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Pregnancy Week by Week : Week 12 (part 1) - Changes in Your Skin

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1. How Big Is Your Baby?

Your baby weighs between ? and ½ ounce (8 to 14g), and crown-to-rump length is almost 2½ inches (6.1cm). 

2. How Big Are You?

Around this time, you may be able to feel your uterus above your pubic bone (pubic symphysis). Before pregnancy, your uterus holds ⅓ ounce (10ml) or less. During pregnancy, it becomes a muscular container big enough to hold the baby, placenta and amniotic fluid. The uterus increases its capacity 500 to 1000 times during pregnancy! By the time baby is born, it’s grown to the size of a medium-size watermelon. The weight of the uterus also changes. When your baby is born, your uterus weighs almost 40 ounces (1.1kg) compared to 2½ ounces (70g) before pregnancy.

3. How Your Baby Is Growing and Developing

Few structures in the baby are formed after this week, but the structures already formed continue to grow and to develop. At your 12-week visit (or near then), you’ll probably be able to hear your baby’s heartbeat! It can be heard with doppler, a special listening machine (not a stethoscope), that magnifies the sound of baby’s heartbeat so you can hear it.

Bones are forming. Fingers and toes have separated, and nails are growing. Bits of hair begin to appear on the body.

The small intestine is capable of pushing food through the bowels. It is also able to absorb sugar.

Baby’s pituitary gland is beginning to work. Its nervous system has developed further. Stimulating baby may cause it to squint, open its mouth and move its fingers or toes.

Dad Tip

At this prenatal visit, it may be possible to hear the baby’s heartbeat. If you can’t be there, ask your partner to record baby’s heartbeat for you to listen to later.

The amount of amniotic fluid is increasing. Total volume is now about 1½ ounces (50ml).

4. Changes in You

Around this time, morning sickness often begins to improve—that’s always a plus. You aren’t very big and are probably still quite comfortable.

If it’s your first pregnancy, you may still be wearing regular clothes. If you’ve had other pregnancies, you may start to show earlier and to feel more comfortable in looser clothing, such as maternity clothes.

You may be getting bigger in places besides your tummy. Your breasts are probably growing, and you may notice weight gain in your hips, legs and at your sides.

5. Changes in Your Skin

During pregnancy, many things can cause changes in your skin, such as hormones and stretching skin. Below we discuss some of the changes you may experience.

Skin-Color Changes. Melanin cells in your skin produce pigment; hormones can cause your body to produce more pigment. These may lead to a variety of skin-color changes. Women of color may be at increased risk for changes in skin color, which may leave the skin darker or lighter than it was before.

Image

Your baby is growing rapidly. It has doubled
its length in the past 3 weeks.

Itchy Skin. Pregnant women often have dry, itchy skin. Moisturizers can help, but you can also help your skin by eating omega-3 fatty acids. They’re good for you and baby. Olive oil, almonds and macadamia nuts contain omega-3 fatty acids, so eat these if you do not eat fish.

If you have sensitive skin and experience itchy hives, try rubbing milk of magnesia on the affected area. Rubbing it into the skin helps reduce itching.

Cholestasis of Pregnancy. A sudden attack of itching on the palms and soles may indicate cholestasis of pregnancy. Itching then spreads to the rest of the body. Cholestasis of pregnancy, also called intrahepatic cholestasis of pregnancy (ICP) or prurigo gravidarum, is a condition in which a woman has severe itching all over the body, but there’s no rash.

The condition is rare. We see only about one case in 10,000 pregnancies in the United States.

Intense itching all over begins in the third trimester. Usually it’s much worse at night. Other symptoms include jaundice, light-colored stools and dark urine.

Treatment includes anti-itch creams and UVB light treatments. Symptoms generally disappear a few days after baby’s birth.

Chloasma. Occasionally irregular brown patches appear on the face and neck, called chloasma or mask of pregnancy. These disappear or get lighter after delivery. Birth-control pills may cause similar changes. Up to 70% of all pregnant women develop chloasma after exposure to the sun. Women of Asian, Hispanic, North African, Indian and Middle Eastern heritage are more prone to developing chloasma.

The best way to prevent chloasma is to stay out of the sun, especially during the hottest part of the day (between 10am and 3pm). Wear sunscreen and protective clothing (hats, long-sleeved shirts, long pants). Brown patches usually fade in the months after delivery. If they don’t, ask your healthcare provider about using Retin-A.

Plaques of Pregnancy (PUPP). Some women have a severe, itchy rash of red bumps that begins on the tummy and spreads to the lower body, then to the arms and legs. This is called plaques of pregnancy, toxemic rash, polymorphic eruption of pregnancy or pruritic urticaria pappules (PUPP). With plaques of pregnancy, your healthcare provider may first rule out scabies.

PUPP is the most common skin problem pregnant women experience; it’s more common in white women. It may be caused by the skin stretching rapidly, which damages tissue, resulting in bumps and inflammation.

This condition usually appears in first pregnancies during the third trimester. It often affects women who gain a lot of weight or those who are expecting multiples.

The good news is that PUPP won’t harm the baby. The bad news is the itching can be so severe that relief may be all you think about, especially at night, which may cause you to lose sleep. PUPP usually resolves within a week of delivery and doesn’t usually come back with future pregnancies.

Many treatments have been recommended for relief, including Benadryl, powders, creams, calamine lotion, soaking in cold tubs, oatmeal baths, witch hazel, going without clothes and ultraviolet (UVB) therapy. If you can’t find relief, talk to your healthcare provider. He or she may have some recommendations for home remedies that have worked for other women. If all else fails, a prescription for oral antihistamines, topical steroids or cortisone cream may be needed.

Pemphigoid Gestationis (PG; Herpes Gestationis). Pemphigoid gestationis (PG) usually begins with blisters around the bellybutton. It may occur in the second or third trimester or immediately after birth. Despite its name, PG has no relationship to the herpes simplex virus. The name came about because the blisters appear similar to herpes infections. It occurs in 1 in 50,000 pregnancies.

The problem begins with sudden onset of intensely itchy blisters on the tummy in about 50% of cases. For the other 50%, blisters can appear anywhere on the body. It often resolves during the last part of pregnancy. It can flare up at delivery or immediately after baby’s birth, which happens more than 60% of the time.

The goal of treatment is to relieve itching and to limit blister formation. Oatmeal baths, mild creams and steroids are used. PG usually eases a few weeks after delivery and can recur in your next pregnancies and with oral-contraceptive use. Infants are not at risk.

Other Skin Changes. Vascular spiders (called telangiectasias or angiomas) are small red elevations on the skin, with branches extending outward. A similar condition is redness of the palms, called palmar erythema. Vascular spiders and palmar erythema often occur together. Symptoms are temporary and disappear shortly after delivery.

In many women, skin down the middle of the abdomen becomes markedly darker or pigmented with a brown-black color. It forms a vertical line called the linea nigra. It causes no problems and may be permanent.

Atopic eruption of pregnancy (AEP) covers three different pregnancy skin conditions that cause itching—eczema of pregnancy, prurigo of pregnancy and pruritic folliculitis of pregnancy. If you experience eczema, you may need prescription skin cream. Research has shown that Elidel and Protopic may have a potential risk for causing cancer. Don’t use either to treat diaper rash or any other type of rashes in baby.

Prurigo of pregnancy is a poorly understood pregnancy skin condition. It may look like insect bites, and it itches. Treatment includes anti-itch creams and steroid creams. The condition usually resolves after delivery. There’s no risk to you or baby.

Pruritic folliculitis of pregnancy (PFP) occurs in the second and third trimesters. It usually appears as an elevated, red area in hair follicles on the chest and back. Usually some mild itching is involved; the problem resolves 2 to 3 weeks after delivery.

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