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Antenatal perineal massage (APM) or Birth Canal Widening (BCW) is the massage of a pregnant woman's perineum – the skin and deep tissues around the opening to the vagina (or 'birth canal' – when a baby is in this passage), performed in the 4 to 6 weeks before childbirth, i.e., 34 weeks or sooner (Reference 7, as more births are occurring at around 28 weeks) and continued weekly until birth.
The heart rate increases, but generally not above 100 beats/ minute. Total systematic vascular resistance decreases by 20% secondary to the vasodilatory effect of progesterone. Overall, the systolic and diastolic blood pressure drops 10–15 mm Hg in the first trimester and then returns to baseline in the second half of pregnancy. [6]
Striae are caused by tearing of the dermis during periods of rapid growth of the body, such as during puberty or pregnancy, in which they usually form during the last trimester. Usually on the belly, these striae also commonly occur on the breasts, thighs, hips, lower back, and buttocks. Pregnancy-related striae are known as striae gravidarum. [2]
The first trimester includes conception, which is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus, where it begins to form the embryo and placenta. During the first trimester, the possibility of miscarriage (natural death of embryo or fetus) is at its highest.
Dilation (or dilatation) and curettage (D&C) refers to the dilation (widening or opening) of the cervix and surgical removal of sections and/or layers of the lining of the uterus and or contents of the uterus such as an unwanted fetus (early abortion before 13 weeks), remains of a non-viable fetus, retained placenta after birth or abortion as well as any abnormal tissue which may be in the ...
The gestational sac is spherical in shape, and is usually located in the upper part (fundus) of the uterus.By approximately nine weeks of gestational age, due to folding of the trilaminar germ disc, the amniotic sac expands and occupy the majority of the volume of the gestational sac, eventually reducing the extraembryonic coelom (the gestational sac or the chorionic cavity) to a thin layer ...
Products of conception, abbreviated POC, is a medical term used for the tissue derived from the union of an egg and a sperm. It encompasses anembryonic gestation (blighted ovum) which does not have a viable embryo. In the context of tissue from a dilation and curettage, the presence of POC essentially excludes an ectopic pregnancy.
Dilation and evacuation can be offered for the management of second trimester miscarriage if skilled providers are available. [6] Some women choose D&E over labor induction for a second trimester loss because it can be a scheduled surgical procedure, offering predictability over labor induction, or because they find it emotionally easier than undergoing labor and delivery.
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