches 4 mm, the volume of amniotic fluid is about 3 ml. Visual organs and cartilage tissue are formed. The placenta is actively growing.

Mother. During this period, a woman may experience increased nausea and irritability. The state of the body is similar to what happens before menstruation. It's time to visit a gynecologist who will prescribe the necessary tests.

7-8 week

Child. The umbilical cord is fully formed, ensuring blood circulation between the mother and child. Small hands and tiny fingers begin to form. At this time, the sex of the child is determined. The face, nose, nostrils, ears, and upper lip are formed. The epidermis is formed. The embryo slowly straightens, grows and reaches a weight of 4-6 g, length - 1.5-2 cm.

Mother. The uterus increases to the size of an orange, so the woman gradually develops a belly and feels tight in her clothes. You need to protect yourself from stress, heavy lifting, and sudden movements. On an ultrasound you can see the baby's first movements.

9-10 week

Child. The fetal head is still tilted forward and the chin is tucked toward the chest. The stomach begins to work, and it is already producing gastric juice. The baby develops facial expressions, eyelids form, but the eyes are still closed. The tail disappears completely. The embryonic stage ends and the baby is now called a fetus. The development of baby teeth begins. Now it weighs 7-8 g, length - 2.5-3 cm.

Mother. Mood swings become a common occurrence for women. The waist is rounded, 2-3 kg are added in weight. Hair becomes drier and skin becomes smoother. The work of the heart increases, because now it pumps about one and a half liters of blood per minute.

11-12 week

Child. The head still takes up half the size of the entire fetus as the brain grows rapidly. The kidneys begin to produce urine. The baby reaches a weight of about 13 g and already has real fingers and toes, and the rudiments of nails are developing. The length of the fetus is 4-5 cm. The formation of the iris of the eyes occurs. He begins to open his mouth. It's time to undergo the first ultrasound examination and get to know the child, and also rule out possible congenital anomalies.

Mother. By the end of the 12th week, a woman must register for pregnancy in antenatal clinic and undergo appropriate examinations by a doctor. Taking vitamins for pregnant women is very important. And most importantly, at this time toxicosis completely passes.

13-14 week

Child. The baby develops a sucking reflex. He turns his head and moves his arms, somersaulting, although these movements are still invisible. You can often see him sucking his thumb on ultrasound! The child grows and his weight becomes about 43 g, and his length is 6-8 cm. The genitals acquire clear outlines. The embryonic fluff appears - lanugo.

Mother. Finally, the tummy becomes noticeable; a longitudinal brown stripe appears on it. Freckles appear and dark spots. Constipation may occur. The uterus rises from the pelvis into the abdominal cavity, and the pregnant woman’s appetite increases significantly.

15-16 week

Child. Hairs begin to grow on the baby's head. It actively swims in the amniotic fluid, which tends to renew itself every 3 hours. The baby produces urine every 45 minutes. At week 16, there is a chance to feel the baby's first movements! The facial muscles have already formed. Marigolds begin to appear and the grasping reflex appears. Weight – about 100 g, length – 12 cm.

Mother. It is worth taking care of your body and purchasing oil against stretch marks. It is very important to visit the dentist, because your body is now actively releasing calcium to your baby, so teeth can deteriorate. It's also time to buy special maternity clothes.

17-18 week

Child. The baby's weight is 140-190 g, length is 14 cm. Most of the bones have already been formed and continue to strengthen. The baby may swallow amniotic fluid. He can already hear well, so you need to talk to him more often and play soft music. During this period, you will definitely feel the baby’s movements, which cannot be confused with anything.

Mother. The woman's breasts become enlarged and colostrum can be produced. The expectant mother may suffer from constipation, so you need to eat more fruits and fresh vegetables. Urination becomes more frequent as the uterus puts a lot of pressure on the bladder.

19-20 week

Child. The baby's body is covered with primordial fluff, his arms are stretched out, he turns his head in different directions. The placenta moves deep into the uterus. The rudiments of permanent teeth appear. The baby's growth slows down, and subcutaneous fat appears from now on. A birth lubricant is formed covering the folds of the skin. The baby turns towards the light. A second ultrasound examination is being conducted to accurately determine the sex of the unborn baby. Its weight is about 300 g, length is 16 cm.

Mother. The back receives significant stress, so you should ensure correct posture and wear comfortable shoes without heels. Brown or red stripes (stretch marks) may appear on the abdomen, thighs and chest.

21-22 weeks

Child. The baby learns to bend and straighten his arms and legs, and grab his heels. Pads with nerve endings appear on the fingers. Eyebrows are indicated on the face. The amount of blood in the body increases. The liquid it captures turns into a solid. It will remain in the intestines until delivery. The baby's weight is 360-430 g, length - 28 cm.

Mother. The first half of the pregnancy was successful. The uterus changes its shape and stretches. Lying on his back is harmful for the baby, he may suffer from a lack of oxygen. Libido increases. Since the fetus is reliably protected, sex cannot harm the child.

23-24 week

Child. The baby's weight reaches 500-600 g, length - 30 cm. Most of the time he sleeps, taking short breaks to stay awake. The skin is a little saggy, as the fat layer has just begun to grow. It pushes with its legs from the inside, floating in the amniotic fluid. Eyelashes appear on the eyelids. Developing respiratory system. Also, the baby is becoming more and more sensitive to the world around him.

Mother. At this time, a woman may experience training contractions, which manifest themselves in the form of short-term painless contractions. Weight gain increases rapidly and reaches 5 kg! Possible heaviness in the legs.

25-26 week

Child. The formation of neurons around the neural tube is completed. The baby is active until late in the evening and sleeps soundly in the morning. He clenches his fists, and at this time it is determined whether he will be left-handed or right-handed. The fetal heartbeat can be heard even without special devices. The lungs are fully formed. 20 rudiments of baby teeth are formed in the jaws, and under them - 20 rudiments of permanent teeth. The remaining 12 are formed after birth. Weight is 660-800 g, length – 35 cm.

Mother. The uterus has enlarged and puts pressure on the diaphragm, displacing the stomach from the abdominal cavity. Because of this, gastric juice rises into the esophagus and heartburn occurs.

27-28 week

Child. The baby's skin is becoming more and more wrinkled. The movements become more and more strong. If the baby is born at this time, his chance of survival is 85%. The child tries to breathe on his own, developing his lungs. He still has enough room to turn himself into the correct position - head down. Weight – 900-1100 g, length – 37 cm.

Mother. Female shapes become more rounded, and blood cholesterol levels increase. While sitting, the uterus puts pressure on the vena cava, which leads to a lack of oxygen and dizziness. Training contractions of the uterus become more frequent. It is worth finding time for proper rest.

29-30 week

Child. The baby's nostrils are free of mucus plugs and amniotic fluid enters them. He already knows how to open and close his eyes and reacts to bright light. The immune system begins its work. The child excretes about 500 ml of urine per day. On ultrasound, movements of the chest are noticeable. Enamel appears on the teeth. The baby's weight reaches 1300 g, length - 39 cm.

Mother. The kidneys work harder and may not be able to cope with the amount of fluid entering them, which can lead to the formation of edema. The organs near the uterus are becoming increasingly crowded. The weight of the expectant mother is actively increasing, movements become more clumsy and relatively slow.

31-32 weeks

Child. The baby becomes plump, thus preparing a protective layer against temperature changes in the future. In boys, the testicles descend into the scrotum and reach their extreme position. The child reacts to strong sounds from the outside, despite the fact that the amniotic fluid creates a kind of plug in the ears. The kidneys are already working well. Nail plate reaches your fingertips. Weight 1600-1900 g, length – 42 cm.

Mother. A woman may experience swelling and dilated veins in her legs, so she needs to control her fluid intake and take walks in the fresh air. At this time, a Doppler ultrasound examination of the baby’s circulatory system is performed.

33-34 weeks

Child. The baby becomes cramped in the womb, so he moves less often than before. The child continues to consume calcium from the mother’s body, which is so important for the formation of the skeleton. A skin pattern appears on the fingers and toes. The skin is now less red, and the hair on the head becomes thicker. Baby weight – 1900-2400 g, length – 45 cm.

Mother. The woman begins to feel short of breath because the two have to consume more oxygen. The gums become soft, bleeding and gingivitis may occur. Forgetfulness and absent-mindedness appear. You should remain calm in any case, because the baby subtly feels the mother’s worries.

35-36 week

Child. In the last weeks of life, the baby's fluff begins to disappear in the womb. The skin becomes pink color and is smoothed out thanks to subcutaneous fat. The cheeks become plumper, this will help in the future to receive food in the right quantity. The amniotic fluid takes on a sticky and viscous consistency. Internal organs continue to improve. The baby's weight is 2400-2600 g, length - 47 cm.

Mother. To reduce sleep problems, it is advisable to drink less fluid at night. If heartburn occurs, you need to eat small portions, but often. The time is suitable for attending courses for pregnant women, choosing a maternity hospital, an obstetrician.

37-38 week

Child. The baby has already turned his head down. It loses its original fluff and there is much less lubrication. Sometimes he scratches himself, making awkward movements with his arms. His lungs are ready to breathe air. The expectant mother may feel her baby hiccupping in her tummy. Its weight is 3000 g, length - 50 cm.

Mother. The pregnant woman's belly has dropped, and now breathing has become much easier. The uterus has increased as much as possible, its volume is 4-5 liters. The pregnancy can already be considered fully term. Now labor can begin any day now, so things for the maternity hospital should be collected in bags.

39-40 week

Child. Most newborns are born with long nails, because by this time they have fully grown. The child’s activity slows down, because his tummy has long been cramped and dark. His intestines are filled with original feces - meconium, which will come out, most likely, after birth. The length of the hair on the head is about 2 cm. Average weight the baby is 3200-3500 g, length - 52 cm. The baby is completely ready for birth - meet the main person in your life!

Mother. A woman suffers from insomnia and has pain in her lower back. The cervix begins to shorten and dilate. The uterus puts more pressure on the bladder. False or real contractions may appear. Childbirth occurs with an error of 1-2 weeks earlier or later than a certain date.

41-42 weeks

Child. The baby is fully developed, all his organs are functioning correctly. He continues to grow and gain weight; his tummy has become very cramped. The bones of the skull continue to strengthen, which may make it slightly more difficult for the baby to pass through the birth canal. You need to count the number of movements per hour, and if it is at least 10, everything is fine with the baby.

Mother. Until the end of the 42nd week, pregnancy is not considered post-term. If the baby has not been born by this time, there is still no cause for concern. Labor activity can be stimulated long walks, bending forward, sex with my husband. If you have not given birth by this time, practice breathing techniques, give valuable instructions to relatives - and quickly go to the delivery room!

Maria Sokolova


Reading time: 15 minutes

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The interactive women's magazine website offers the most detailed weekly pregnancy calendar with really useful information for expectant mothers, as well as photo and video materials for each week.

Choose your week and read the details: photos, videos, reviews, tips


The birth of a new life

What could be more amazing than the birth of a new life? Every woman who goes through the miracle of pregnancy certainly remembers all the delights of this path. Modern mothers want to know everything about pregnancy, control the process and be sure that the pregnancy is progressing in accordance with the norms. It is for this purpose that we have created our pregnancy calendar by week with photos and videos.

Starting from the first weeks of pregnancy, which you may not yet know you have, you will move forward every week. You can find out about your due date or look ahead. Each article contains a lot of useful, comprehensive information.

It’s like that for me, what about you? Let's find out and share experiences. Real stories future mothers.

In the first months, you will be interested in learning about the signs of pregnancy and comparing them with those that are observed in you. Of course, every woman wants to know what she will feel every week and what changes are happening in her body. In addition, each article is supplemented by reviews real women who are in this period. Thanks to our interactive pregnancy calendar, you can easily find the week of pregnancy that interests you.

How is the baby doing? Photos, videos and useful information.

Feeling like a future mother, you will certainly become interested in your baby. It is very interesting to watch how your baby turns from a small cell into a little person. Every week changes occur in his body; in one week they can be dramatic, and in another - just a continuation of this change. However, every week is important and interesting.

Visual materials will be a nice addition to printed information. This includes photos of the fetus, ultrasound pictures, and photos of the belly of expectant mothers every week. We have also prepared a video for you that clearly explains each week of pregnancy.

Enjoy your “interesting” position and walk this path with us! Our online pregnancy calendar is at your service!

Maria Sokolova

Colady magazine pregnancy expert. Mother of three children, obstetrician by training, writer by vocation.

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This calendar is compiled based on the actual period of pregnancy, that is, from conception. The obstetric deadline, the one set by gynecologists, is 2 weeks ahead of the real one. Take this into account.

In the first week of pregnancy, the fusion of the egg and sperm occurs, forming a zygote, from which the chorion (placenta) and embryo (unborn child) will subsequently form. At conception, the sex of the baby is determined.

The second week of the baby’s life is marked by the fact that the zygote finds a place in the woman’s body where it will develop. Implanted into the wall of the uterus or other organ (then it occurs ectopic pregnancy). Chorionic gonadotropin (hCG) is determined in a woman’s urine and blood.

In the third week, pregnancy tests “strip” and the woman begins to experience delayed menstruation and toxicosis. On an ultrasound, most likely, the fertilized egg will not be seen yet, it is too small. But signs of pregnancy are already appearing. And a very tiny embryo begins its development. His body and head are clearly defined.

At the 4th week, the length of the embryo is 2-4 mm, and the fertilized egg is about 1 cm or a little more. They are clearly visible on good ultrasound equipment. If everything is normal, the fertilized egg has an even shape. If there is a detachment of the ovum, the doctor poses a threat spontaneous miscarriage. Most often, pregnancies are terminated at this stage due to severe chromosomal abnormalities of the fetus.

In the fifth week, the fetal heart begins to beat, and it is its beats that are the main evidence that the pregnancy is developing. It's time to register with a gynecologist and be sure to read the calendar by week of pregnancy.


At 6 weeks, the embryo weighs about 5 grams and is about 20 mm long. It grows a millimeter per day. Almost all of his organs are formed. There are even convolutions in the brain. And facial features become more and more distinct.

At 7 weeks, doctors stop calling the little man an embryo. Now he is a fruit. And it will remain so until the birth. The baby is very mobile in the uterus, moving with all his might, surrounded by amniotic fluid, but the mother does not yet feel his movements. The fruit is still very small.

At 8 weeks, the baby's size can be compared to a prune. It’s still a baby, but the body is already formed. There are even tiny nails on my hands. In the future, all organs and systems will only improve.
Nine weeks is the minimum period at which a doctor can see the so-called genital tubercle in the fetus and guess its gender. The accuracy of this “prediction” depends on the experience of the doctor and the quality of the equipment used.

Next week marks the first screening - ultrasound plus blood test. The baby has grown so much that the doctor can accurately diagnose possible chromosomal abnormalities in him.

Week 11 is the last week in which the screening will be informative. Don't forget to pass! The baby is growing rapidly. Blood began to form on him, and colorless vellus hairs appeared on his head.

With a two-dimensional ultrasound at twelve weeks, the baby now looks more like a small humanoid, but with a three-dimensional ultrasound, facial features are visible. True, there is not enough fatty tissue yet, and the baby’s face looks very thin. The first innate reflexes and facial expressions appear.

All 9 months of pregnancy in 4 minutes.

Next week, some mothers begin to feel the first movements of their babies. These are mainly women who are not carrying their first baby. The height of the children reaches 10 centimeters and their weight is 50 grams.

At 14 weeks, the gender of the baby is clearly visible on an ultrasound. There shouldn't be any mistakes. However, sometimes it cannot be determined if the baby is in uncomfortable position. Babies at this gestational age begin to make breathing movements and squint if a bright light source is pointed at their mother’s belly.

By the fifteenth week, mommy’s pregnant belly begins to appear. You have to buy clothes for expectant mothers or those that fit your rounded belly.
By this time, the placenta is fully formed, protects the fetus from infections and serves as a transmitter of nutrition and oxygen from the mother’s body.

16 weeks is a special period in the development of a child, since the thymus gland is formed - this is a temporary organ that gradually, over the course of 30 years of life, disappears in all people. In addition, the brain is actively developing, and the bones begin to accumulate calcium.

At seventeen weeks, some mothers will notice that their shoes are too small or narrow for them. This occurs due to swelling of the legs. Temporary phenomenon.
The fetus develops the rudiments of molar teeth. He already has tactile sensations, touch. That's why he loves to feel his body.

18 weeks is the ideal time for a second ultrasound screening. The baby is already big and most of the markers of chromosomal abnormalities are visible. Almost all women already feel fetal movements and it is at this stage, on an ultrasound, that they find out who they are expecting - a boy or a girl. Approximate height the fetus is 20 cm, and its weight is close to 400 grams.

The baby is becoming more and more like an ordinary newborn, albeit very small and thin. At nineteen weeks, he already swallows amniotic fluid and pees in it. Spinning in the uterus with might and main. Can change the head position to a transverse or pelvic position daily. At this stage, doctors do not pay attention to the presentation of the fetus.

Twenty weeks of gestation are marked by an improvement in the child's hearing. He quite clearly, as far as possible, hears the beating of his mother’s heart and her voice. You can understand how a child hears if you completely lower your head into the water and ask someone to say something. This is how he hears through the amniotic fluid. Also, this is the period when the fetus reaches a weight of 500 grams, and if it is born now, doctors will be obliged to fight for its life.

By the 21st week of pregnancy, the fetal heartbeat can be easily heard using a special wooden tube - an obstetric stethoscope. The baby continues to grow. Fat is deposited around his organs. This is necessary for their normal functioning after birth.

At 22 weeks, the weight of the fetus is about 700 grams and its height is 22 cm. The intrauterine daily routine is formed. Usually the baby at this stage sleeps during the day, involuntarily rocked to sleep by his mother, and is awake at night.

By twenty-three weeks, the baby's hearing is so improved that he can distinguish between familiar and unfamiliar voices. The vocal cords are formed and subcutaneous fat is deposited. If you now do a three-dimensional ultrasound, you can clearly see the child’s face and understand which parent he looks more like.


At 24 weeks, the baby can distinguish between light and dark and reacts to flashes of light. But the eyes are still devoid of pigment. It will appear in about a month. But the final color of the eyes will be formed only 4-6 months after birth.

At 25 weeks, the weight of the fetus approaches one kilogram, and its height is about 40 cm. In the future, the baby will not grow as actively in length; at birth, full-term babies have an average height of 50-55 cm, but will gain at least another 1.5-5 cm in weight. 2 kg.

At the 26th week of pregnancy, the fetal hair acquires an individual shade; it is no longer snow-white. The lungs are actively developing, but if the baby is born now without medical preparation (dexamethasone injections to the mother), then he will only be able to breathe on a ventilator.

At twenty-seven weeks, the fetus occupies the entire uterine cavity, so it is less likely to turn upside down and back again. However, it is too early to worry about his presentation. By the way, a doctor can easily determine the position of the fetus at this stage by palpating the pregnant woman’s abdomen on the couch.

If you do an ultrasound at the twenty-eighth gestational week, then mommy will be able to see her baby sucking his thumb! This habit will remain with him even after birth. The sucking reflex is very important for the first months of a child's life. And the fetus has learned to cry, and sometimes real tears flow from its eyes!

At 29 weeks, the weight of the fetus is approximately 1.5 kg and the height is about 45 cm. No special development of organs occurs. Essentially only the lungs develop. They produce surfactant - a substance that will prevent them from sticking together after birth.

Thirty weeks is the ideal period for undergoing a mandatory third ultrasound. The doctor looks at how and exactly how much the child is developed, whether the utero-fetal blood flow is in order, whether amniotic fluid. It also gives the approximate weight of the fetus. Depending on these data, we can assume whether there is a tendency to give birth to a large child.

At 31 weeks, the fetus is so developed that it can see and hear well. True, in utero its eyes are almost always closed, since keeping them open in water is not very comfortable. In boys, the testicles have descended into the scrotum. And the appearance of the girls’ genitals became common - the labia majora covered the labia minora.

On next week the fetus undergoes a leap in the development of the immune system. She actively produces antibodies. The adrenal glands, which produce steroid hormones, also function.

At 33 weeks the baby weighs about 2400 grams, almost like a full-term baby. And, most likely, she will be able to breathe on her own if she is born at this time. Nevertheless, he is still immature, and mommy should try to “hold out” for at least another 3 weeks.

The next week is the beginning of the last month of pregnancy, the eighth. The weight of the fetus is approximately 2700 grams, and some babies have already gained 3 kilograms. The bones on the baby's head are movable to make it easier for him to be born. Almost all the children lay down with their heads down. But even if the baby at this stage is in breech, there is still hope for its revolution, if there is not too little amniotic fluid.

35 weeks - at this period some babies are born. But even though they are officially eight months old, born ahead of schedule, in almost one hundred percent of cases do not require rehabilitation and are not in children's department or intensive care after birth, and in the ward with the mothers.

39 weeks. More often these are those who ovulated a little later than the standard 12-14 days of the cycle. At the same time, children are born completely normal weight. If the ultrasound shows that the fetus feels well, is actively moving, and the woman’s cervix is ​​not “oaky,” she is admitted to the hospital and waits for labor to begin on its own.

40 weeks of pregnancy from conception or 42 obstetric, the last one that doctors can give while waiting for the onset of labor. But more often this week they are stimulated.

Interactive pregnancy calendar

In order for the program to create your personal pregnancy calendar, enter the date of the first day of your last menstruation. All obstetricians and gynecologists accurately calculate the gestational age in this way.

This way you can figure out what to expect in a given week of pregnancy. It is very interesting. Try it!

Pregnancy calendar: waiting for a miracle

Pregnancy in the life of every woman is forty weeks of pleasant troubles, unforgettable sensations and, of course, many questions. What happens to the baby before he is born? How should a future mother behave correctly in a given situation? You will find all the answers to the problems that concern you in our pregnancy calendar.

What will you see

In our calendar you will find forty chapters - one for each week of pregnancy. Each chapter is a 7-day story of the baby's life inside your tummy, written in understandable human language. But that is not all! All chapters are supplemented with many illustrations, photographs of expectant mothers and charming bellies, and ultrasound images.

What you will learn about

Note for pregnant women

Our calendar is a unique combination useful tips and recommendations from doctors, psychologists, lawyers, and site visitors. You will find interesting illustrations and beautiful pictures. And, of course, the impressions of expectant mothers every week of pregnancy.

The Pregnancy Calendar section of our website will become your guide for the entire period of bearing a child. You will learn the necessary examination methods for each week, which will help your doctor more carefully monitor the progress of pregnancy and promptly identify possible deviations in the development of the child or the condition of the expectant mother herself.

Surely A woman will be interested to learn in detail about the changes in her body, new sensations, especially if this is her first pregnancy and the woman has not yet gotten used to her new status.

Nutrition

Of particular importance is the section devoted to the nutritional characteristics of pregnant women, because now future mom should completely review her diet so that the child receives the full amount of nutrients. During pregnancy, the need for vitamins and minerals increases significantly, which are more optimally obtained from food rather than by taking synthetic drugs. During this period, a woman should not follow only her food preferences, but choose products that help the normal development of the baby.

Sex

Often married couples have questions about the possibility of sexual relations during pregnancy. You can find information about this in the pregnancy calendar detailed information. However, it should be remembered that this information is for informational purposes only; decide on the issue of sex at this period Only your doctor should, taking into account the course of your pregnancy. For example, if the condition is bad, sexual relations are strictly contraindicated.

Diseases

Unfortunately, pregnancy is not always physiological. As a result of the change hormonal levels, global restructuring of the body, a decrease in protective properties, the expectant mother is extremely susceptible to many infectious diseases, and pre-existing chronic diseases often worsen. Possible complications from