THIRD TRIMESTER PREGNANCY

( Fetal development , Complication And Discomfort In Pregnancy )

Disusun Oleh :

Erika Irawanie

( D3E613002 )

NurAini

( D3E613007 )

AKADEMI KEBIDANAN MEDIKA OBGIN

Jl. Buah Batu No. 69 Kota Bandung 40262
Telp. 022-7309505 Fax. 022-7309506

BANDUNG
2015

INTRODUCTION

TABLE OF CONTENTS
Introduction .................................................................................................................
Table Of Contents .......................................................................................................

Chapter 1. Introduction
1.1....................................................................................................................Back
ground........................................................................................................
1.2....................................................................................................................Form
ulation of the problem................................................................................
1.3....................................................................................................................Purp
ose of writing paper ..................................................................................

Chapter 2. Contents
2.1....................................................................................................................Fetal
development ..............................................................................................
2.2....................................................................................................................Com
mon discomfort in third trimester pregnancy ...........................................
2.3....................................................................................................................Com
plication in third trimester pregnancy .......................................................

Chapter 3. Closing
3.1....................................................................................................................Conc
lusion ........................................................................................................

Chapter 4. Reference ..................................................................................................

CHAPTER 1. INTRODUCTION
1.1.

BACKGROUND

1.2.

FORMULATION OF THE PROBLEM

a. How about fetal growth in third trimester pregnancy?
b. How about discomfort in third trimester pregnancy?
c. How about complication in third trimester pregnancy?

1.3.

PURPOSE OF WRITING PAPER

In the manufacture of this paper aims to find out the fetal development , complication and
discomfort in third trimester of pregnancy.

CHAPTER 2. CONTENTS
2.1 FETAL DEVELOPMENT
a. Fetal development in 30 weeks pregnancy
The fetal in 30 weeks in pregnancy measures a little more than 39 cm from
crown to toe. The fetals growth in terms of length will soon slow down but will
continue to gain weight until fetals born. Probably the weighs about 1.3 kg at this
stage. The fetals lungs and digestive tract are almost fully developed. He
continues to open and shut his eyes. He can probably see what's going on inside
uterus (womb), tell light from dark and even track a light source. If mother shine
a light on her stomach, the fetal may move his head to follow the light or even
reach out to touch the moving glow.
Some researchers think baring mother stomach to light stimulates visual
development. But baby won't be able to see much when he is born. Newborns can
see a distance of only between 20 cm and 30 cm. Children with normal vision
don't reach 20/20 vision (the same as an adult) until the age of about eight.
The fetal in this stage has eyebrows and can bat her eyelashes! About a litre of
amniotic fluid now surrounds fetal, but that volume decreases as he gets bigger
and has less room in mothers uterus. As mother, her fetal continue to grow, don't
be alarmed if mother feel breathless, as if mother can't get enough air. It's just
mothers uterus pressing against her diaphragm. There is a light at the end of the
tunnel, though.
At about 34 weeks (or just before birth, if this is the second or third
pregnancy), the fetalshead will move down into mothers pelvis as she gets into
the right position for birth. That will make breathing and eating a lot easier.
b. Fetal development in 31 weeks pregnancy
Fetal weigh about 1.5 kg and looks more than ever like a newborn. He
measures about 41cm from crown to toe. His arms, legs and body continue to fill
out and they are finally proportional in size to his head.
Up until now, the fetals movements have been gradually increasing. But from
now until the end of pregnancy, the movements will probably plateau. This doesn't
mean that they should slow down, but that may notice that the type of fetal
movements makes change.

As long as mother can feel him squirming and

kicking, mother will know he's just fine. Believe it or not, he still has plenty of
growing to do. Mother can expect him to gain at least 900 gr before birth.

The fetalsorgans are continuing to mature and he is passing water from his
bladder, which is good practice for the weeing he'll do after he's born. Also, the
marrow in his bones has taken over from his liver the job of producing red blood
cells.
Mother have probably gained weight this month, somewhere between 1.3 kg
and 1.8 kg. Gaining 450 g a week is quite normal during the last trimester as baby
has a final growth spurt before he arrives in the world.
c. Fetal development in 32 weeks pregnant
Baby weighs now about 1.7kg and is around 42cm long from head to toe.
Although his lungs won't be fully developed until just before birth, mothers little
one is busy inhaling amniotic fluid to exercise his lungs. From 32 weeks, babies
born early have good chance of surviving and thriving. His skin is becoming soft
and smooth as he plumps up in preparation for birth.
Some babies have a head of hair already, others have only a few wisps. Thick
hair at birth doesn't necessarily mean thick hair later on. But children with fine
hair in childhood also tend to have fine hair when they've grown up.
If baby is a boy, his testicles should have descended from his abdomen into his
scrotum. Sometimes, however, one or both testicles won't move into position until
after birth. In two thirds of all baby boys who have undescended testicles at birth,
the condition corrects itself by their first birthday. Mothers probably gaining
450g a week, largely because baby is likely to gain more than half his birthweight
during the seven weeks before birth. Make sure you are eating well in these last
few weeks. Mothers bump will be getting quite big now, and you may find it
attracts a lot of attention!

Note: Every baby develops differently. This page is

designed to give a general idea of how a fetus grows in the uterus.

d. Fetal development in 33 weeks pregnant
Baby weight now about 2kg and measures up to 44cm from head to toe. She
may already be getting ready for birth by turning upsidedown. His head should be
pointing down, ready for his journey into the world. Doctor or midwife will be
paying careful attention to the fetalsposition in the coming weeks. Some babies
do decide to turn back round again.
The fetals skull is still quite pliable. The plates of bone that make up hisskull
have not completely fused. This is so she can ease out of the relatively narrow
birth canal, the passage between mothers cervix and the opening of her vagina.

But the bones in the rest of his body are hardening. The fetals skin is also
gradually becoming less red and wrinkled as fat builds up underneath.
If you're a firsttime mum, the fetalshead may move into mothers pelvis this
week and press firmly against her cervix. This happens for about half of all firsttime mums. If this is a secondtime mum, mother can expect this to happen a week
before labour. For some, this won't happen until the start of labour. Hoping to
manage your labour naturally? Here's all you need to know about natural pain
relief.
mother may notice that her feet and ankles are quite swollen by the end of the
day. Water retention, also known as oedema, is often worse in warm weather and
late in the day. Surprisingly, keeping hydrated helps reduce water retention.
Mothers body, particularly her kidneys, and her baby need plenty of fluids, so
drink up. If mother suddenly feel swollen or puffy in her hands or face, however,
call doctor it may be a sign of preeclampsia.
e. Fetal development in 34 weeks
Baby weight more than 2.2 kg and is 45 cm from top to toe. he's filling out and
getting rounder hell need his fat layers later to regulate his body temperature
once he's born.
If mother don't already talk to her baby, this is a good time to start at 34
weeks his hearing is fully developed. Don't feel ridiculous if mother already
chatting in baby talk. Some evidence shows that newborns pay closer attention to
highpitched tones.
If mother have been nervous about going into premature labour, she'll be
happy to know that 99 percent of babies born at 34 weeks can survive outside the
uterus (womb) and most have no major problems. Although the fetals central
nervous system is still maturing, his lungs are nearly fully developed by now.
Many women start to notice a tingling sensation or numbness in the pelvic
region or pain as they walk. This may be caused by the pelvic joints loosening,
ready for labour. If mothers in pain or hips are sore, mention it to midwife or
doctor and check out.
f. Fetal development in 35 weeks pregnant
Baby now weighs about 2.4kg and measures around 46cm from head to toe.
His elbows, feet or head may protrude from mothers stomach when he stretches
and squirms about. Soon, as the wall of her uterus (womb) and her belly stretch
thinner and let in more light, her baby will begin to develop daily activity cycles.

This week, her little one is sporting fulllength fingernails and toenails and has a
fully developed pair of kidneys. His liver can also process some waste products.
There's much less amniotic fluid and much more baby in uterus. Mother have
probably put on between 11kg and 13.6kg and her weight gain has hit its peak.
Even her belly button has got bigger and has popped outward. She may be feeling
breathless and get indigestion now that the top of her uterus is up under her ribs.
Try getting down on all fours to take deeper breaths. See our photo gallery for
how to ease late pregnancy aches. Although the pressure on your bladder will
make the bathroom second home, don't drink any less water baby needs the
fluids, but mother may like to cut down on drinks that make mother wee more
frequently, because they are diuretics. These include tea and coffee.
g. Fetal development in 36 weeks
Baby is still gaining weight about 28g a day. His weighs nearly 2.7kg and is
about 47cm long from head to toe. Mother may begin to feel an increased
pressure in her lower belly and notice that her baby is gradually dropping. This is
called lightening or engagement, and her lungs and stomach will finally get a
chance to stretch out a little breathing and eating

should become easier.

However, walking may become increasingly uncomfortable.

Some women say it feels as if their baby is going to fall out. Also, mother
may still feel as if she need to go to the loo all the time. Check out eating well
guide and stock up on those lastminute nutrients.
The good news is that by the end of this week, pregnancy will be fullterm and
mother could give birth any day. Babies between 37 weeks and 42 weeks are
considered fullterm. A baby born before 37 weeks is premature and after 42
weeks is postterm.
mother may have noticed that your breasts are leaking a little. This is quite
normal. They are producing the rich, first milk called colostrum that will give her
baby a great start in life. If mother feel like she is going into labour, doctor or
midwife will check to see if the neck of her womb (cervix) is starting to open.
They'll look to see if mothers cervix is dilating, or widening, and effacing, or
thinning.
Midwife will be keeping an eye on what position baby is in, to estimate how
far baby has dropped into pelvis.
h. Fetal development in 37 weeks pregnant
Baby weighs close to 2.8kg and may be about 48.6cm long from head to toe.
Baby's head is now cradled in mothers pelvic cavity surrounded and protected

by her pelvic bones. This position clears some muchneeded space for babys
growing legs and buttocks.
Many babies now have a full head of hair, with locks up to 3.5cm long. And
then, of course, some babies don't have any hair at all. Speaking of hair, most of
the downy coat of lanugo that covered baby from 26 weeks has disappeared, and
so has most of the vernix caseosa, the protective whitish substance that also
covered him. Baby will swallow his lanugo and exterior coating, along with other
secretions, and store them in hiser bowels. These will become her first poo, a
blackish waste called meconium. Around now many women start worrying about
whether they will know if they are in labour. Look no further than our labour and
birth section. There mother will find advice on everything from creating the
perfect environment for giving birth to tips for birth partners.
i. Fetal development in 38 weeks
If mother don't know already, can her tell if she is carrying a boy or a girl?
One hint may come from the size of her baby boys tend to be slightly heavier
than girls. Babies at week 39 weigh between 3kg and 3.2kg and continue to build
the fat stores that will help regulate body temperature after birth.
The fetalsorgan systems are fully developed and in place, but his lungs will be
last to reach maturity. Even after baby is born, it may take a few hours before he
establishes a normal breathing pattern. After he's born, he'll have a series of brief
tests which will measure his health on what's called the Apgar scale.
Wondering what colour the fetalseyes will be? Most white European babies
are born with dark blue eyes and their true eye colour be it brown, green, grey
or blue may not reveal itself for weeks or months. The colour of the fetalseyes
in the first minutes after birth won't last exposure to light changes a baby's
initial eye colour. Most babies of African and Asian descent have dark grey or
brown eyes at birth, but it won't be clear what precise shade their eyes will be
until after the first six months or year. If mother go into labour this week, find out
how to cope in the early stages.
j. Fetal development in 39 weeks pregnant
It's all about watching and waiting now, as baby could arrive any day. Baby
could be up to 50cm long, and weigh about 3kg. But that's only an average figure.
As soon as baby is born, midwife will weigh him, and it's only then you'll know
for sure how much his weighs.

Baby is shedding the greasy, white substance (vernix caseosa) which has been
protecting his skin. This turns the amniotic fluid, which was once clear, pale and
milky. The outer layers of the fetals skin are also sloughing off as new skin forms
underneath.
The hair on the fetalshead may now be thick, and his fingernails extend
beyond his fingertips. They may look long when he's born. The fetalsskull bones
are not yet fused, which allows them to overlap as he passes through the birth
canal during labour. This is the reason the fetalshead may look coneshaped after
birth.

And if the week passes and there's still no baby? Try not to worry babies

have a habit of not arriving on their scheduled due date. Most doctors wait
another two weeks before considering a pregnancy overdue. Check out how to
cope with being overdue.
k. Fetal development in 40 weeks
After months of anticipation, mothers due date has been and gone, and... she
is still pregnant.
situation.

It's frustrating, but lots of women find themselves in this

Rest assured her baby is quite cosy where he is. Baby is getting a little

heavier and may grow a bit more in length. The average, he is about 51cm long
from head to toe and weighs about 3.4kg at birth. But if baby is anywhere
between 2.5kg and 3.8kg, that's a healthy weight.
Baby continues to shed the greasy, white substance (vernix caseosa) which has
been protecting his skin. If he shows no sign of making an appearance after
another week, he may have slightly dry skin when she arrives.
Baby has mastered all the skills he'll need after he's born. She can instinctively
search for her thumb and suck it, just as he will search for your breast for a feed
soon after birth.
In TV dramas, labour always begins with the waters breaking in the middle
of a crowded room, of course just before contractions start. The reality is that,
even if mothers membranes do rupture, the fetalshead will tend to act like a cork
at the opening of your uterus (womb). If mother lie down, however, she may
notice fluid leaking. Her body will continue to produce amniotic fluid until her
baby is born.
Try to stay calm if waters break or start to feel contractions, call doctor or
midwife straight away. Mother may be advised to wait at home until contractions
are really under way. Find out how to tell when mothers in labour.

2.2 COMMON DISCOMFORT IN THIRD TRIMESTER PREGNANCY

a. Fatigue
As the body works overtime to provide a nourishing environment for the fetus,
it is no wonder a pregnant woman often feels tired. In the first trimester, her blood
volume and other fluids increase as her body adjusts to the pregnancy. Sometimes
anemia is the underlying cause of the fatigue. Anemia is a reduction in the
oxygen-carrying capability of red blood cells, and is usually due to low iron
levels. A simple blood test performed at a prenatal visit will check for anemia.
b. Hemorrhoids
Because of increased pressure on the rectum and perineum, the increased
blood volume, and the increased likelihood of becoming constipated as the
pregnancy progresses, hemorrhoids are common in late pregnancy. Avoiding
constipation and straining may help to prevent hemorrhoids. Always check with
your physician or midwife before using any medication to treat this condition.
c. Varicose veins
Varicose veins--swollen, purple veins--are common in the legs and around the
vaginal opening during late pregnancy. In most cases, varicose veins are caused by
the increased pressure on the legs and the pelvic veins, and by the increased blood
volume.
d. Heartburn and indigestion
Heartburn and indigestion, caused by pressure on the intestines and stomach
(which, in turn, pushes stomach contents back up into the esophagus), can be
prevented or reduced by eating smaller meals throughout the day and by avoiding
lying down shortly after eating.
e. Bleeding gums
Gums may become more spongy as blood flow increases during pregnancy,
causing them to bleed easily. A pregnant woman should continue to take care of
her teeth and gums and go to the dentist for regular checkups. This symptom
usually disappears after pregnancy.
f. Pica
Pica is a rare craving to eat substances other than food, such as dirt, clay, or
coal. The craving may indicate a nutritional deficiency.
g. Swelling/fluid retention
Mild swelling is common during pregnancy but severe swelling that persists
may indicate preeclampsia (abnormal condition marked by high blood pressure).
Lying on the left side, elevating the legs, and wearing support hose and
comfortable shoes may help to relieve the swelling. Be sure to notify your
physician or midwife about sudden swelling, especially in the hands or face, or
rapid weight gain.
h. Skin changes

Due to fluctuations in hormone levels, including hormones that stimulate

pigmentation of the skin, brown, blotchy patches may occur on the face, forehead,
and/or cheeks. This is often called the mask of pregnancy, or chloasma, and often
disappears soon after delivery. Using sunscreen when outside can reduce the
amount of darkening that occurs.
Pigmentation may also increase in the skin surrounding the nipples, called
the areola. In addition, a dark line frequently appears down the middle of the
abdomen. Freckles may darken, and moles may grow.
i. Stretch marks
Pinkish stretch marks may appear on the abdomen, breasts, thighs, or buttocks.
Stretch marks are generally caused by a rapid increase in weight, and the marks
usually fade after pregnancy.
j. Yeast infections
Due to hormone changes and increased vaginal discharge, also called
leukorrhea, a pregnant woman is more susceptible to yeast infections. Yeast
infections are characterized by a thick, whitish discharge from the vagina and
itching. Yeast infections are highly treatable. Always consult your physician or
midwife before taking any medication for this condition.
k. Congested or bloody nose
During pregnancy, the lining of the respiratory tract receives more blood, often
making it more congested. This congestion can also cause stuffiness in the nose or
nosebleeds. In addition, small blood vessels in the nose are easily damaged due to
the increased blood volume, causing nosebleeds.
l. Constipation
Increased pressure from the pregnancy on the rectum and intestines can
interfere with digestion and subsequent bowel movements. In addition, hormone
changes may slow down the food being processed by the body. Increasing fluids,
regular exercise, and increasing the fiber in your diet are some of the ways to
prevent constipation. Always check with your physician or midwife before taking
any medication for this condition.
m. Backache
As a woman's weight increases, her balance changes, and her center of
gravity is pulled forward, straining her back. Pelvic joints that begin to loosen in
preparation for childbirth also contribute to this back strain. Proper posture and
proper lifting techniques throughout the pregnancy can help reduce the strain on
the back.
n. Dizziness
Dizziness during pregnancy is a common symptom, which may be caused by:
Low blood pressure due to the uterus compressing major arteries
Low blood sugar
Low iron

Quickly moving from a sitting position to a standing position

Dehydration
To prevent injury from falling during episodes of dizziness, a pregnant
woman should stand up slowly and hold on to the walls and other stable
structures for support and balance.
o. Headaches
Hormonal changes may be the cause of headaches during pregnancy,
especially during the first trimester. Rest, proper nutrition, and adequate fluid
intake may help alleviate headache symptoms. Always consult your physician or
midwife before taking any medication for this condition. If you have a severe
headache or a headache that does not resolve, call your health care provider. It
may be a sign of preeclampsia.

2.3 COMPLICATION IN THIRD TRIMESTER PREGNANCY

a. Preterm Labor
One out of 10 babies in the United States is born prematurely, before 37
weeks gestation. The fetus is viable around 24 weeis ks, when the lungs start to
produce surfactant, Case Western Reserve Professor Judi Maloni, PhD, RN states.
Surfactant is produced in the lungs and helps the lungs inflate so oxygen can be
absorbed.
If labor occurs prematurely, drugs called tocolytics may be given to stop
labor. Steroid medications to help mature fetal lungs may also be given. Patients
may also need to be on bed rest to prevent contractions. Very premature infants
have many complications and the survival rate without significant long term
problems is low; the longer the fetus stay in the womb, the better chance he has of
surviving.

b. Pregnancy Induced Hypertension

Pregnancy induced hypertension, or PIH, sometimes still called preeclampsia, may occur in women who didnt have high blood pressure before they
got pregnant, or may complicate chronic hypertension. Around seven in 100
women have PIH, the University of Maryland Medical Center states. Pregnancy
induced hypertension is caused by abnormalities with the placenta, and can lead

to fetal growth retardation, prematurity and dangerous complications such as

seizures and liver failure. Serious complication occur when PIH progresses to
eclampsia, which affects one in 1,500 women. Women with pregnancy induced
hypertension and their babies need close monitoring, possibly bed rest, and
possibly early delivery.

c. Placenta Previa
Placenta previa is the growth of the placenta across the opening to the
uterus, the cervix. Placenta previa is common in early pregnancy. Doctors dont
get concerned about it until the third trimester, because the placenta normally
migrates up the uterine wall by that time. After six months, this is less likely to
happen. Placenta previa causes painless bright red bleeding that can become
heavy without warning. Bed rest is usually required to prevent hemorrhage and
serious complications for mother and baby. Placenta previa is present in up to 1 in
200 deliveries. Women who have placenta previa when they give birth have to
deliver by c-section.

d. Abnormal Fetal Presentation

Until the middle of the third trimester, the position of the fetus isnt of
great concern. Most babies have plenty of room to turn if theyre not in a head
down position. However, after 32 weeks, it becomes less likely that a fetus is
going to change position, the Family Practice notebook states. Around 3 percent
of babies decide not to face the world head on, preferring instead to plant their
bottom down or to lie sideways in the uterus. Obstetricians may suggest trying a
version, which means attempting to change the babys position through gentle
abdominal manipulation. Others decide a cesarean delivery is the best option; this
is the only option if the fetus is transverse, or sideways.
Twins are a complicated situation if one is head down and one head up; if
the first is head down, a vaginal delivery may be tried, since the second twin may
flip or can be rotated after the first is delivered. Some obstetricians prefer to play
it safe and plan a cesarean from the start.

e. Preeclampsia
Preeclampsia is a serious condition that affects about 5 percent of pregnant
women. You're diagnosed with preeclampsia if you have high blood pressure and
protein in your urine or liver or kidney abnormalities after 20 weeks of
pregnancy.
Most expectant mothers who get preeclampsia develop mild symptoms
near their due date, and they and their babies do fine with proper care. But it can
progress quickly, and severe preeclampsia can affect many organs and cause
serious or even life-threatening problems. Women whose preeclampsia is severe
or getting worse need to deliver early.

f. Low amniotic fluid (oligohydramnios)

The amniotic sac fills with fluid that protects and supports your
developing baby. When there's too little fluid, it's called oligohydramnios.
According to the March of Dimes, about 4 percent of pregnant women have low
levels of amniotic fluid at some point, usually in their third trimester.
If this happens to you, your caregiver will follow your pregnancy closely
to be sure your baby continues to grow normally. If you're near the end of your
pregnancy, labor will be induced.

CHAPTER 3. CLOSING
CONCLUSION

CHAPTER 4. REFERENCE
[1] www.babycenter.com
[2] www.m.webmd.com