4 - 5 Weeks AOG 3 Trimester: Period

First 6 weeks AOG Corpus luteum as initial site of Progesterone Formation
8 – 9 days after ovulation HCG is detected in maternal Serum / urine

(3-4 Weeks AOG)
8 – 10 weeks AOG Peak of HCG hormone
(60 – 70 days ) Nausea & Vomiting may be severe
1.4 – 2 days Doubling time
16 weeks AOG HCG plateaus
Preterm labor Below 18 yrs old
Females less than 5 feet
Periodontal disease
18 – 20 Weeks AOG QUICKENING: Primigravid
16 – 18 Weeks AOG QUICKENING: Multigravid
4 – 5 weeks AOG Gestational Sac
After 6 weeks Embryo; seen as a linear structure adjacent to the yolk sac
3rd Trimester Increased Awakenings
Decreased deep sleep / REM sleeo
More likely to snore
More than or equal to 14 First Trimester
weeks
14 1/7 – 28 6/7 Second Trimester
29 – 42 weeks Third Trimester
< 20 weeks abortus Non-viable
20 – 36 6/7 weeks Pre term
37 – 42 weeks Term
>42 weeks Postterm
MATERNAL DEVELOPMENT
6 Weeks AOG Within the 6mbryonic period
No obvious signs of abdominal enlargement
After 8 Weeks Fetal period
12 Weeks AOG 12etal period
Fetus is at fetal period
20 Weeks AOG Midp20int pregnancy
Fundus = level of umbilicus
22 Weeks AOG 2 (Congenital anomaly ultrasound performed) 2
28 Weeks AOG 2 + 8 = 1kg
Fetus approximately 1kg
37 Weeks AOG Delivery is possible
39 Weeks AOG 3version of the N9vel
40 Weeks AOG Used to compute the Naegele’s rules
PHYSIOLOGICAL CHANGES
By 12 Weeks - UTERUS Globular & Spherical
The ovarian ligaments are attached slightly above the middle
of the corpus
HORMONES IN PREGNANCY
B-hCG Maintains corpus luteum
Estrogen Prepares maternal body for delivery by increasing oxytocin receptors in the uterus
Progesterone SM relaxant & maintains uterine lining
PHYSIOLOGIC CHANGES
Respiratory System Intra-abdominal Pressure -> more diaphragmatic breathing ->
Hyperventilation &  Tidal volume
Cardiovascular Changes  in Cardiovascular Output (HR &  SV)
 Systemic Vascular Resistance = SV
34 Weeks H3m4tological Change: peak in plasma volume (40%) that contributes to
edema
 Red Cell volume (25%)
Anemia in Pregnancy  Red Cell volume (25%): Net less RBC / volume
peak in plasma volume (40%)
due to larger % increase in plasma volume
Hypercoagulable state in  Clotting factors
Pregnancy DEEP VEIN THROMBOSIS
What is the recommended minimum daily dosage of 400 ug – 600 ug

FOLIC ACID .4 mg – .6 mg
At what week age of gestation quickening Primigravid: 18 – 20 weeks AOG
Multigravid: 16 – 18 weeks AOG
Best Supplement to give a patient desirous of Folic Acid
pregnancy
Recommendations for hemorrhoids Hot sitz bath
Stool-softeners, topical anesthetics
Rectal suppositories
Surgery: if sever & weight benefits more than risk
A 26 year old G1P0, 8-9 weeks AOG, consulted Recommendations: small meals, more frequent
because of vomiting of previously ingested food for 5 intervals (every 2-3 hours) , stopping short of
days, more severe towards the evening. She is a call satiation
center agent who works from 8pm-4am. Physical
Examination was unremarkable. What is the BEST There is still no need for medications
management at this time?
UTERINE SOUFFLE soft, blowing sound synchronous with the maternal
pulse
▪ loudest near the lower part of uterus (large vessels at
the lowest part of the uterus)
▪ Cause: passage of blood through the dilated
uterine vessels
FUNIC SOUFFLE ▪ sharp, whistling sound synchronous with the fetal
heart tone
▪ Cause: rush of blood through the umbilical
arteries
Alma who is on her 28th week of gestation plans to go Periodic rest and leg elevation
on a 3 hour drive by car. The course of her pregnancy Automobile and Air Travel
is unremarkable. What is the BEST advice to give ● Ask when, where and how
● up to 36 weeks AOG (no complications
her? present)
● use of seatbelt
● periodic lower extremity movement
- risk for deep vein thrombosis (DVT)
● hourly ambulation
● Remind to be careful of infectious disease
acquisition
PREIMPLANTATION EMBRYONIC FETAL

2 weeks from fertilization to Encompasses the period of After 8 Weeks
implantation organogenesis
Most crucial period with regards to
Called the “all or none” period structural malformations
Permanent alterations
Usually causes death of the 2nd – 8 week
embryo MAJOR structural malformations MINOR structural malformations
Exposure to teratogenic causes

fetal death or abortion
Functional Residual Capacity 20 – 30%

Composed of
Expiratory Reserve Volume 15 – 20 %
Residual Volume 10 – 125%
Total Lung Capacity Unchanged
FRC + IC  5%
Inspiratory Capacity  5 – 10%
UNCHANGED
1. RR
2. Gastric Emptying (prolonged during labor)
3. Upper Extremity Venous Pressure
4. Excretion of Na & Potassium (there is increased tubular reabsorption)
5. B lymphocyte number
6. Ratio of CD4 to CD8 lymphocytes
DECREASED
1. IL2
2. INF-Y Pregnancy suppresses humoral & cell-
3. TNF-B mediated immunological function
4. T helper 1
5. T cytotoxic cell
6. Factors XI, XIII
- Ilang days meron sa month na yon? January : 31 days

- Fast forward to one month, same day Jan. 20 2021 – Feb. 20
2021
- Plus ka ng one (kasi counted ung mismong day ng LNMP) 31 days + 1 = 32 days
- Minus mo ung days para maka 28 ka 32-28 = 4 days
- Eto na sagot 20-4 = 16 HAHAHA
YEY
FEB. 16 ang ika 28th day
mo HAHAHA

4 - 5 Weeks AOG 3 Trimester: Period

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First 6 weeks AOG Corpus luteum as initial site of Progesterone Formation

8 – 9 days after ovulation HCG is detected in maternal Serum / urine

What is the recommended minimum daily dosage of 400 ug – 600 ug

PREIMPLANTATION EMBRYONIC FETAL

Exposure to teratogenic causes

Functional Residual Capacity 20 – 30%

- Ilang days meron sa month na yon? January : 31 days

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