stages of pregnancy and normal birth

Question 1

how many trimesters are there

Answer 1

3

Question 2

how long is 1 trimester

Answer 2

3 months

Question 3

what hormone is secreted after egg is implanted

Answer 3

HCG Human chorionic gonadotropin

Question 4

what does oestrogen do

Question 5

what increases during pregnancy

Answer 5

blood pressure+ stroke volume
air moved in/out lungs increase and oxygen
kidneys receive more blood
gi changes- morning sickness (rising hcg levels)
breasts get bigger and become darker
uterus becomes bigger and larger
cervix is softer
metabolic rate increases
increase appetite

Question 6

what forms during the first few weeks

Answer 6

main organs and systems

Question 7

when is it classed as fetus and not embryo

Answer 7

week 10

Question 8

what week do the genitals begin to form

Answer 8

week 12

Question 9

when is second trimester

Answer 9

week 13-26

Question 10

symptoms during second trimester

Answer 10

• swollen and bleeding gums
• pains on the side of your belly caused by your expanding womb (known as “round ligament pains”)
• headaches
• nosebleeds
• bloating
• constipation
• indigestion and heartburn
• sore breasts
• leg cramps
• feeling hot
• dizziness
• swollen hands and feet
• urine infections
• vaginal infection
• darkened skin on your face or brown patches – this is known as chloasma or the “mask of pregnancy”
• greasier, spotty skin
• thicker and shinier hair

Question 11

how big is the foetus at 13 weeks

Answer 11

foetus, is around 7.4cm long, which is about the size of a peach.

Question 12

when is full term

Answer 12

week 37-40

Question 13

when is the third trimester

Answer 13

week 27 to birth

Question 14

how big is a baby at 28 weeks

Answer 14

foetus, is around 37.6cm long from head to heel. That’s approximately the size of an aubergine.

Question 15

what is a babies heartbeat

Answer 15

Your baby’s heart rate is changing all the time. Around week 5 or 6, when a baby’s heart is first detectable, it is around 110 beats per minute (bpm). Then it goes up to around 170 bpm in week 9 and 10.

Now, it’s slowed down to around 140 bpm and it will be around 130 bpm at birth.

That’s still a lot faster than your heart rate, which will be around 80 to 85bpm. This is partly because babies’ hearts are so small that they cannot pump much blood, but they can make up for this by going faster. It also helps to keep them warm.

Question 16

what is the furry hair covering a foetus until week 38

Answer 16

lanugo

Question 17

what is the sticky green slime in a foetus’ bowels

Answer 17

meconium

Question 18

what is the first milk called

Answer 18

colostrum- high in antibodies

Question 19

when does a baby go head down by

Answer 19

32 weeks

Question 20

what is excessive nausea and vomitting during pregnancy called

Answer 20

hyperemesis gravidarum (HG)

Question 21

signs and symptoms of HG

Answer 21

prolonged and severe nausea and vomiting
dehydration – symptoms include feeling thirsty, tired, dizzy or lightheaded, not peeing very much, and having dark yellow and strong-smelling pee
weight loss

Question 22

what causes HG

Answer 22

It’s not known exactly what causes HG, or why some women get it and others do not. There is evidence that it is linked to the changing hormones in your body that occur during pregnancy.

There is some evidence that it runs in families, so if you have a mother or sister who has had HG in a pregnancy, you may be more likely to get it yourself.

If you have had HG in a previous pregnancy, you are more likely to get it in your next pregnancy than women who have never had it before, so it’s worth planning in advance.

Question 23

what can be given by doctors for HG

Answer 23

anti-sickness (anti-emetic) drugs, steroids, or a combination of these.

Question 24

psychological effects of HG

Answer 24

• anxious about going out or being too far from home in case you need to vomit
• isolated because you do not know anyone who understands what it’s like to have HG
• confused as to why this is happening to you
• unsure about how to cope with the rest of the pregnancy if you continue to feel very ill

Question 25

what is more at risk if you have HG

Answer 25

Because HG can cause dehydration, there’s also an increased risk of having a blood clot (deep vein thrombosis), although this is rare.

If you are dehydrated and immobile, there is treatment that you can be given to prevent blood clots.

Question 26

what is the condition when pregnant women have a new onset of high blood pressure

Answer 26

pre-eclampsia

Question 27

signs and symptoms of pre-eclampsia

Answer 27

Early signs of pre-eclampsia include having high blood pressure (hypertension) and protein in your urine (proteinuria).

In some cases, further symptoms can develop, including:

severe headache
vision problems, such as blurring or flashing
pain just below the ribs
vomiting
sudden swelling of the face, hands or feet

Question 28

risk factors of pre-eclampsia

Answer 28

• having diabetes, high blood pressure or kidney disease before you were pregnant
• having an autoimmune condition, such as lupus or antiphospholipid syndrome
• having high blood pressure or pre-eclampsia in a previous pregnancy
• Other things that can slightly increase your chances of developing pre-eclampsia include:
• a family history of pre-eclampsia
• being 40 years old or more
• it’s more than 10 years since your last pregnancy
• expecting multiple babies (twins or triplets)
• having a body mass index (BMI) of 35 or more
• If you have 2 or more of these together, your chances are higher.

Question 29

what may pregnant women with pre-eclampsia take

Answer 29

advised to take a 75 to 150mg daily dose of aspirin from the 12th week of pregnancy until baby is born.

Question 30

what causes pre-eclampsia

Answer 30

Although the exact cause of pre-eclampsia is not known, it’s thought to occur when there’s a problem with the placenta, the organ that links the baby’s blood supply to the mother’s.

Question 31

what is maternal sepsis

Answer 31

Maternal sepsis is a life-threatening condition that arises when the body’s response to infection causes injury to its own tissues and organs during pregnancy, childbirth, post-abortion or the postpartum period.

Question 32

signs of (maternal) sepsis

Answer 32

Slurred speech or confusion
Extreme shivering or muscle pain
Passing no urine (in a day)
Severe breathlessness
It feels like you’re going to die
Skin mottled or discoloured

Additional symptoms which might affect people during or after pregnancy due to the possibility of infection include:

Fever and chills
Dizziness
Lower abdominal pain
Foul-smelling vaginal discharge
Vaginal bleeding
Increased heart rate
Discomfort or illness

Question 33

cause of maternal sepsis

Answer 33

Pregnant women face a slightly higher risk of sepsis due to naturally occurring immunological changes, the need for procedures or surgery, and risks due to complications, such as premature rupture of membranes or gestational diabetes. 

The most common cause is a severe bacterial infection of the uterus during pregnancy or immediately after childbirth. Maternal sepsis could also be caused by a urinary infection, or pneumonia. 

Pregnant women who have a chronic condition impacting one of their organs are the most at risk from maternal sepsis. 

Question 34

how can clinicans spot maternal sepsis

Answer 34

Detecting sepsis in pregnant women can be challenging since the natural adaptations to the body during pregnancy may mask the signs and symptoms of infection until the woman deteriorates. 

Due to the physiological changes in pregnancy, the National Early Warning Score (NEWS) is not designed for use in pregnant patients. Use of a Modified Obstetric Early Warning Score (MEOWS) alongside the Maternal Sepsis screening tool is recommended to facilitate the early recognition and escalation of deteriorating maternal patients.  

Question 35

what are placenta complications that may occur

Answer 35

• low-lying placenta and placenta praevia
• retained placenta – when part of the placenta remains in the womb after giving birth
• placental abruption – when the placenta starts to come away from the wall of the womb

Question 36

what is placenta previa and low lying placenta

Answer 36

As your pregnancy progresses, your womb expands and this affects the placenta’s position. The area where the placenta is attached usually stretches upwards, away from your cervix.

If the placenta stays low in your womb, near to or covering your cervix, it may block the baby’s way out.

This is called low-lying placenta if the placenta is less than 2cm from the cervix, or placenta praevia if the placenta is completely covering the cervix.

Placenta praevia, where the cervix is completely covered at the end of pregnancy, affects about 1 in every 200 births.

Question 37

what is retained placenta

Answer 37

After your baby’s born, part of the placenta or membranes can remain in the womb. This is known as retained placenta. If untreated, a retained placenta can cause life-threatening bleeding.

Breastfeeding your baby as soon as possible after the birth can help your womb contract and push the placenta out.

Your midwife may also ask you to change your position (for example, by moving to a sitting or squatting position). In some cases, you may be given an injection of a medicine to help your womb contract.

If these methods don’t work, a doctor may need to remove the placenta by hand. This can be painful, so you’ll be given an anaesthetic.

Question 38

what is placentaral abruption

Answer 38

Placental abruption is a serious condition in which the placenta starts to come away from the inside of the womb wall.

It can cause stomach pain, bleeding from the vagina and frequent contractions.

It can also affect the baby, increasing the risk of premature birth, growth problems and stillbirth.

Question 39

risk factors of placentaral abruption

Answer 39

It’s not clear what causes placental abruption, but factors that increase the risk include injury to the abdominal area, smoking, cocaine use and high blood pressure.

Question 40

what is the first stage of labour called

Answer 40

latent stage

Question 41

what are the contractions in the latent stage of labour like

Answer 41

You may begin to feel irregular contractions, but it can take many hours, or even days, before you’re in established labour. It’s usually the longest stage of labour.

At this stage, your contractions may range from being slightly uncomfortable to more painful. There’s no set pattern to how many contractions you get or how long they last.

Question 42

how much is the dilation during established labour

Answer 42

Established labour is where your cervix has dilated to about 4cm and your contractions are stronger and more regular.

Question 43

what colour should amniotic fluid be

Answer 43

clear or straw like colour

Question 44

what is a green like amniotic fluid mean

Answer 44

baby may have made his first bowel movement inside

Question 45

how big will a cervix dilate to be fully dilated

Answer 45

cervix needs to open about 10cm for your baby to pass through it. This is what’s called being fully dilated.

Question 46

what does ARM stand for

Answer 46

Breaking the membrane that contains the fluid around your baby (your waters) is often enough to make contractions stronger and more regular. This is also known as artificial rupture of the membranes (ARM).

Question 47

what does oxytocin do

Answer 47

If breaking your waters does not work, your doctor or midwife may suggest using a medicine called oxytocin (also known as syntocinon) to make your contractions stronger. This is given through a drip that goes into a vein, usually in your wrist or arm.

Oxytocin can make your contractions stronger and more regular and can start to work quite quickly, so your midwife will talk to you about your options for pain relief.

You will also need electronic monitoring to check your baby is coping with the contractions, as well as regular vaginal examinations to check the drip is working.

Question 48

when is the second stage of labour

Answer 48

The 2nd stage of labour lasts from when your cervix is fully dilated until the birth of your baby.

Question 49

what pain relief can be given for labour

Answer 49

entonox

Question 50

why might gentle pressure be applied to babys head

Answer 50

to slow down the birth to reduce tearing

Question 51

what do you need to consider when cutting the placenta

Question 52

what do you need to make a note of when baby is born

Answer 52

time baby is born

Question 53

what is bleeding heavily after giving birth called

Answer 53

Postpartum haemorrhage (PPH) is a complication where you bleed heavily from the vagina after your baby’s birth.

Question 54

what are the two types of postpartum haemorrhage

Answer 54

There are 2 types of PPH, depending on when the bleeding takes place:

primary or immediate – bleeding that happens within 24 hours of birth
secondary or delayed – bleeding that happens after the first 24 hours and up to 12 weeks after the birth

Question 55

causes of post partum haemorrhage

Answer 55

Sometimes PPH happens because your womb doesn’t contract strongly enough after the birth.

It can also happen because part of the placenta has been left in your womb or you get an infection in the lining of the womb (endometritis).

To help prevent PPH, you’ll be offered an injection of oxytocin as your baby is being born. This stimulates contractions and helps to push the placenta out.

4 ts
(uterine atony [Tone]; laceration, hematoma, inversion, rupture [Trauma]; retained tissue or invasive placenta [Tissue]; and coagulopathy [Thrombin])

Question 56

risk factors for post partum haemorrhage

Answer 56

Those with placental problems like placenta accreta, placenta previa, placental abruption and retained placenta are at the highest risk of PPH.

An overdistended uterus also increases the risk for PPH. This is when your uterus is overstretched from:

Multiple pregnancies.
Having twins, triplets or more.
Birthing a large baby (9 pounds or more).
Too much amniotic fluid.
Certain factors during labor and delivery can increase your risk for hemorrhage:

C-section.
You were given oxytocin (Pitocin®) to include labor.
You were given general anesthesia.
You were given tocolytics to stop labor.
Prolonged labor.
Infection during labor.
Tearing (perineal lacerations) during vaginal delivery.
You’ve had PPH in prior deliveries.
Other health conditions that can increase your risk for postpartum hemorrhage are:

High blood pressure or preeclampsia.
Infection.
Blood clotting disorders or other blood-related conditions.
Intrahepatic cholestasis of pregnancy (ICP).
Anemia.
Obesity.
Advanced maternal age.
A history of five or more previous deliveries.