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2nd & 3rd trimester, birth & complications

31 important questions on 2nd & 3rd trimester, birth & complications

What happens during the third trimester of pregnancy?

The fetus grows rapidly and all organs are functioning.

When do you speak from a developing embryo, when is it a fetus?

The first two months you speak of a developing embryo, from 9 weeks onwards to birth it is called fetal development.

In the early stage of pregnancy there is development and differentiation, can you explain the differences of these processes?

Differentiation is the change in genetic activity. Development is the gradual change in anatomy and physiology.

When does the risk of having a miscarriage get lower?

After 12 weeks --> there is a solid foundation, all the organs are developed the fetus just needs to grow from then on.

Pregnancy is associated with significant changes in the body of the mother. What are these? Why does this happen?

Increased:

Speed of respiration
intake of nutrients and vitamins
blood volume
glomerular filtration

This happens because the growing fetus is completely dependent on the organ systems of the mother for nutrition, respiration and secretion.

The placenta is an endocrine organ, what are the hormones released by the placenta?

Human chorionicgonadotropin (hCG)
Human placental lactogen (hPL)
Placental prolactin
Relaxin
Progesterone
Estrogens

What is human placental lactogen (hPL)?

hPL is for preparing the breasts for milk production.

What is the function of progesteron and estrogens during pregnancy?

Progesteron and estrogens are needed for a normal course of pregnancy.

What is 'false' labor?

False labor means that there are contractions of the uterine wall, this moves the fetus to the right position in the uterus.

What is the difference between abortion and a miscarriage?

A miscarriage is the spontaneous or unplanned expulsion of a fetus from the womb before it is able to survive independently (before the 20th week of pregnancy).
Abortion is the medical term for the deliberate premature termination of a pregnancy (due to (medical) intervention).

What is a spontaneous abortion, what is a different term?

Spontaneous abortion means that there are problems with the embryo or fetus. These problems can be chromosomal, endocrine, because of drug (ab)use etc.
It is also called a miscarriage.

What is a therapeutic abortion?

You speak of a therapeutic abortion when the life of the mother is in danger. This can be an infection of a fallopian tube, ectopic pregnancy, choriocarcinoma (aggressive tumor of the placenta) etc.

What is an induced abortion?

An induced abortion means that it is the mother's choice, this can have many different reasons.

What are the indications of a spontaneous abortion?

Indications:

blood loss / pink mucous discharge
heavy bleeding accompanied by back cramps
cardiac arrest in echo

What is the difference between an early and late miscarriage?

An early miscarriage is within the first 12 weeks, due to serious genetic defects. A late miscarriage is after 12 weeks and can have many different reasons:

Cervix insufficiency (uterus mouth too weak)
Tearing of the amnion (dutch: vruchtzak), amniotic fluid draining away
Malfunctioning placenta

What are the different phases of labor?

Dilation
Expulsion
Child birth
After birth

What are the two phases of dilation? What is the difference between these two phases?

Latent phase and active phase. In the latent phase the cervix is dilated 0 to 4 cm. The active phase is when contractions start, the cervix dilates 4 to 10 cm in this phase.

When can expulsion contractions occur?

Expulsion contractions occur when full disclosure (10 cm) has been reached.

What are expulsion contractions?

Expulsion contractions are waves of contractions through the whole body with the intention of pushing the baby down, out of the uterus.

What happens when the placenta does not get out of the uterus?

The mother gets a shot of oxytocin which induces contractions, the placenta gets pushed out of the uterus in this way.

By what test is the condition of the baby determined?

APGAR

When do you speak of preterm, and when do you speak of extreme preterm labor?

Extreme preterm labor: before 32 weeks
Preterm labor: between 32 and 37 weeks

What is the treatment of the mother when the baby is about to be born preterm?

Premature rupture of membranes or excessive loss of fluid: rest and antibiotics
24-34 weeks: contraction inhibitors (Indometacin is a prostaglandin-synthase inhibitor; it is also analgesic, anti-inflammatory and anti-fever)
Inject maternal corticosteroids (to accelerate maturation of alveoli); effect already measurable after 12 hours, and optimally after 24-48 hours

What is Respiratory Distress Syndrome (RDS)?

RDS is the inefficient exchange of gasses. Respiration takes too much energy.

How can you explain that the brain of preterm babies is not fully developed?

The production of neurons takes place at 20 weeks, however the migration only happens around week 25-26. This means that the neurons are produced when born but they are not yet in the right position. This could have an effect on intelligence later in life.

What are the guideline for treatment of preterm babies in the Netherlands?

> 26 weeks: always provide treatment
25-26 weeks: depending on condition, typically yes
24-25 weeks: depending on condition, typically no
< 24 weeks: do not provide treatment

What is the danger of late labor?

The danger of late labor is that the digestive system of the baby is already working. The fetus could 'eat' its own feces in this case.

If, due to maternal or fetal causes, the birth does not or cannot proceed normally. What procedures can be done?

Vacuum-assisted delivery
Forceps delivery
Cesarean section

What are complications during pregnancy, that are caused by the placenta?

Placenta previa
Placenta Accreta
Placenta-insufficiency
Placenta-abrubtion

What is placenta accreta?

Placenta accreta means that the placenta abnormally attaches to the myometrium. Serious issues occur during normal delivery so a C-section has to be done.

When does placenta insufficiency occur?

When being pregnant with twins.

The question on the page originate from the summary of the following study material:

Human Development

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