7. You Should Also Know

Ultrasound in the Third Trimester

If you have an ultrasound exam in the third trimester, your healthcare provider is looking for particular information. Performed later in pregnancy, this test can:

• evaluate baby’s size and growth

• determine the cause of vaginal bleeding

• check for IUGR

• determine the cause of vaginal or abdominal pain

• evaluate a baby after an accident or injury to the mother-to-be

• detect some birth defects

• monitor the growth of multiples

• monitor a high-risk pregnancy

• measure the amount of amniotic fluid

• check whether baby is head first or breech

• determine which delivery method to use

• find out the maturity of the placenta

• be used with amniocentesis, to determine fetal lung maturity

• be used as part of a biophysical profile

Shingles during Pregnancy

Shingles occurs when a type of herpes virus becomes active after having been dormant in nerve root ganglia. This can happen long after the primary infection has gone away. The condition is also called herpes zoster. It occurs more often in people who are older, although it can occur in younger people as well.

A time of great concern for a pregnant woman is during the first trimester because of concern about viral infections affecting a fetus. Around the time of delivery concern is for the baby coming through the birth canal and contracting the virus from mom. Pain from shingles occurs in specific areas of nerve distribution. Treatment centers around pain control with pain medications. If you think you have shingles, contact your healthcare provider, who can decide on treatment for you.

Baby’s sucking reflex develops before birth.

What Is Placenta Previa?

With placenta previa, the placenta attaches to the lower part of the uterus instead of the upper wall; it lies close to the cervix or covers it. The problem occurs about once in every 170 pregnancies.

Placenta previa is serious because of the chance of heavy bleeding. Bleeding may occur during pregnancy or during labor. There are three main types of placenta previa:

• placenta touches the cervix (low-lying placenta)

• the placenta partially covers the cervix (partial placenta previa)

• the placenta completely covers the cervix (total placenta previa)

The cause of placenta previa is not completely understood. Risk factors include previous Cesarean delivery, over age 30, smoking and delivery of several babies.


In this illustration of total placenta previa, note how the placenta
completely covers the cervical opening to the uterus.

A woman who conceives with in-vitro fertilization has a greater chance of developing placenta previa. Experts believe insertion of the embryo into the uterus may cause contractions, which could cause the embryo to implant low in the uterus, raising the risk of placenta previa. In addition, embryos may intentionally be implanted low in the uterus because research shows this placement may improve the chance of pregnancy.

The most characteristic symptom of placenta previa is painless bleeding without contractions. This doesn’t usually occur until close to the end of your second trimester or later when the cervix thins out, stretches and tears the placenta loose.

Bleeding may occur without warning and may be extremely heavy. It occurs when the cervix begins to dilate with early labor, and blood escapes.

Placenta previa should be considered when a woman has vaginal bleeding during the second half of pregnancy. The problem can’t be diagnosed with a physical exam because a pelvic examination may cause heavier bleeding. Healthcare providers use ultrasound to identify the problem. Ultrasound is particularly accurate in the second half of pregnancy because the uterus and placenta are bigger, and things are easier to see.

Your healthcare provider may advise you not to have a pelvic exam if you have placenta previa. This is important to remember if you see another healthcare provider or when you go to the hospital.

It’s not possible to deliver the placenta first, followed by the baby. The baby may also be in a breech presentation. Babies are usually delivered by Cesarean delivery. The baby is delivered first, then the placenta is delivered so the uterus can contract. Bleeding can be kept to a minimum.

Some Information May Scare You

If a woman experiences a serious problem, she and her partner will probably want to know as much about it as possible. If a woman has a friend or knows someone who has problems during pregnancy, reading about it might relieve her fears. We also hope our discussions can help you start a dialogue with your doctor, if you have questions.

Nearly all pregnancies are uneventful, and serious situations don’t arise. However, please know we have tried to cover as many aspects of pregnancy as we possibly can so you’ll have all the information at hand that you might need and want. Knowledge is power, so having various facts available can help you feel more in control of your own pregnancy. We hope reading it helps you relax and have a great pregnancy experience.

If you find serious discussions frighten you, don’t read them! Or if the information doesn’t apply to your pregnancy, just skip over it. But realize information is there if you want to know more about a particular situation.

8. Exercise for Week 35


Stand with your feet apart, knees softly bent. Raise your arms so your upper arms are parallel to the floor and your hands point up into the air. Squeeze your shoulder blades together, hold for 3 seconds, then release. Do 10 times. Improves posture and relieves upper-back stress.


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