妊娠40周（晚孕篇）

妊娠第28周：到目前为止，你的宝宝从顶臀径大约有25cm长，体重超过1000g——大约相当于一个南瓜大小。他或她可以做各种各样的事情——眨眼、咳嗽、打嗝，甚至可能在做梦！婴儿正在进入分娩所需的位置（胎方位），每天都在接近分娩。如果他/她仍是臀部朝下，先不要惊慌，此时仍然有机会转变为头位。由现在起，建议你怀孕期间需要每两周去一次产科门诊。你可以和你的妇产科医生讨论的胎位的事情，你也会遇到更多的和你一样的孕妇，相互聊聊经历也是不错的。

By now your baby measures about 10 inches long from the top of the head to the rump and weighs more than 2 pounds — about as large as a squash. He or she can do all sorts of things — blink, cough, hiccup, and possibly even dream! Baby is moving into position for childbirth, which is getting closer every day. If he or she is facing rump first, don't panic. There's still time to move into a headfirst position. That's something you can discuss with your ob-gyn, who you'll be seeing more of now, with visits about once every 2 weeks during a normal pregnancy.

妊娠第29周：婴儿的生长速度飞快，而且由于子宫里的空间更小，胎儿每一个动作都会让你感同身受。随着婴儿的骨骼和肌肉变得越来越强壮，有时肘部和膝盖的动作会非常强烈。从肺到大脑等等，婴儿身体的其他部分也在发育。随着神经细胞连接的建立，大脑正在产生更多的皱褶，这些皱褶正是记忆的开始。此时婴儿声音、光线和触觉的感官反应越来越有显著了。

Baby is growing at a rapid rate, and because there's less room in the womb, you should be able to feel just about every movement. Some of those elbow and knee jabs will be pretty intense as baby's bones and muscles get stronger. Every other part of baby's body is maturing too, from lungs to brain. That brain is developing more wrinkles as nerve cell connections are established. Baby's senses are also becoming more aware of sound, light, and touch.

妊娠第30周：这周，你的宝宝顶臀径长度约为28cm，并将其大小接近1.5kg——大约相当于一只小烤鸡的大小。宝宝长大了，肚子也在变大，身体的重心也在发生变化。重心的变化可能会让你感到不舒服，也会很尴尬，例如不自主的漏尿。你可能会注意到你的脚也在肿胀，同时你的骶髂关节在为分娩而变得松弛。此时的你，去买一双更大更舒适的鞋子可能是个很好的选择。

This week your baby measures about 11 inches long from the top of the head to the rump, and tips the scales at nearly 3 pounds — about the size of a small roasting chicken. As your baby grows, your belly is growing to match. That can be uncomfortable, and awkward, as your center of balance shifts. You might notice your feet expanding too, as your joints loosen up in preparation for labor. If that's the case, a shopping trip for a bigger pair of shoes may be in order.

妊娠第31周：你每周的增加体重大约是900g，你的宝宝也会胖起来。为了让你的身体准备好分娩，腹部可能已经开始出现Braxton Hicks收缩（无痛性宫缩）了。这些“预热”性质的收缩可以持续30秒到2分钟。如果宫缩变得更强烈或更稠密，请联系你的医生，以鉴别你是否真正的临产。婴儿的肺仍在发育阶段，如果孩子现在出世，他或她需要呼吸机的帮助才能呼吸。

You're putting on about a pound a week, and your baby is plumping up too. To get your body ready for labor, you may be starting to have Braxton Hicks contractions. These "practice" contractions can last from 30 seconds to 2 minutes. If contractions get more intense or closer together, call your doctor to make sure you're not in labor for real. Baby's lungs are still developing, and he or she would need the help of a ventilator to breathe if you gave birth right now.

妊娠第32周：你的宝宝，将近3.5kg，就像一个哈密瓜，压在你的肚子上！你的子宫里已经没有多少空间了，但是你的小包袱仍然会在那里极尽所能的扭动、蠕动，尽管可能没有以前那么有力。宝宝正在为他或她的外貌施展最后的妆容：胎毛正在脱落，毛发也只会保留在那些点睛的地方——睫毛、眉毛和头。

Your baby, at almost 4 pounds, is like a cantaloupe weighing down your belly! There isn't much room left in your uterus, but somehow your little bundle will still manage to wriggle and squirm around in there, though maybe not as forcefully as before. Your baby is making final preparations for his or her appearance. The fine covering of body hair called lanugo is falling off, and hair only remains where it's meant to be — on the eyelashes, eyebrows, and head.

妊娠第33周：这周，你的宝宝的身体继续变得更加饱满，而妈妈的骨盆则需要支撑着它产生的更大压力。此时唯一仍保持柔软的骨头是宝宝的颅骨，以便适当压缩来适应产道。婴儿的颅骨，在出生后最初的几年中，仍然会有一些柔软的地方（囟门），让大脑得以生长。与此同时，你的腰围越来越大，会让你感觉更不舒服，从胃灼热到痔疮都可能会有。别担心——再熬过几个星期就可以了！

This week your baby's body continues to plump up, while the bones underneath harden to support it. The only bones that will stay soft are inside your baby's skull, which will need to compress slightly to fit through the birth canal. There will still be soft spots in your baby's skull throughout the first few years, to allow the brain to grow. Meanwhile, your growing girth is making you more uncomfortable, with afflictions ranging from heartburn to hemorrhoids. Don't worry — only a few more weeks to go!

妊娠第34周：现在你的宝宝顶臀径超过30cm，重2250g------大约相当于一个大菠萝的大小。大多数主要的器官（消化系统、呼吸系统和神经系统）几乎都能自主工作。宝宝可能已经处于头位朝下，他/她已经准备好了！此时子宫里的空间更加局促，如果你看到一个不合时宜肘部或膝盖从你的腹部突出来，请不要感到惊讶。

Right now your baby measures more than 12 inches from the top of the head to the rump, and weighs 5 pounds — about the size of a large pineapple. Most of the major organs — digestive, respiratory, and nervous systems — are almost able to work on their own. Your baby may already be in the head-down position, ready for delivery! Space in your uterus is tight these days, so don't be surprised if you see an errant elbow or knee poking out from your belly.

妊娠第35周：你的子宫里可能没有多少空间了，你的宝宝体重将近2500g，而且开始了更迅速的增长。在接下来的几个星期里，你的宝宝每周会增加450g或更多的体重。婴儿也会在你的盆骨中沉降下来——这个动作被称为“衔接”。这对你的肺来说是个好消息（呼吸现在应该变得更容易了）；但是对你的膀胱来说是个坏消息，它将会感觉到更大的压力，因此，你可能会在厕所里花上更多的时间。

There may not be much room left in your uterus, with your baby weighing in at nearly 5 1/2 pounds, but now the serious growth begins. For the next few weeks, your baby will put on 1/2 pound or more a week. Baby is also settling into position lower in your pelvis for delivery – this movement is called "lightening." That's good news for your lungs — breathing should get easier now — but bad news for your bladder, which will start to feel more pressure. As a result, you'll be spending even more time in the bathroom.

妊娠第36周：再过几天，你的宝宝就会被认为是足月儿了。体重大约2700（大约相当于一个蜜瓜的大小），孩子的身体已经准备好出生了。在这9个月的旅程中，被称为“胎脂”的蜡状白色物质，覆盖了他或她的大部分身体。婴儿吞下胎脂，会形成黑绿色的胎粪，这些胎粪在婴儿的第一块尿不湿中便该找到。从现在开始直到你临产，每周都该去见你的产科医生。

In just a few days, your baby will be considered full-term. At almost 6 pounds — about the size of a honeydew melon — your child's body is just about ready for birth. The waxy, white substance called vernix caseosa that covered much of his or her body during this 9-month journey has dissolved. Baby has swallowed this and other substances, which will form the blackish-green meconium bowel movements you'll find in baby's first diapers. From now until the end of your pregnancy, you'll see your ob-gyn at least once a week.

妊娠第37周：你的宝宝足月了，重量约3000g，差不多是一个小的保龄球！婴儿自己也正在为分娩做准备，在几周的时间内——或者在这其中的任何一天，他/她的脑袋在你的骨盆中移动，这过程被称为“下降”。此时婴儿的免疫系统功能也启动了，并将在出生后继续发挥作用。建议你采取母乳喂养，这会更好的激发婴儿的免疫系统。

Your pregnancy is now full-term, and your baby is just about full-sized. At a weight of 6 1/2 pounds, it's like you're carrying around a small bowling ball! Baby is getting ready for labor, which could be a couple of weeks away — or any day now! His or her head is moving into position in your pelvis, which is called "engaged." Baby's immune system is also arming up, and will keep developing after birth. If you breastfeed, you'll boost baby's immune system even more.

妊娠第38周：冲刺阶段！婴儿现在体重超过了3000g。大部分的重量是厚厚的脂肪，这将有助于他或她适应外面世界的温度。宝宝的成长速度已经放缓了，但是器官正常运转更加顺畅。大脑已经开始掌控整个身体的功能——从呼吸到心率调节。机体反应也很活跃（包括抓握和吮吸），这表现为宝宝在出生后不久就能抓住你的手指并放在胸前（握持反应、拥抱反应）。

You're in the home stretch! Baby now weighs more than 6 1/2 pounds. Much of that weight is a layer of fat, which will help keep him or her warm in the outside world. Your baby's growth has slowed down, but the organs should all be working now. The brain has started to control the functions of the entire body — from breathing to regulating the heart rate. Reflexes are also active — including the grasping and sucking that allow baby to grab your hand and latch on to a breast soon after birth.

妊娠第39周：你的宝宝在你的肚子里就像一个小西瓜，你能感觉到每一份重量。你可能已经准备好了告别胃灼热、背痛和厕所依赖症，并准备好迎接你的宝宝！你不用再等太久了，婴儿随时都可能出生。当你的身体准备分娩时，你可能会注意到更多的Braxton Hicks收缩。如果他们变得更有规律和强烈，是时候联系您的产科医生了。

At just over 7 pounds, your baby is like a little watermelon in your belly — and you can feel every ounce. You're probably more than ready to be done with the heartburn, backaches, and constant bathroom visits and ready to meet your baby already! You won't have to wait much longer. Baby could be born any day now. You may notice more Braxton Hicks contractions as your body prepares for labor. If they get more regular and intense, it's time to call the doctor.

妊娠第40周：在这一周，你终于可以看一看你在过去的九个月里一直怀着的那个蠕动的小包袱了！然而，小调皮往往不配合时间表，准点靠岸。如果你的孩子仍决定在你的子宫里停留，在预产期前，和你的医生谈谈诱发分娩，也就是所谓的引产。新生儿的体型会有所不同，平均每个宝宝的体重是3200g，顶臀径是50cm。总之届时该恭喜你，终于有了自己的宝宝。

This is the week when you should finally get to meet the squirmy little bundle you've been carrying around for the last 9 months! However, often babies don't cooperate and arrive on schedule. If yours decides to stick around in your womb past your due date, talk to your doctor about whether he or she will cause you to go into labor, also known as inducing. Your baby is now full-sized. Although newborn sizes can vary, the average baby weighs 7 pounds, and measures 20 inches long from the top of the head to the rump.

生育是女性最伟大的奉献，也是女性体质发生重大变化的关键节点，产后百病诱生，欢迎继续了解下一章节产后诸症。

姚志韬医师

浙江省中医院妇科 主治医师

浙江省中医院 医务部 副部长

浙江省数理医学会盆腔整合医学学会 青年委员兼学会秘书

浙江省抗癌协会妇科肿瘤分会青年委员

浙江省中医院盆腔肿瘤中心秘书

浙江省中医盆腔肿瘤MDT秘书

本文系姚志韬医生授权好大夫在线（www.haodf.com）发布，未经授权请勿转载。