Second Trimester

Question 1

When does the second trimester take place?

Answer 1

14 - 27 WEEKS GESTATION

Question 2

Name the 4 main hormonal changes happening in the second trimester?

Answer 2

DECREASED FATIGUE and NAUSEA
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ACNE
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CHLOASMA
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LINEA ALBA = LINEA NIGRA

Question 3

Name the general physical changes happening in the second trimester? (3)

Answer 3

BEGINS TO “SHOW”
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CENTRE OF GRAVITY CHANGES (Enlarged uterus, placenta)
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QUICKENING BEGINS (connection) - 1ST MOVEMENTS FELT

Question 4

Is there a strain on the spine in the second trimester?

Answer 4

YES
LUMBAR - ANTERIOR PELVIC TILT
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THORACIC - KYPHOSIS

Question 5

Is there a strain on the respiratory in the second trimester?

Answer 5

YES
ADDED PRESSURE IN ABDOMEN = DECREASED PRESSURE IN LUNGS
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RIBCAGE FLARES UP and OUT (costal margin pain)

Question 6

Which muscle group would experience loads of increased MRT due to the new weight on the anterior torso?

Answer 6

GLUTEAL MM

Question 7

Stretch marks may begin to appear in the second trimester, also known as what?

Answer 7

STRIAE GRAVIDARUM

Question 8

What cause spider veins and varicosities to develop in the second trimester?

Answer 8

GROWING UTERUS + ANTERIOR PELVIC TILT HINDERS BLOOD FLOW TO LEGS

Question 9

Gait changes in the second trimester may show what? (3)

Answer 9

PLANTAR FASCIITIS
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PES PLANUS (ankles in, flat foot)
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CALLOUSES

Question 10

What happens to blood pressure in the second trimester?

Answer 10

BP DROPS

Question 11

Is constipation in the 2nd trimester mechanical or hormonal?

Answer 11

MECHANICAL

Question 12

Is increased edema and heartburn normal in the 2nd trimester?

Answer 12

YES

Question 13

What’s the name of the practice contractions which begin in the second trimester?

Answer 13

BRAXTON HICKS CONTRACTIONS

Question 14

What should you be searching for in assessing posture in the 2nd trimester? (4)

Answer 14

PELVIC CHANGES (Anterior pelvic tilt, SIJ/innominate/pubic symphysis dysfunction)
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THORACIC SPINE/RIBCAGE CHANGES
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GAIT CHANGES
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NERVE COMPRESSION

Question 15

List the 3 main ways a nerve can become compressed in pregnancy?

Answer 15

1. PIRIFORMIS SYNDROME (NOT Sciatica)
2. THORACIC OUTLET SYNDROME (short pec/scalenes, apical breathing, +edema)
3. CARPAL TUNNEL SYNDROME

Question 16

Is abdominal massage indicated in the second trimester?

Answer 16

YES
NO DEEP/DOWNWARD PRESSURE
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LIFT and MASSAGE
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TOWARD LINEA ALBA/NIGRA
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ENHANCES TISSUE STRETCH
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ENSURE PATIENT WANTS IT

Question 17

What can we do for edema occurring in the 2nd trimester?

Answer 17

LYMPH DRAINAGE
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EXTRA PILLOWS (promote drainage)
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COOL FOOT and ARM BATHS

Question 18

Breast massage is indicated and useful in 2nd trimester to help with ______________ and drainage.

Answer 18

CONGESTION

Question 19

Why do we want to consider the greater trochanter for pain by the second trimester?

Answer 19

SIDE SLEEPING (LEFT recommended)
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COMPRESSION ISCHEMIA, FASCIAL and IT RESTRICTIONS

Question 20

What could be happening in the second trimester which would cause further contraindications from the first?

Answer 20

POSSIBLE BED REST
DVT
GESTATIONAL DIABETES