2546- Third Trimester
When does the third trimester occur?
28 weeks - delivery/ term
Vernix casoesa
The white thick coating that serves as extra protective coating from fluid
The longer the fetus remains the less of the caseosa
Crown-to-rump measurment
28: 27, 1100g
30-31: 31cm, 1800-2100
36: 35, 2200-2900
40: 40, 3200+
Fetal development: Musculoskeletal
Bone ossification
head movement
Fetal Development: nervous system
sleep-wake cycle
cries
stong such reflex
Fetal Development: Respiratory
Lung maturity
2:1 ratio
Fetal Development: sensory organ
sense of taste
aware of sounds
reacts to light
Fetal Development: Genital
Testes in scrotum and vagina development
not always descended until birth
Maternal Development: Lightening
Drop in the fundal height
less pressure on the diaphragm and more pressure on the bladder
Colostrum is produced by prolactin
Maternal Development: Cardio and respiratory
SBP decreases and DBP increases until the term
Chest breathing is more than abdominal breathing
Maternal Development: Musculoskeletal
Waddling gait
Rectus abdominal separation may occur
protrusion or flattening of the umbilical
Maternal Development: Gastrointestinal
Acid reflux
maternal gut microbe: beneficial for the baby
Maternal Development: neurological
Carpel tunnel caused by peripheral edema
Common Discomforts
Insomnia
dyspnea
Ankle edema
Psychosocial
Routine Prenatal care
Visits every 2 weeks
after 35 weeks a weekly visit
Care for after 40 weeks
Induction 41- 42+
Kick counts
Sit down
feet up
6 kicks in 2 hours
High Risk: HPD
Non- Severe: 140/90, 2 separate measurements- 15 mins apart
Severe: 160/110, 2 separate measurements- 15 mins apart
High Risk: Chronic HPD
Pre-existing or before 20 weeks
A) Comorbid
type 1 or type 2
B) Super imposed
Resistant hypertension
Proteinuria
Adverse comp
High Risk: GHPD
Occurs for the first time beyond 20 weeks
Pre-eclampsia
High Risk: GHPD management
BP consistently
Tendon reflexed
NST, BPP, US
activity and diet
Labetalol HCL
High Risk: Pre-eclampisa
HPD with proteinuria
Reduced organ perfusion
PROTEINURIA: 0.03g/L in 2 random urine- 6 hrs apart
0.3g/l in 24 hrs
High Risk: Pre-eclampsia complications
Headaches, GCS <13
O2<50
Increase in creatine
Abnormal FHR
Hematoma
N&V
High risk: Eclampsia
Strokes before, during or after birth
Pre-eclamp & Eclamp Etiology
Thick, rigid placenta
leading to cell activation that leads to decrease in organ perfusion
HELLP syndrome
hemolysis, elevated liver enzyme, low platelets
HPD and Proteinuria may not be present
S&S: Malais, N&V, Epigastric RUQ pain
HELLP Pathophysiology
Endothelial cell dysfunction that leads to RBC hemolysis and narrowing of BV
Hyperbilirubinemia causes necrosis and increase of liver enzymes
HELLP Management
Monitor urine output
Monitor FHR and look for Hypoxia
Placental deattachment
HELPP Pharmacological measurements
1) Corticosteroids
Buys time for lung maturity
Admin: 12mg IM X2- 24 hrs apart
2) Mg(SO4)
CNS depressant- seizure
IV 4g loading- 1-2 maintenance: 24 hrs
3) Calcium gluconate
Mg Toxicity
GDM BG control
Fasting: 3.8-5.2
1hr PP: 5.5-7.7
2hr PP: 5.0-6.0
High Risk: Placenta Previa
Placenta Implants in lower segments either fully or partially cover the uterus
S&S: Bright red and painless bleeding
VS and FHR may be normal
Increase in fundal height and non- tender uterus
Expectant VS Active Placenta Previa
EXCPECTANT: Pt < 36 weeks
monitor bleeding and decrease activity
ACTIVE: Pt> 36 weeks
Prep fo surgery
High Risk: Placental Abruption
Detattachment of placentas from the implantation site
S&S: Rigid Abdomen
Vaginal Bleeding
Placental Abruption Management
Rh Immunoglobin
large Bore IV
Indwelling folley
blood on standby
High Risk: Premature Dilation of Cervix & management
dilation in the second trimester
Management: Cervical cerclage
no sexual intercourse
High Risk: PROM & PPROM
weakening of amniotic membrane
gush or leak of odourless liquid
High Risk: Preterm Labour & birth
20-36.6 wks of regular uterine activity
Diagnosis: Tocolytics
Antibiotics
High Risk: Poly/ oligohydramnios
Poly: excess AFV, > 2L
olio: Too little AFV, < 300ml
High Risk: Amniotic Fluid Embolisim
Sudden Cardiac hypotension and hypoxia collapse
Foreign substances entered maternal circulation
Occurs during labour, birth, or after delivery
Intervention: Oxygenate, CPR
High Risk: IUGR
Symetrical: Chronic, genetic, and chromosomal abnormalities
Asymmetrical: Weight associated, deprivation, undernutrition
High Risk: Multiple Gestation
Dizygotic: faternal
Monozyogtic: identical
| Quiz |
|---|
| Patologia generale |
| Scentific method |
| Atrama ir judėjimas |
| GOVERNANCE & DEVELOPMENT |
| FINANCIAL MANAGEMENT |
| Augalo organizmas |
| gyvybes ivairove |
| H1 |
| bio |
| duits H1 (4) |
| geschiedenis 1.1 2.1 |
| no kärnfysik åk9 nr2 |
| duits H1 (3) |
| duits |
| inicio del desarrollo del sistema circulatorio |
| Duits 2 H 1 woordjes |
| english week 41 |
| derecho |
| KOTOBA PM LEMBAR 11(hal 43,44,45,46) |
| BRW |
| segmentación y delaminación del mesodermo |
| Glossary Vocab Qiuz |
| Test 2 |
| 2546- Second Trimester |
| 2546- First Trimester |
| homework |
| demografi migration etc |
| Karens Midterm |
| Afrikaans se instruksies |
| Hjärtat |
| geography case studies |
| frans |
| duits H1 (2) |
| duits H1 |
| SO-cold war |
| Laboratório Anexo3Medição em Química |
| SPANISHI would like |
| Salesforce data cloud 2024 |
| KOTOBA PM LEMBAR 10(hal 37,38,39,40-41,43) |
| QUIZ Ethics |
| NSTPdrrm |
| 312 |
| bio 12 quiz on Macro molecules |
| no kärnfysik |
| Normalvärden, triage och HLR |
| Week 4 - Joints (Chapter 9) |
| 6.1 ( school subjects spanish) |
| 5.3 (directions spanish) |
| 5.2 ( why you go there spanish) |
| 5.1 (Places in town Spanish) |
| voc 5 (The death penalty) |
| Palavras ou expressões p1 em inglêsP1 |
| unidad 2 |
| p |
| O |
| MIDTERMS THEORY |
| Glosor |
| COUNTRIES CAPITAL AND CURRENCIESby Ayaz Sindhi |
| KOTOBA PM LEMBAR 9(hal 34,35,36,37) |
| OB |
| FREN 3P03 VOCABULAIRE |
| Ite 366 |
| Parcial 1 |
| Quiz Gine Parcial |
| S&A |
| gr 9 science exam 1 |
| Week 6 - Nervous System Chapter 12 |
| Week 5 - Axial Skeleton (Chapter 7) |
| FREN 3P03 |
| Diritto PrivatoIl diritto è un sistema di regola per la soluzione di conflitti fra gli uomini. |
| Chapter 21 vessels |
| NO |
| ses |
| MAD Mobile Application development MIDTERM part 2 |
| MAD Mobile Application development MIDTERM part 1 |
| MAD Mobile Application development chapter 5 part 2 |
| MAD Mobile Application development chapter 5 part 1 |
| MAD Mobile Application development chapter 4 part 4 |
| MAD Mobile Application development chapter 4 part 3 |
| MAD Mobile Application development chapter 4 part 2 |
| MAD Mobile Application development chapter 4 part 1 |
| MAD Mobile Application development chapter 3 |
| MAD Mobile Application development chapter 2 |
| MAD Mobile Application develooment chapter 1 part 2 |
| MAD Mobile Application develooment chapter 1 part 1 |
| Ganda - copy |
| ak hoofdstuk 1 havo 2 |
| ITP |
| glosor V.40 |
| kap 7 |
| Duits woordenlijst |
| Kompletering prefix små tal |
| にほんごの質問 |
| Matte complwtering prefix stora tal |
| Grunder i belysningsteknik övningstenta A+BÖvningstenta |
| STAINS |
| zahlen |
| frage wörter |
| Konjugation verben auf -ar |
| Konjugation ser |
| 3Osso dell'anca, ileo, ischio, pube |
| LO1 |
| Glosor v41 |
| FRÅGOR |
| KOTOBA PM LEMBAR 8(hal 31,32,33,34) |
| banking gk and awareness |
| Fysik 5.1 , 5.2 Rörelse åk 8 |
| Anatomofisiologia |
| CHAPTER 4 |
| anatomia 2 parcial |
| French and indian warSTUDY |
| systeme nerveux |
| Enzymes, Chemical Peels, Circadia Cocoa Enzyme Lactic Acid Treatment |
| intrinsic aging and hormones |
| koder pli |
| Vicios del lenguaje |
| burn |
| wound |
| Auf die Räder |
| auro |
| cosmeceuticals |
| galvanic |
| Science 9 test 1 |
| neurulacion |
| come si scirvere un cv |
| CVlinguaggio formale. come scivere una cover letter. |
| notocorda |
| anglais |
| definition and characteristics of rubrics |
| les autochtones |
| ORG AGRI REVIEWER |
| vocabulaire 1er chapitre term |
| Kapitel 10 |
| intrinsic aging and hormones |
| Kapitel 9 |
| FOLA M1 |
| Auteurs sociologie contemporaine |
| Genesis 1:2 And the earth was without form, and void; and darkness was upon the |
| sinterizzazione |
| Kapitel 1 - copy |
| BASIC KEYBOARDING |
| 1L1M Understanding the self |
| ROTC |
| KOTOBA PM LEMBAR 7(hal 26,27,28,29,30) |
| Drinkar 3De 10-20 första drinkarna |
| class 12 ch 1 |
| enzymes |
| PAE 2P |
| modernismo y posmodernismo |
| microbiology |
| parcial 1 y 2 - copia |
| Enzymes, Chemical Peels, Circadia Cocoa Enzyme Lactic Acid Treatment |
| FREN 3P05 Test 1 oct 2024 |
| Urinary system |
| historia |
| inglês palavras adjetivos(p1)Palavras e expressões guardadas de Português para inglês e vice versa
Adjetivos |
| french untie 1 |
| Quiz 2 Body mechanics |
| Week 4 - Skeletal System (Chapter 6) |
| Chapitre 1c semaine 40 ord + futurum med ALLER |
| kapitel 8 |
| prefix |
| kranialnerver |
| Lab Heart |
| Cirkulationssystemet |
| the younger brother's inheritance |
| Kort transaksionele tecks woordeskat |
| evolution |
| biology |
| CHAPTER 3: TYPICAL SIGNS AND SYMPTOMS OF PSYCHOPATHOLOGY (PART 3) |
| 40 |
| civil olyndand |
| Grammar Ending's German |
| Salesforce Data Cloud 1 - copy |
| Kapitel 6 |
| C# Chapter 4 part 2 |
| C# Chapter 4 part 1 |
| C# Chapter 3 Part 2 |
| C# Chapter 3 Part 1 |
| C# Chapter 2 Part 2 |
| C# Chapter 2 Part 1 |
| C# Chapter 1 part 2 |
| C# Chapter 1 part 1 |
| Kapitel 4 |
| KOTOBA PM LEMBAR 6(hal 19,20,21,22-23,24,25,26) |
| Kaptiel 3 |
| Cognitive psychology attention |
| 76-100 |
| قیافه شناسی |
| marketing |
| Paris Basin |
| انتقال ها |
| Market StudiesMarket Studies is a discipline used to understand the market, the customers, the development of the offer and the position of the brand & its communication. |
| Many Kingdoms |
| SCI-401 |
| Pacial Gine |
| morfologia das articulações |
| articulacoes |
| articulações anatomia humana |
| Spanska v. 40 |
| Forensic Toxicology |
| Math, Unit 2 Quiz |
| Blodet |
| kap 1 |
| BLED CHAP 12 |
| TLE (tech) (1st exam)Study!!! |
| BLED CHAP 11 |
| integumentary |
| CHAPTER 3: TYPICAL SIGNS AND SYMPTOMS OF PSYCHOPATHOLOGY (PART 2) |
| ekologi |
| Analyse qualitative des données |
| Spanska - djur 1 |
| Spanska - djur |
| Sociologie des mobillitéjj |
| tyska glosor |
| Handel och logistik - kopia |
| ModalsModal is an auxilliary verb |
| KOTOBA PM LEMBAR 5(hal 15,16,17,18) |
| Drinkar 2De 10 första drinkarna |
| Merkantilism |
| Keynesianismen |
| Kanji 一 |
| Handel och logistik |
| aparato reproductor femeninocompruebe los temas estudiados de el aparato reproductor femenino |
| 51-75 |
| Math GRE |
| BAB 25 |
| la materia y sus interacciones |
| endocrinologia |
| Rock |
| PSYC-2018 Quiz |
| Revolution francaise |
| Lavar |
| Drinkar VGHär kommer ett härligt sätt att övar på drinkar! |
| Spanska |
| Forensic Ballistics (3) |
| English vocabulary 3 |
| atividades de ocio |
| Resonera |
| Djur stamtavla |
| Ropa |
| Tipos de comercio |
| интеркаларни, латерални, трауматични меристеми и меристемоиди |
| Normas de trabajo y seguridad. 1 |
| Вегетациона купа коријена |
| HEPSY Cours 2 |
| DNL |
| havo maatschappijleer se1 |
| Virology |
| Hi |
| NEURO TD2 |
| computer |
| gs so 2.2,3,5 |
| Geo glaciersHehe |
| Mandarin |
| hge |
| KOTOBA PM LEMBAR 4(hal 12,13,14,15) |
| Anglais S5 Voc 1 |
| kap 6 |
| Animal physiology |
| Forensic Ballistics (2) |
| GEOGRAFIA |
| FÍSICA |
| sistema oseosistema oseo |
| moment 1 |
| FILOSOFIA |
| musculosmusculos de la cabeza |
| Léna |
| Sociology |
| Relgion prov 1 |
| Test 1 |
| BIOLOGIA 2.0 |
| lite randoms |
| frågor |
| färger |
| kläder |
| veckodagarna |
| Jag är... |
| Food accessories |
| Food |
| Djur |
| math |
| مکتب ها |
| scheikunde se1 |
| Gender and Society |
| KOTOBA PM LEMBAR 3(hal 8,9,10,11,12) |
| AP 10 |
| Chapter 20 Cardiac |
| Java 2 chapter 10 review study |
| Java 2 Chapter 8 review study |
| Vegetaciona kupa stabla |
| Java 2 chapter 9 review study |
| LED fakta |
| Suffixes Forming AdjectivesSuffixes which transform any parts of speech into adjective |
| voc 4 (america's gun culture) |
| Ljustekniska storheter och enheterklar |
| 16 LERNWORTSCHATS |
| VerbChoose the correct answer and earn points! Good luck!! |
| Suffixes Forming NounsSuffixes which transform any parts of speech into noun |
| intro to transpo L1 |
| Kapitel 2 |
| Ljusfördelning och avbländning |
| Art and power : the power of music |
| its PL1 |
| svt 2 |
