Pregnancy Trimesters

Content:
The trimesters
Test and Procedures
Hormone

THE TRIMESTERS
What are the months of the three Trimesters in pregnancy?
First trimester: 0 - 12 weeks (0 - 3 and a half months)

Second trimester: 12 - 24 weeks (3 1/2 months to 6 mths)

Third trimester: 24 - 40 weeks (7 mths to delivery)

First trimester
Size of baby during 1st month = a dime
has eyes, mouth and head and his legs and arms are growing.
heart and lungs have begun to beat - lungs have begun to form.
at the end of this month of pregnancy, about half an inch long.
Most miscarriages occur during this period
Some studies show that mild to moderate sickness is a sign of a good pregnancy, and less risk of miscarriage.

What to expect
Tender breasts.
Increased hormone production – more sensitive. Feel fuller and heavier. Wearing a more supportive bra or a sports bra may help.

Bouts of nausea.
Queasiness, nausea or vomiting - normal hormonal changes. Usually worse in the morning, but it can last all day. To help relieve this symptom, eat small, frequent meals throughout the day. Suck on hard candy. Try ginger ale or ginger tea. Lemon and peppermint sometimes help, too. Avoid foods or smells that make your nausea worse. If you're not able to eat or drink for more than 24 hours, contact your health care provider.

Unusual fatigue.
body prepares to support the pregnancy. Heart will pump faster and harder, and pulse will quicken. To combat fatigue, rest as much as possible. Make enough iron and protein. Include physical activity in your daily routine, such as a brisk walk.

Increased urination.
Enlarging uterus presses on bladder. May cause you to leak urine when sneezing, coughing or laughing. To help prevent urinary tract infections, urinate whenever you feel the need to. If losing sleep due to middle-of-the-night bathroom trips - drink less fluid in the evening. If you're worried about leaking urine - panty liners.

Dizziness.
Due to normal circulation changes. Stress, fatigue and hunger play a role. To prevent mild, occasional dizziness - avoid prolonged standing. Rise slowly after lying or sitting down. If you start to feel dizzy while you're driving, pull over. If you're standing when dizziness hits, sit or lie down.

Seek prompt care if the dizziness is severe and occurs with abdominal pain or vaginal bleeding. This may indicate an ectopic pregnancy — a condition in which the fertilized egg implants itself outside the uterus. To prevent life-threatening complications, the ectopic tissue must be removed.

Second trimester
Size of baby = 3 inches in length
baby's face has a defined nose, chin, and forehead by now.
can even smile due to development of facial muscle.
Fine hair starts growing all over your baby's body.
She has a distinct set of fingerprints.
She now has her own identity and is no longer just a bunch of cells.

What to expect
Larger breasts.
Stimulated by estrogen and progesterone, the milk-producing - larger. Additional fat - accumulate in your breasts. The result may be 1 pound of extra breast tissue or up to two additional cup sizes. Initial breast tenderness may improve, nipple tenderness may continue throughout the pregnancy. A supportive bra is a must.

Growing belly.
Uterus becomes heavier and expands to make room for the baby- abdomen expands — sometimes rapidly. Expect to gain up to 4 pounds a month until the end of your pregnancy.

Braxton Hicks contractions.
Uterus start contracting to build strength for the big job ahead - Braxton Hicks contractions, in lower abdomen and groin - painless and on-and-off. Contact your health care provider if the contractions become painful or regular. This may be a sign of preterm labor.

Skin changes.
blood circulation increases - certain areas of skin become darker, such as the skin around your nipples, parts of your face and the line that runs from your navel to your pubic bone.

Dizziness.
Blood vessels dilate in response to pregnancy hormones. Until blood volume expands to fill them, you may experience occasional dizziness. Lower blood pressure due to your rapidly expanding circulatory system play a role. Avoid prolonged standing, and rise slowly after lying or sitting down.

Leg cramps.
Pressure from uterus on the veins returning blood from your legs may cause leg cramps, especially at night. Stretch the affected muscle or walk your way through the cramps.

Heartburn and constipation.
Movements pushing swallowed food from esophagus into stomach are slower – stomach takes longer to empty. Slowdown gives nutrients more time to be absorbed into bloodstream and reach baby. May also lead to heartburn and constipation. May help to eat small, frequent meals. To prevent or relieve constipation, include plenty of fiber in diet and drink lots of fluids.

Nasal and gum problems.
Circulation increases - more blood flows through body's mucous membranes - causes the lining of nose and airway to swell - can restrict airflow and lead to snoring, congestion and nosebleeds. Can also soften your gums, which may cause minor bleeding when you brush or floss your teeth.

Shortness of breath.
Lungs - processing up to 40 percent more air than they did before your pregnancy - allows blood to carry more oxygen to placenta and the baby – may cause breathing slightly faster and feeling short of breath.

Vaginal discharge.
May notice a thin, white vaginal discharge (acidic) - thought to help suppress the growth of potentially harmful bacteria or yeast. Wear panty liners for comfort. Contact your health care provider if discharge becomes strong-smelling, green or yellowish or if it's accompanied by redness, itching or irritation. May indicate a vaginal infection.

Bladder and kidney infections.
Hormonal changes slow the flow of urine, expanding uterus — both factors that increase the risk of bladder and kidney infections. Contact your health care provider if you need to urinate more often than usual, you notice a burning sensation when you urinate, or you have a fever, abdominal pain or backache. Left untreated, urinary infections increase the risk of preterm labor.

Third trimester
baby is likely to grow fastest!
-Seventh Month
the head of the baby will appear to be in proportion to the rest of the body and the brain is better developed.
baby can now, bat his eyelids and can actually produce tears.
The weight of the baby will be close to three pounds (1.360777 kilograms) now, though the physical growth takes a lower pace.
-Eigth Month
May not be much room for the growing baby to move around - the mother may not feel much movement within the womb.
Mild discomforts - indigestion, heartburn during pregnancy, shortness of breath and tiredness may be experienced.
The baby - slowly change position - the head faces the bottom. The amniotic fluid will be at its highest now, and the baby may begin taking alternate breaths, thereby getting himself prepared to breathe air.
The sleep pattern of the baby - more regular now.
By the end of the month, the hearing capability of the baby would have developed completely - recommended that parents should talk to their baby as much as they can.
-Ninth Month
Baby’s head descend into the pelvic region - mother may experience more frequent urge for urination – common.
The baby’s head - have hair, the lungs - completely developed by now and the weight - will now be about 7.25 pounds (3.28854468 kilograms )
chances of the mucus plug getting burst, anytime, which is a sure sign of approach of labor.


TEST & PROCEDURES
FIRST TRIMESTER
During the first appointment:
-Basic medical history
Menstrual cycle
Use of contraceptives
Past pregnancies
Allergies
Other medical conditions
-Due date
Counting ahead 40 weeks from the start of last period
Early establishment helps to monitor foetus’s growth as accurately as possible
-Physical exam
Weight
Height
Blood pressure
Heart beat
Overall health
-Pelvic exam
Examine vagina and cervix for any infections or abnormalities
May require pap test to screen for cervical cancer
Changes in the cervix and in the size of uterus can help confirm the stage of pregnancy
-Blood test
Blood type
Rh factor
Syphilis
Measles
Mumps
Rubella
Hepatitis B
HIV
-Urine tests
Bladder or kidney infection
Diabetes
-Lifestyle issues
Discuss importance of nutrition, prenatal vitamins, exercise, and other lifestyle issues
Work environment
-Other appointment
Scheduled every four to six weeks
Check weight and blood pressure
Discuss signs and symptoms
Screening and diagnostic tests for foetal abnormalities
-Ultrasound
-Blood test
-Chorionic villus sampling (CVS)
Between 10 and 12 weeks of pregnancy
The doctor inserts a needle through abdomen or inserts a catheter through cervix in order to reach the placenta. The doctor then takes a sample of cells from the placenta
Look for problems with chromosomes
-Nucchal translucency screening (NTS)
Between 11 and 14 weeks
Uses an ultrasound and blood test to calculate the risk of some birth defects (e.g. down syndrome)
Ultrasound – check the thickness of the back of the foetus’s neck
Blood test – to check the levels of pregnancy-associated plasma protein and human chorionic gonadotropin (hCG)

Second trimester
Once a month
During every visit:
-Check blood pressure and weight
Track your baby’s growth
By measuring the abdomen from the top of uterus to pubic bone
-Listen to your baby’s heartbeat
Using doppler
-Assess foetal movement
-Routine lab tests
Urine test
Sugar or protein
Blood test
Low iron levels
-Gestational diabetes
Prenatal testing
Blood test
Developmental or chromosomal disorders
Ultrasound
Evaluate foetus’s growth and development
Diagnostic test
-Amniocentesis
At least 16 weeks
Inserting a thin needle through your abdomen, into your uterus, and into the amniotic sac to take out a small amount of amniotic fluid for testing.
Look for problems with chromosomes
Miscarriage: 1 in 200
-Maternal serum screening test
Blood test
Between 15 and 20 weeks of pregnancy
Check for birth defects (down syndrome, Edward syndrome)
Done by checking for alpha-phetoprotein (AFP) (made by foetus’s liver), estriol and (hCG)
-Targeted ultrasound
Between 18 and 20 weeks
Look for physical defects
Find out the sex of the baby
Can look for any neural tube defects (e.g. spina bifida)

Third trimester
Weekly checkups during the last month of pregnancy
Continue to monitor blood pressure and weight, foetus’s heartbeat and movement
-Screening for group B streptococcus
Harmless to adults, but not for foetus
Can become critically ill
If positive, be given intravenous antibiotic during labor
-Resuming vaginal exams
Check the foetus’s position
Feeling the foetus’s head in the lower abdomen or at the top of the birth canal
Detect cervical changes
Cervix will begin to soften, open (dilate) and thin (efface)
Help in determining how difficult it would be to induce labor

HORMONES
Human Gonadotropic Hormone (hCG)
produced only during pregnancy.
(First by ovary and later by placenta)
hCG values double every two days or so in the early part of the first trimester.
Keeps estrogen and progesteroneat their appropriate levels until the placenta has developed enough to take over this function.
Estrogen
Regulate the production of progesterone
Assist in the development of foetus
Regulates bone density in a foetus
Maintains the endometrium during pregnancy
Promotes blood flow within the uterus
Maintains, regulates and triggers the production of other hormones
Protects female foetuses from the effects of androgens in the mother's system.
Progesteron (mostly together with estrogen)
Makes the endometrium develop and secrete fluids after being primed by estrogen
Maintains the functions of the placenta and fights off unwanted cells near the womb that could cause damage to the placenta or foetus.
Keeps the endometrium in a thickened condition
Stops the uterus making spontaneous movements
Stimulates the growth of breast tissue
Strengthens the mucus plug covering the cervix to prevent infection.
Strengthens the pelvic walls in preparation for labour.
Stops the uterus from contracting (thus keeping the baby where it is)
Estrogen &Progesterone
control the onset of breast milk
inhibiting the breasts' response to the hormone prolactin.
At the time of delivery,Estrogen and progesterone levels decrease, allowing prolactin to stimulate the breasts' milk flow.

Increased level
Estrogen
Appearance of rashes or red blotches on skin
Progesterone
Constipation
Heartburn
Runny and irritable nose
Eyesight problems (blurring or headaches)
Increased kidney infection risk.
Prolactin
made by the baby’s kidneys
reduced about a week after birth.
remain high within the mother's blood for about two weeks after birth.
important for the regulation of the mother's metabolism during the pregnancy
assists in the stimulation of immune system cell growth.
prepares the breasts for breastfeeding
promotes the growth of the baby.
Oxytocin
Causes uterus to contract so that birth happen rapidly
Stimulates mammary glands to produce milks
High level of progesterone prevent oxytocin effect