Question

For each stage of pregnancy A–E, select the most appropriate option from the following list of months. 

1. Month one. 

2. Month two. 

3. Month five. 

4. Month eight. 

A. The levels of oestradiol and progesterone are around their maximum; the level of chorionic gonadotrophin is submaximal. 

B. Morning sickness is relatively mild, if present; joint discomfort is not usually a problem either. 

C. The levels of oestradiol, progesterone and chorionic gonadotrophin are all rising rapidly. 

D. The level of chorionic gonadotrophin is approaching its maximum; the levels of oestradiol and progesterone are well below their maximum. 

E. Heartburn from regurgitation of gastric acid to the oesophagus is favoured by a marked loss of smooth muscle tone in the lower oesophagus and by a marked rise in intraabdominal pressure.

Answer 1

A. Option 4 Month eight. In the last trimester (3-month period) of pregnancy, the hormones sustaining pregnancy are having their maximal effect; the maximal level of chorionic gonadotrophin occurs in the first trimester when it is maintaining the corpus luteum. 

B. Option 3 Month five. The middle trimester tends to have the least discomfort; morning sickness has usually subsided and the physical effects of a relatively huge uterus in the last trimester are not yet marked. 

C. Option 1 Month one. The gonadotrophin rises rapidly to produce the corpus luteum essential in the first trimester, and the corpus luteum rapidly increases its activity to initiate the major changes of pregnancy via oestradiol and progesterone. 

D. Option 2 Month two. The middle of the first trimester is the mirror image of the last trimester in terms of these hormones. 

E. Option 4 Month eight. Regurgitation is favoured by relaxation of the lower oesophageal sphincter, particularly by progesterone and by the concomitant surge in uterine size and intra-abdominal pressure; both of these effects subside dramatically on delivery of the baby, and so does the heartburn.