The Second Trimester - Presentation

THE SECOND
TRIMESTER
By: MAC PAUL V. ALARIAO
THE SECOND TRIMESTER: WHAT TO EXPECT
• The second trimester marks a turning point for the mother and fetus.
The pregnant mother will usually begin to feel better and start
showing the pregnancy more.
• The fetus has now developed all its organs and systems and will now
begin growing in length and weight.
• During the second trimester, the umbilical cord continues to thicken as
it carries nourishment to the fetus. However, harmful substances also
pass through the umbilical cord to the fetus, so care should be taken
to avoid alcohol, tobacco and other known hazards.
• During the second trimester, both your body and the fetus continue to
grow.
THE SECOND TRIMESTER: CHANGES TO YOUR BODY
• The second trimester is the most physically
enjoyable for most women.
• Morning sickness usually lessens by this time, and the
extreme tiredness and breast tenderness usually ease
up.
• These changes can be attributed to a decrease in levels
of human chorionic gonadotropin hormone and an
adjustment to the levels of estrogen and progesterone
hormones.
The following is a list of changes and symptoms that may happen
during the second trimester:
• Appetite may increase.
• The pregnant mother may be able to feel the movement of the fetus for
the first time around 20 weeks. This phenomenon is called QUICKENING.
• The uterus grows to the height of the bellybutton around 20 weeks,
making the pregnancy visible.
• The skin on the belly may itch as it grows, and there may be pain down
the sides of the body as the uterus stretches. The lower stomach may
ache as ligaments stretch to support the uterus.
• The need to urinate often may decrease as the uterus grows out of the
pelvic cavity, relieving pressure on the bladder.
• Your nose may become congested, and you may experience nosebleeds.
This is due to the increase in hormones (estrogen and progesterone) and
blood flow that affect the mucous membranes and blood vessels in the
nose.
• Your gums become spongier and may bleed easily. This is due to the
increase in hormones (estrogen and progesterone) that affect the
mucous membranes in the mouth.
• Varicose veins and hemorrhoids may appear.
• You may have a white-colored vaginal discharge called leukorrhea. (A
colored or bloody discharge may signal possible complications and
should be examined immediately.)
• The increasing weight gain may cause backaches.
• Skin pigmentation may change on the face or abdomen due to the
pregnancy hormones.
• Heart burn, indigestion and constipation may continue.
THE SECOND TRIMESTER: FETAL DEVELOPMENT
Now that all the major organs and systems have formed in the
fetus, the following six months will be spent growing. The weight of
your fetus will multiply more than seven times over the next few
months, as the fetus becomes a baby that can survive outside of
the uterus.
By the end of the second trimester, the fetus will be about 13 to 16
inches long and weigh about 2 to 3 pounds. Fetal development
during the second trimester includes the following:
• The fetus kicks, moves and can turn from side to side.
• The eyes have been gradually moving to the front of the face, and the
ears have moved from the neck to the sides of the head. The fetus can
hear your voice.
• A creamy white substance (called vernix caseosa, or simply vernix)
begins to appear on the fetus and helps to protect the thin fetal skin.
Vernix is gradually absorbed by the skin, but some may be seen on
babies even after birth.
By the end of the second trimester, your fetus will be about 13 to
16 inches long and weigh about 2 to 3 pounds. Fetal development
• The fetus is developing reflexes, like swallowing and sucking.

• The fetus can respond to certain stimuli.
• The placenta is fully developed.
• The brain will undergo its most important period of growth from the
fifth month on.
• Fingernails have grown on the tips of the fingers and toes, and the
fingers and toes are fully separated.
• The fetus goes through cycles of sleep and wakefulness.

• Skin is wrinkly and red, covered with soft, downy hair (called lanugo).
• Hair is growing on the head of the fetus.
• Fat begins to accumulate in the fetus.
• Eyelids are beginning to open, and the eyebrows and eyelashes are
visible.
• Fingerprints and toe prints have formed.

• Rapid growth is continuing in fetal size and weight.
• The 20th week marks the halfway point of the pregnancy.
• A fetus born at the end of 24 weeks may survive in a neonatal intensive
care unit.
SECOND TRIMESTER PREGNANCY COMPLICATIONS
The second trimester is often when people
feel their best during pregnancy. Nausea and
vomiting usually resolve, the risk of
miscarriage has dropped, and the aches and
pains of the ninth month are far away. Even
so, there are a few complications that can
occur.
SECOND TRIMESTER PREGNANCY COMPLICATIONS
BLEEDING
• Although a miscarriage is much less common in
the second trimester, it can still occur.
• Vaginal bleeding is usually the first warning
sign. Miscarriages in the second trimester
(before 20 weeks) may be caused by several
different factors
BLEEDING
UTERINE SEPTUM –
A wall, or septum,
inside the uterus
divides it into two
separate parts.
BLEEDING
INCOMPETENT
CERVIX - When the
cervix opens too
soon, causing early
birth.
BLEEDING
AUTOIMMUNE
DISEASES – Examples
include lupus or
scleroderma. These
diseases can occur
when your immune
system attacks healthy
cells.
BLEEDING
AUTOIMMUNE DISEASES:
ANTIPHOSPHOLIPID SYNDROME
Antiphospholipid syndrome, which causes
blood clots to form too easily or excessively,
can cause the following during pregnancy:
 A miscarriage or stillbirth
 High blood pressure or preeclampsia (a
type of high blood pressure that occurs
during pregnancy)
 A fetus that may not grow as expected (
small for gestational age)
BLEEDING
IMMUNE THROMBOCYTOPENIA (ITP)
 In immune thrombocytopenia , antibodies decrease
the number of platelets (also called thrombocytes) in
the bloodstream. Platelets are cell-like particles that
help in the clotting process. Too few platelets
(thrombocytopenia) can cause excessive bleeding in
pregnant women and their babies.
 If not treated during pregnancy, immune
thrombocytopenia tends to become more severe.
 The antibodies that cause the disorder may cross the
placenta to the fetus. However, they rarely affect the
platelet count in the fetus.
 The fetus can usually be delivered vaginally.
BLEEDING
MYASTHENIA GRAVIS
 Myasthenia gravis causes muscle weakness. Its
effects during pregnancy vary. Pregnant women may
have more episodes of weakness.
 Thus, they may need to take higher doses of the
drugs (such as neostigmine) used to treat the
disorder. These drugs can have side effects such as
abdominal pain, diarrhea, vomiting, and increasing
weakness. If these drugs are ineffective, women may
be given corticosteroids or drugs that suppress the
immune system (immunosuppressant).
BLEEDING
SYSTEMIC LUPUS ERYTHEMATOSUS (LUPUS)
 Women who develop lupus often have a history of repeated miscarriages, fetuses
that do not grow as much as expected (small for gestational age ), and preterm
delivery . If women have complications due to lupus (such as kidney damage or
high blood pressure), the risk of death for the fetus or newborn and for the woman
is increased.
 If women with lupus were taking hydroxychloroquine before they became pregnant, they
may take it throughout pregnancy. If flare-ups occur, women may need to take a low dose
of prednisone (a corticosteroid) by mouth, another corticosteroid such
as methylprednisolone given intravenously, or a drug that suppresses the immune system
(immunosuppressant) such as azathioprine.
BLEEDING
RHEUMATOID ARTHRITIS
If a flare-up occurs during
pregnancy, it is treated with
prednisone (a corticosteroid). If
prednisone is ineffective, a drug that
suppresses the immune system
(immunosuppressant) may be used.
BLEEDING
SYSTEMIC LUPUS ERYTHEMATOSUS (LUPUS)
 Women who develop lupus often have a history of repeated miscarriages, fetuses
that do not grow as much as expected (small for gestational age ), and preterm
delivery . If women have complications due to lupus (such as kidney damage or
high blood pressure), the risk of death for the fetus or newborn and for the woman
is increased.
 If women with lupus were taking hydroxychloroquine before they became pregnant, they
may take it throughout pregnancy. If flare-ups occur, women may need to take a low dose
of prednisone (a corticosteroid) by mouth, another corticosteroid such
as methylprednisolone given intravenously, or a drug that suppresses the immune system
(immunosuppressant) such as azathioprine.
BLEEDING
•CHROMOSOMAL
ABNORMALITIES OF THE
FETUS – This is when
something is wrong with the
baby’s chromosomes, which
are cells that are made up of
DNA
BLEEDING
CHROMOSOMAL ABNORMALITIES OF THE
FETUS
MISCARRIAGE
Chromosomal errors can prevent an embryo from developing
normally. When this happens, the pregnant person's immune system
may respond by spontaneously terminating the pregnancy, though
some miscarriages still require medical or surgical assistance for the
tissue to pass from the uterus.
BLEEDING
FETUS
MOLAR PREGNANCY
During a molar pregnancy, tissues that were meant
to form into a fetus instead become an abnormal
growth on the uterus.
BLEEDING
FETUS
MOLAR PREGNANCY
 A COMPLETE MOLAR PREGNANCY is caused when the egg has no genetic
information and is fertilized by one or two sperm. Due to the lack of genetic
information from the mother's side, the fertilized egg develops a placenta that
looks like a cluster of grapes without an accompanying fetus.
 PARTIAL MOLAR PREGNANCY A partial molar pregnancy occurs when an egg
with genetic material is fertilized by two sperm. It causes the development of
an embryo that has multiple copies of chromosomes, forms some abnormal
placental tissue, and usually does not survive.
BLEEDING
Other causes of bleeding in the second
trimester include:
Early Labor
Problems with the placenta, such as placenta
previa (placenta covering the cervix)
Placental Abruption (Placenta Separating
From The Uterus)
BLEEDING
Problems with the placenta, such as placenta
previa (placenta covering the cervix)
Placenta previa is a condition in which the placenta lies very low
in the uterus and covers all or part of the cervix. The cervix is the
opening to the uterus that sits at the top of the vagina.
Placenta previa happens in about 1 in 200 pregnancies. If you
have placenta previa early in pregnancy, it usually isn’t a problem.
However, it can cause serious bleeding and other complications
later in pregnancy.
BLEEDING
Placental Abruption (Placenta Separating From
The Uterus)
Placental abruption is a serious condition in which
the placenta separates from the wall of the uterus
before birth. It can separate partially or completely. If
this happens, your baby may not get enough oxygen
and nutrients in the womb. You also may have
serious bleeding.
BLEEDING
Placental Abruption (Placenta Separating From
The Uterus)
We don’t really know what causes placental abruption. You
may be at higher risk for placental abruption if:
You smoke cigarettes. You had an abruption in a previous pregnancy.
You use cocaine. You have problems with the uterus or umbilical cord.
You’re 35 or older. You have more fluid around the baby than is normal.
You have high blood pressure. You’re pregnant with twins, triplets or more.
You have an infection in your uterus. Your belly is harmed from a car accident or physical abuse.
Your water breaks before 37 weeks.
PRETERM LABOR
When labor occurs before the 38th week of pregnancy, it’s considered
preterm. Various conditions may cause preterm labor, such as:
• bladder infection
• smoking
• chronic health condition, like diabetes or kidney disease
Risk factors for preterm labor include:

• a previous preterm birth
• twin pregnancies
• multiple pregnancies
• extra amniotic fluid (the fluid surrounding the fetus)
• infection of the amniotic fluid or amniotic membranes
PRETERM LABOR
SYMPTOMS
• The signs and symptoms of preterm labor may be subtle. They can include:
• vaginal pressure
• low back pain
• frequent urination
• diarrhea
• increased vaginal discharge
• tightness in the lower abdomen
• In other cases, the symptoms of preterm labor are more obvious, such as:
• painful contractions
• leakage of fluid from the vagina
• vaginal bleeding
• Call your doctor if you have these symptoms and are worried about being in labor. Depending
on your symptoms, your doctor may tell you to go to the hospital right away.
PRETERM LABOR
TREATMENT
• Each additional day you don’t go into preterm labor offers a chance for fewer
complications when the baby is born. Several medications can be helpful in
stopping preterm labor. These include:
• Magnesium sulfate (Magnesium sulfate therapy is used to prevent seizures in women with
preeclampsia. It can also help prolong a pregnancy for up to two days. This allows drugs that
speed up your baby's lung development to be administered.)
• Corticosteroids (They are considered relatively safe in pregnancy when used in low doses
and are designated as category B medications. Nonetheless, corticosteroids may increase
the maternal risk of hypertension, edema, gestational diabetes, osteoporosis, premature
rupture of membranes, and small-for-gestational-age babies)
PRETERM LABOR
TREATMENT
• Tocolytics (Tocolytics are drugs that are used to delay your delivery for a
short time (up to 48 hours) if you begin labor too early in your pregnancy.)
• If preterm labor can’t be stopped, your doctor will give you a
steroid medication. Doing so helps develop the baby’s lungs and
reduces the severity of lung disease. It’s most effective two days
after the first dose, so your doctor will try to prevent delivery for at
least two days.
PRETERM PREMATURE RUPTURE
OF MEMBRANES (PPROM)
• It’s normal for your membranes to rupture (break) during labor.
People often refer to it as “your water breaking.”
• This occurs when the amniotic sac surrounding the baby
breaks, allowing the amniotic fluid to flow out. That bag
protects the baby from bacteria. Once it’s broken, there’s a
concern of the baby getting an infection.
• While your water is supposed to break when you go into labor,
it can cause serious problems for your baby when it happens
too early. This is called preterm premature rupture of
membranes (PPROM).
• The exact cause of PPROM isn’t always clear. In many cases,
though, the source of the problem is an infection of the
membranes.
• PPROM in the second trimester is a big concern, as it can lead to
a preterm delivery. Infants born between the 24th and 28th weeks
of pregnancy are at the greatest risk for developing serious long-
term medical problems, particularly lung disease.
• The good news is that with the appropriate intensive care nursery
services, most preterm infants tend to do very well.
TREATMENT
• Hospitalization
• Antibiotics
• Steroids, such as betamethasone
• Medications that can stop labor, such as terbutaline (They help prevent and
slow contractions of the uterus. It may help delay birth for several hours or days.)
• If there are signs of an infection, labor may be induced to avoid serious
complications. Antibiotics will be started to prevent infection.
• Many babies are born within two days of rupture, and most will deliver
within a week. In rare cases, especially with a slow leak, the amniotic sac
can reseal itself. Preterm labor can be avoided, and the baby is born
closer to their due date.
CERVICAL INCOMPETENCE (CERVICAL
INSUFFICIENCY)
• The cervix is a tissue that connects the vagina and the
uterus. Sometimes, the cervix is unable to withstand
the pressure of the growing uterus during pregnancy.
The increased pressure can weaken the cervix and
cause it to open before the ninth month.
• This condition is known as cervical incompetence, or
cervical insufficiency. While it’s an uncommon
condition, it can cause serious complications.
INSUFFICIENCY)
• The opening and thinning of the cervix eventually
leads to the rupture of membranes and delivery of a
very premature fetus. This usually occurs around the
20th week of pregnancy. Since the fetus is too
premature to survive outside the uterus at that point,
the pregnancy often can’t be saved.
INSUFFICIENCY)
•Women are at a higher risk for cervical
incompetence if they’ve had:
• A previous cervical trauma, such as a tear
during delivery
• A cervical cone biopsy
• Other operation on the cervix
INSUFFICIENCY)
SYMPTOMS
•Unlike preterm labor, cervical
incompetence typically doesn’t cause
pain or contractions. There may be
vaginal bleeding or discharge.
INSUFFICIENCY)
TREATMENT
• Treatment for cervical incompetence is limited. An emergency
cerclage (stitch around the cervix) is a possibility if the membranes
haven’t ruptured yet. The risk of rupturing the membranes is higher
if the cervix is very dilated (wide). Extended bed rest is necessary
after the placement of a cerclage.
• In other cases, when the membranes have already ruptured and the
fetus is old enough to survive, your doctor will likely induce labor.
INSUFFICIENCY)
PREVENTION
• You can prevent cervical incompetence. If you have a
history of it, you can receive a cerclage with future
pregnancies at about 14 weeks. This will lower, but
not eliminate, the risk of having a preterm delivery
and losing the baby.
PREECLAMPSIA
• Preeclampsia occurs when you develop:
• High blood pressure
• Proteinuria (a large amount of protein in the urine)
• Excessive edema (swelling)
• Preeclampsia affects every system in the body, including the
placenta.
• The placenta is responsible for providing nutrients to the baby.
Though preeclampsia typically occurs during the third trimester for
first-time pregnancies, some people develop preeclampsia during
the second trimester.
PREECLAMPSIA
• Before making a diagnosis, your doctor will evaluate you
for other conditions that may be confused with
preeclampsia, such as lupus (which causes inflammation
throughout the body) and epilepsy (a seizure disorder).
• Your doctor will also evaluate you for conditions that can
increase the likelihood of developing early preeclampsia,
such as blood clotting disorders and molar pregnancy.
That’s a noncancerous tumor that forms in the uterus.
PREECLAMPSIA
SYMPTOMS
• Symptoms of preeclampsia include rapid swelling of your
legs, hands, or face. Call your doctor right away if you
experience this type of swelling or any of the following
symptoms:
• Headache that doesn’t go away after taking acetaminophen
(Tylenol)
• Loss of vision
• “Floaters” in your eye (specks or spots in your vision)
• Severe pain on your right side or in your stomach area
• Easy Bruising
INJURY
• You’re more prone to injury during pregnancy. Your
center of gravity changes when you’re pregnant, which
means it’s easier to lose your balance.
• In the bathroom, be careful when stepping into the
shower or tub. You may want to add nonskid surfaces
to your shower so you don’t slip. Consider adding grab
bars or rails in your shower, too. Also check your house
for other hazards that could cause you to fall.
THANK

The Second Trimester - Presentation

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

The Second Trimester - Presentation

Uploaded by

Copyright:

Available Formats

THE SECOND

• The fetus is developing reflexes, like swallowing and sucking.

• The fetus goes through cycles of sleep and wakefulness.

• Fingerprints and toe prints have formed.

Risk factors for preterm labor include:

You might also like