Week 19 of pregnancy: Senses Developing

Many people have their anomaly scan around now, and the report can raise questions. Words like soft marker or low-lying placenta sound worrying but often lead only to a later check. Your baby is swallowing more fluid and, in some babies, the very first responses to low sounds can be measured from about 19 weeks. For you, sudden calf cramps at night are a common new complaint. Take your report to your doctor, ask what each finding means, and learn a simple stretch for the cramps.

The 15.3 cm figure is a crown–rump length, measured from head to bottom, and 14–15 cm is typical this week. Measured head to heel, the same baby would be about 24 cm, which is why some sites quote much bigger numbers. Weights of about 240–300 g are usual; the fruit is only a rough guide.

Every pregnancy is different - you may have some, all or none of these.

Leg cramps

A sudden hard calf muscle, often at night. Straighten the leg and pull your toes towards you, or stand and press the heel down, then massage the muscle. A painful, swollen, warm or red calf that does not ease is different and needs checking.

Round ligament pain

Short, sharp groin pain when you change position. Turn slowly and support your bump when you get out of bed. Continuous pain, or pain with bleeding or fever, needs a check.

Tight, itchy skin

The skin over your bump is stretching. A plain moisturiser can ease dryness. Itching of the palms and soles, especially at night, is different and should be reported.

Disturbed sleep

Cramps, a growing bump and trips to the toilet can interrupt sleep. A pillow between the knees and a calm bedtime routine may help.

• Reviewing your anomaly scan report

  Routine

  After the 18 to 22 week scan

  Go through the report with your doctor. Most show normal anatomy and growth. The report also records the placenta's position, the amount of fluid and measurements compared with your dates.

• Soft markers

  Only if needed

  Found at the anomaly scan

  A soft marker is a small variation that is often seen in healthy babies and is not a problem in itself. Depending on the marker and your earlier screening results, your doctor may simply note it, or suggest a detailed fetal medicine scan, a fetal echo, or a discussion about further screening or diagnostic tests.

• Low-lying placenta rescan

  Only if needed

  Later in pregnancy, as your doctor advises

  If the placenta lies low, near or over the cervix, a later scan is usually arranged to see where it sits as the uterus grows. Until then your doctor may advise avoiding heavy lifting or sex, and bleeding becomes an important warning sign to report straight away.

• Continuing IFA and calcium

  Routine

  Throughout pregnancy

  Keep taking the iron-folic acid and calcium tablets you have been given, as prescribed. Mention leg cramps at your next visit rather than starting any new supplement yourself.

What happens after a finding varies between centres and between findings. Ask exactly what was seen, what the next step is and by when, and who to contact if you have questions before then.

• 🌿Magnesium- and potassium-rich foods are this week's focus. Dal, rajma, chana, green leafy vegetables, whole wheat, millets, bananas, nuts and seeds all contain them.
• 🌿Magnesium and potassium are often suggested for cramps, but the evidence that food or supplements prevent pregnancy leg cramps is limited, so do not start magnesium or other supplements without your doctor's advice.
• 🌿Drink steadily through the day. Water, chaas and nimbu pani with little added sugar all count towards more than 2 litres of fluid.
• 🌿Eggs are not vegetarian for most Indian readers. If you are vegetarian, milk, dahi and paneer supply vitamin B12; strict vegetarians or vegans may need a supplement, so ask your doctor.

• •Stretch your calves before bed: stand facing a wall, place one foot behind the other and lean forward with the back heel down, holding for a slow count. Repeat on both sides.
• •Regular daytime walking keeps leg muscles conditioned. Build up gradually, wear supportive footwear and try not to sit with your legs crossed for long periods.
• •If you have been told your placenta is low, ask your doctor which activities are suitable for you before continuing any strenuous exercise.

• •Keep your anomaly scan report safe; you will need it at later visits and if you see a different doctor.
• •Write down the exact words used in the report and ask what each means. A term that sounds alarming online is often minor in context.
• •If a follow-up scan has been suggested, put the date in your calendar now so it is not missed.
• •If your placenta is low, ask what that means for travel, lifting and sex until the next scan, and read the reasons behind these limits.

• ?Did my scan show any soft markers, and do they change anything for me?
• ?Where exactly is my placenta, and when will it be checked again?
• ?Are there any activities I should avoid until the next scan?
• ?Is there anything I can do about night cramps, and should my calcium or other levels be checked?

• Scan report read and questions written down
• Follow-up scan date noted, if one is needed
• Evening calf stretch added to your routine
• Water glass by the bed
• Pillow between the knees for sleep