Calcium in pregnancy and breastfeeding

2015 ◽  
Author(s):  
Sir Peter Gluckman ◽  
Mark Hanson ◽  
Chong Yap Seng ◽  
Anne Bardsley
Keyword(s):  
Vitamin D ◽  
Bone Loss ◽  
Bone Growth ◽  
Calcium Absorption ◽  
The Body ◽  
Calcium Stores ◽  
Third Trimester ◽  
Pregnant Adolescents ◽  
The Third ◽  
In Pregnancy

Most calcium in the body is present in the skeleton, where it serves a structural role and also as a reservoir for use in other tissues. During pregnancy, calcium is accumulated in the fetal skeleton, mostly during the third trimester when bone growth is at its peak. Although this increases the demand on maternal bone stores, the calcium transfer to the fetus is balanced by increased intestinal calcium absorption in the mother, mediated by compensatory changes in vitamin D synthesis and endogenous hormone levels. Bone loss is minimized if calcium intake is maintained at 1,000#amp;#x2013;1,200 mg/day during pregnancy. This intake level builds up calcium stores in early pregnancy for increased fetal transfer in the third trimester. Additional dietary calcium is usually not required if pre-pregnancy intake is adequate, although pregnant adolescents and women carrying multiple fetuses may require supplementation.

scholarly journals Asuhan Kebidanan pada Ibu Hamil Trimester III dengan Anemia

2021 ◽  
Vol 1 ◽  
pp. 1669-1673
Author(s):  
Lutfiah Febriana ◽  
Nina Zuhana
Keyword(s):  
Pregnant Women ◽  
Normal Limit ◽  
Late Pregnancy ◽  
Hemoglobin Level ◽  
The Body ◽  
Third Trimester ◽  
The Third ◽  
Mild Anemia ◽  
In Pregnancy

AbstractAnemia is a condition where the level of hemoglobin in the blood is less than the normal limit (<12 g%) caused by a lack of iron in the body due to malnutrition. While anemia in pregnancy is a condition where the hemoglobin level in pregnant women is <11gr% or <10.5gr% in third trimester pregnant women which generally occurs due to the hemodilution process. The purpose of this case to find out the cause of anemia in late pregnancy and the treatment that can be done to prevent complications that occur with care to routinely consume blood-added tablets (Fe) and recommend foods high in iron. This care design used a comprehensive care method for pregnant women in the third trimester who experience mild anemia (haemoglobin <10,5gr%) in Kalimade Village, Kesesi District, Pekalongan Regency. The results of this care showed an increase in hemoglobin levels in the mother. The conclusion of this case study shows that regularly consuming Fe tablets can increase hemoglobin levels in the blood so that it can prevent and treat anemia. For this reason, pregnant women are expected to routinely consume Fe tablets during pregnancy and midwives are expected to provide education about the benefits of Fe tablets to pregnant women to prevent anemia.Keywords: Haemoglobin; Anemia; Pregnancy AbstrakAnemia merupakan suatu kondisi dimana kadar haemoglobin dalam darah kurang dari batas normal (<12 gr%) yang disebabkan karena kurangnya zat besi didalam tubuh akibat kurang gizi. Sedangkan anemia pada kehamilan adalah kondisi dimana kadar haemoglobin pada ibu hamil <11gr% atau <10,5gr% pada ibu hamil trimester III yang umumnya terjadi karena adanya proses hemodilusi. Tujuan dari kasus ini yaitu untuk mengetahui penyebab terjadinya anemia pada kehamilan lanjut serta penanganan yang dapat dilakukan guna mencegah terjadinya komplikasi yang mungki terjadi dengan asuhan untuk rutin mengkonsumsi tablet tambah darah (Fe) serta anjuran mengkonsumsi makanan tinggi zat besi. Rancangan Asuhan ini menggunakan metode asuhan komprehensif pada ibu hamil trimester III yang mengalami anemia ringan (Haemoglobin <10,5gr%) di Desa Kalimade Kecamatan Kesesi Kabupaten Pekalongan. Hasil asuhan ini menunjukan adanya peningkatan kadar haemoglobin pada ibu. Simpulan studi kasus ini menunjukan bahwa dengan rutin mengkonsumsi tablet Fe dapat meningkatkan kadar Haemoglobin dalam darah sehingga dapat mencegah serta mengobati anemia. Untuk itu ibu hamil diharapkan agar rutin mengkonsumsi tablet Fe selama kehamilan. Bidan diharapkan agar bisa memberikan edukasi tentang manfaat tablet Fe pada ibu hamil guna mencegah terjadinya anemia.Kata kunci: Haemoglobin; Anemia; Kehamilan

THE USE OF A CALCIUM-CONTAINING VITAMIN-MINERAL COMPLEX IN CHRONIC GENERALIZED PERIODONTITIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

2021 ◽  
pp. 18-22
Author(s):  
Наталия Александровна Полушкина ◽  
Наталия Владимировна Чиркова ◽  
Жанна Владимировна Вечеркина ◽  
Кристина Павловна Кубышкина ◽  
Марина Николаевна Бобешко
Keyword(s):  
Vitamin D ◽  
Blood Serum ◽  
Bone Remodeling ◽  
Human Body ◽  
Bone Growth ◽  
Calcium Absorption ◽  
The Body ◽  
Bone Architecture ◽  
Ultraviolet Rays ◽  
Vitamin D Metabolism

Витамин Д является жирорастворимым витамином, который в организме человека вырабатывается только при определённых условиях, когда ультрафиолетовые лучи солнечного света попадают на кожу человека. В организм человека витамин Д поступает в ограниченном количестве 20- 30% от потребности , в таких продуктах питания как: лосось(200-800 МЕ на 100 г), сметана-50 МЕ, печень говяжья-45МЕ, масло сливочное-10-150 МЕ, молоко, обогащённое витамином Д, желтки яиц-45 МЕ. Витамину Д для активации в организме необходимо пройти два процесса гидроксилирования. Первый из них происходит в печени (до 90%) и превращает витамин Д в 25-гидроксивитамин Д-25(ОН)Д или кальцидиол. Второй этап происходит в почках (10%), в результате чего синтезируется активный 1,25 -дигидроксивитамин Д или кальцитриол. Уровень образования Д-гормона в организме взрослого человека составляет около 0,3-1,0 мкг/сут. Важнейшая реакция, в которой участвует витамин Д - абсорбция кальция в кишечнике и его реабсорбция в почках, поддержание необходимого уровня кальция и фосфатов в крови, он необходим для роста костей и процессов костного ремоделирования. Чтобы сохранить нормальный гомеостаз кальция и костного ремоделирования, организму необходимо получать витамин D3. В условиях физиологии его потребность варьирует в сутки от двухсот-четырёхсот МЕ (у взрослых людей), до шестисот-восьмисот МЕ (у людей пожилого возраста) и до одной тысячи МЕ у лиц, живущих в районах Крайнего Севера. Концентрация промежуточного метаболита [25-(OH)D3] в сыворотке крови считается самым надёжным показателем общего обмена витамина D, поэтому этот показатель может быть использован для определения обеспеченности организма витамином D. Также он необходим для выяснения причин патологических концентраций кальция в сыворотке крови пациентов. Адекватное содержание [25-(OH)D3] поддерживает абсорбцию кальция и костный метаболизм. Содержание же [25-(OH)D3] ниже целевого значения 30 нг/мл вызывает снижение кальция в плазме крови и повышение секреции ПТГ, и как следствие, остеокластическую резорбцию кости, нарушение процессов ремоделирования и минерализации костной ткани, снижение её плотности и изменение костной архитектуры Vitamin D is a fat-soluble vitamin that is produced in the human body only under certain conditions, when ultraviolet rays of sunlight fall on the human skin. The human body receives vitamin D in a limited amount of 20-30% of the need, in such food products as: salmon (200-800 IU per 100 g), sour cream-50 IU, beef liver-45 IU, butter-10-150 IU, milk enriched with vitamin D, egg yolks-45 IU. Vitamin D needs to undergo two hydroxylation processes to be activated in the body. The first of these occurs in the liver (up to 90%) and converts vitamin D to 25-hydroxyvitamin D-25(OH)D or calcidiol. The second stage occurs in the kidneys (10%), resulting in the synthesis of active 1,25 -dihydroxyvitamin D or calcitriol. The level of D-hormone formation in the adult body is about 0.3-1.0 mcg/day. The most important reaction in which vitamin D is involved is the absorption of calcium in the intestine and its reabsorption in the kidneys, maintaining the necessary level of calcium and phosphates in the blood, it is necessary for bone growth and bone remodeling processes. To maintain normal calcium homeostasis and bone remodeling, the body needs to receive vitamin D3. In the conditions of physiology, its need varies per day from two hundred to four hundred IU (in adults), to six hundred to eight hundred IU (in the elderly) and up to one thousand IU in people living in the Far North. The concentration of the intermediate metabolite [25-(OH)D3] in the blood serum is considered the most reliable indicator of the total vitamin D metabolism, so this indicator can be used to determine the body's vitamin D supply. It is also necessary to find out the causes of abnormal concentrations of calcium in the blood serum of patients. Adequate [25-(OH)D3] content supports calcium absorption and bone metabolism. The content of [25-(OH)D3] below the target value of 30 ng / ml causes a decrease in calcium in the blood plasma and an increase in PTH secretion, and as a result, osteoclastic bone resorption, a violation of the processes of bone remodeling and mineralization, a decrease in its density and a change in bone architecture

Clinical-sonographical and dopplerometric criteria of determining the obstetrician's tactics in cases of the umbilical cord entanglement of the fetal body

2021 ◽  
Vol 50 (2) ◽  
pp. 66-71
Author(s):  
U. R. Khamadyanov ◽  
V. I. Ivakhah
Keyword(s):  
Umbilical Cord ◽  
Color Doppler ◽  
The Body ◽  
Complex Method ◽  
Third Trimester ◽  
The Third ◽  
Trimester Pregnancy ◽  
Pregnancy And Delivery ◽  
Umbilical Cord Entanglement

The complex method of antenatal diagnostics of the cord entanglement round the body of the fetus is elaborated. It includes echography, color Doppler mapping, dopplerometry and actocardiography. On the basis of the data received the system of prognosing and estimating the severity of feta l hypoxia in the end of the third trimester pregnancy is suggested, that allows to choose the correct tactics of pregnancy and delivery management in different rates ofcord entanglement. The use o f this method made it possible to rise the effectiveness of antenatal diagnostics of this gestational complication from 23,5% to 79,4%, to decrease the frequency of postnatal asphyxia to 46,1% and, therefore, to avoid intra- and postnatal loss.

The effect of maternal vitamin D supplementation in the third trimester on the incidence of early-onset sepsis in their newborns

2020 ◽  
Vol 9 (2) ◽  
pp. 74
Author(s):  
Prathapa Shetty ◽  
Manasee Deka ◽  
ManojKumar Yadav ◽  
Geeta Gathwala ◽  
Sunny Lohia ◽  
...  
Keyword(s):  
Vitamin D ◽  
Early Onset ◽  
Vitamin D Supplementation ◽  
Third Trimester ◽  
Maternal Vitamin ◽  
The Third ◽  
Early Onset Sepsis

MENGURANGI KECEMASAN PADA MASA KEHAMILAN TM III DENGAN METODE ACCUPRESSURE DEPRESSION POINTS

2021 ◽  
Vol 13 (02) ◽  
pp. 172
Author(s):  
Dyah Ayu Wulandari ◽  
Meika Jaya Rockhmana ◽  
Adelina Cahyaningrum
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Psychological Adaptation ◽  
The Body ◽  
Wilcoxon Test ◽  
P Value ◽  
Third Trimester ◽  
Purposive Sampling ◽  
The Third

ABSTRAKAdaptasi fisik dan psikis kehamilan trimester III secara fisiologis dapat menimbulkan kecemasan ibu hamil. Adanya kecemasan pada ibu hamil trimester III dapat menyebabkan komplikasi ibu dan janin saat kehamilan, persalinan bahkan nifas. Terapi acupressure merupakan natural terapi dengan cara menekan acupoint  untuk merelaksasi tubuh, melancarkan sirkulasi darah serta memberikan rasa tenang dan nyaman. Acupoint KID 27 dan CV 17 adalah titik yang berhubungan dengan kecemasan, agitasi, penyimpangan kelenjar tiroid, keseimbangan tubuh dan pusat jantung. Penekanan pada titik ini menyeimbangkan kadar hormon tiroid dan mengatasi gangguan kecemasan. Tujuan penelitian mengetahui pengaruh acupressure depression points terhadap kecemasan ibu hamil trimester III. Metode: Jenis penelitian kuantitatif dengan metode penelitian pre-experimental One Group Pretest-Posttest Design. Penelitian dilakukan Bulan Februari-Agustus 2021. Populasi penelitian ibu hamil trimester III yang melakukan ANC bulan Juni 2021 dengan keluhan kecemasan. Sampel penelitian 22 ibu hamil trimester III dengan teknik purposive sampling. Instrumen penelitian menggunakan kuesioner PRAQ-R2. Analisa data univariat dan bivariat (Uji Wilcoxon) Hasil: Hasil analisa statistik dengan uji Wilcoxon diperoleh nilai P-value 0,000 pada tingkat kecemasan. Kesimpulan: Acupressure depression points berpengaruh terhadap tingkat kecemasan ibu hamil trimester III di Semarang.Kata kunci: kecemasan, ibu hamil trimester IIIREDUCE ANXIETY IN PREGNANT MOTHER TRIMESTER III WITH ACCUPRESSURE DEPRESSION POINTS METHODABSTRACTPhysical and psychological adaptation of the third trimester of pregnancy can physiologically cause anxiety for pregnant women. The existence of anxiety in third trimester pregnant women can affect the quality of sleep which causes maternal and fetal complications during pregnancy, delivery and even postpartum. Acupressure therapy is a natural therapy by pressing the acupoints to relax the body, improve blood circulation and provide a sense of calm and comfort. Acupoints KID 27 and CV 17 are points associated with anxiety, agitation, thyroid disorders, body balance and heart centers. Emphasis on this point balances thyroid hormone levels and treats anxiety disorders thereby improving sleep quality. Objective: to determine the effect of acupressure depression points on the level of anxiety and sleep quality of pregnant women in the third trimester. Methods: This type of research is quantitative with pre-experimental research method One Group Pretest-Posttest Design. The study was conducted in February-August 2021. The study population was pregnant women in the third trimester who performed ANC in June 2021 with complaints of anxiety. The study sample was 22 pregnant women in the third trimester with purposive sampling technique. The research instrument used the PRAQ-R2. Analysis of univariate and bivariate data (Wilcoxon test) Results: The results of statistical analysis using the Wilcoxon test obtained a P-value of 0.000 on anxiety levels. Conclusion: Acupressure depression points have an effect on the level of anxiety of pregnant women in the third trimester at Semarang.Keyword: Anxiety, Pregnant Women In The Third Trimester

scholarly journals Ibuprofen-related renal tubular acidosis in pregnancy

2011 ◽  
Vol 4 (3) ◽  
pp. 122-124 ◽  
Author(s):  
Andrew Mallett ◽  
Matthew Lynch ◽  
George T John ◽  
Helen Healy ◽  
Karin Lust
Keyword(s):  
Renal Dysfunction ◽  
Renal Tubular Acidosis ◽  
History Taking ◽  
Third Trimester ◽  
The Third ◽  
Healthy Neonate ◽  
Renal Tubular ◽  
In Pregnancy

Ibuprofen-related renal tubular acidosis (RTA) has not been previously described in pregnancy but its occurrence outside of pregnancy is being increasingly described. In this case, a 34-year-old woman presented in the third trimester of pregnancy with Type 1 or distal RTA related to ibuprofen and codeine abuse. It was complicated by acute on chronic renal dysfunction and hypokalemia. Delivery at 37 weeks gestation due to concerns of evolving preeclampsia resulted in the birth of a healthy neonate. RTA and hypokalemia were remediated and ibuprofen and codeine abuse ceased. Some renal dysfunction however continued. Thorough and repeated history taking as well as vigilance for this condition is suggested.

The renin-aldosterone system in pre-eclampsia, essential and transient hypertension during pregnancy, and normotensive pregnant and non-pregnant control subjects

1982 ◽  
Vol 101 (2) ◽  
pp. 273-280 ◽  
Author(s):  
E. B. Pedersen ◽  
A. B. Rasmussen ◽  
P. Johannesen ◽  
H. J. Kornerup ◽  
S. Kristensen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin ◽  
Urinary Sodium Excretion ◽  
Third Trimester ◽  
Plasma Aldosterone Concentration ◽  
The Third ◽  
Control Subjects ◽  
Hypertension In Pregnancy ◽  
Normotensive Pregnancy ◽  
In Pregnancy

Abstract. Plasma renin concentration (PRC), plasma aldosterone concentration (PAC), and blood pressure were determined in the third trimester in pregnancy, 5 days and 6 months after delivery in pre-eclampsia, essential and transient hypertension in pregnancy and in normotensive pregnant and non-pregnant control subjects. PRC and PAC were elevated several fold above non-pregnant level in all groups during pregnancy. In pre-eclampsia PRC and PAC were 220 and 160%, respectively, above the levels 6 months after delivery, and thus lower than the corresponding values, 360 and 402%, in normotensive pregnancy. In essential and transient hypertension PRC and PAC increased to the same degree as during normotensive pregnancy. Urinary sodium excretion, serum sodium and creatinine clearance were reduced in pre-eclampsia, but not in essential and transient hypertension when compared to normotensive pregnant controls. All the parameters determined were the same as in non-pregnant controls 6 months after delivery in all groups. There were no correlations between blood pressure and PRC or PAC in any of the groups neither in pregnancy nor after delivery. It is concluded that the renin-aldosterone system is stimulated in lesser degree in pre-eclampsia than in both essential hypertension, transient hypertension and normotensive pregnancy, and there was no evidence for a causal relationship between the renin-aldosterone system and blood pressure neither in normotensive nor hypertensive pregnancy.

scholarly journals DESENHO DA GRAVIDEZ E SENSIBILIDADE SONORA: CONTRIBUTOS PARA O ESTUDO DA PSICOLOGIA DA GRAVIDEZ

2016 ◽  
Vol 1 (1) ◽  
pp. 25
Author(s):  
Mª Eduarda Salgado Carvalho ◽  
Joao Manuel Rosado de Miranda Justo
Keyword(s):  
Longitudinal Study ◽  
Graphical Representation ◽  
Third Trimester ◽  
Psychological Study ◽  
Portuguese Version ◽  
The Third ◽  
Projective Measures ◽  
Music Representations ◽  
Maternal Orientation ◽  
In Pregnancy

Resumo.Introdução: Esta comunicação pretende descrever um estudo longitudinal acerca da aplicação da Escala do Desenho da Gravidez e da Escala da Sensibilidade Sonora-Musical na Gravidez, ambas construídas e validadas para este estudo, numa amostra de 211 mulheres grávidas aguardando a realização das ecografias do II e do III trimestres de gestação. Objectivos: 1) avaliar a evolução das variáveis do desenho da gravidez e das variáveis sonoro-musicais na passagem do II para o III trimestre e 2) analisar a contribuição de cada uma de estas variáveis para o estudo da psicologia da gravidez. Método: 1) estudo longitudinal comparando as variáveis do desenho da gravidez e a sensibilidade sonoro-musical observadas nos dois momentos de avaliação; 2) estudo correlacional entre cada uma destas variáveis e as variáveis de vinculação materna pré-natal e de orientação materna pré-natal. Instrumentos: Escala do Desenho da Gravidez (Carvalho, 2011), Escala da Sensibilidade Sonora-Musical na Gravidez (Carvalho & Justo, 2013), Escala de Vinculação Materna Pré-natal (versão Portuguesa, Camarneiro & Justo, 2010) e Questionário do Paradigma Placentário (versão portuguesa, Carvalho, 2011). Resultados: Os resultados revelam a existência de diferenças significativas, entre o II e o III trimestres nas variáveis estudadas, apontando para: a) um aumento da sensibilidade sonoro-musical no terceiro trimestre, b) uma evolução da auto-representação da imagem materna no terceiro trimestre e c) um aumento da frequência de representação gráfica da posição de apresentação fetal cefálica da imagem do bebé na passagem para o terceiro trimestre. Observaram-se correlações significativas entre, por um lado, as variáveis da sensibilidade sonoro-musical e as variáveis do desenho da gravidez e, por outro lado, as variáveis de orientação materna pré-natal. Registaram-se correlações significativas entre sensibilidade sonoro-musical, por um lado, e vinculação materna pré-natal e a orientação maternal pré-natal, por outro. Conclusão: Será importante investigar a dialética entre a representação do bebé imaginado através de medidas projectivas maternas e a percepção do comportamento fetal recorrendo à observação ecográfica e a medidas biofísicas e hemodinâmicas.Palavras chave: Gravidez, Escala do Desenho da Gravidez, Escala das Representações Sonoro-Musicais na Gravidez, Escala de Vinculação Materna Pré-Natal, Questionário do Paradigma Placentário.Abstract.Background: This paper aims to describe a longitudinal study about the use of the Drawing Pregnancy Scale and of the Sound-Music Representations in Pregnancy Scale, both of it created and validated in a sample of 211 pregnant women while waiting for sonograms of the II and III trimesters of pregnancy. Aims: 1) to assess, the evolution of variables in drawings of pregnancy and also of sound-music variables, by the transition of the II to the III trimester of gestation and 2) to analyze the contribution of each one of these variables for the psychological study of pregnancy. Method: 1) longitudinal study comparing variables in drawings of pregnancy and sound-music variables at the two moments of assessment; 2) correlational study between each one of these variables and variables of maternal pre-natal attachment and also of maternal pre-natal orientation. Instruments: Drawing Pregnancy Scale (Carvalho, 2011), Sound-Music Representations in Pregnancy Scale (Carvalho & Justo, 2013), Maternal Pre-natal Attachment Scale (Portuguese version, Camarneiro & Justo, 2010) and Placental Paradigm Questionnaire (Portuguese version, Carvalho, 2011). Results: Results show the existence of significant diferences between the II and the III trimestres in some of the variables under analysis, suggesting: a) a increase of the sound-music sensibility by the third trimester, b) an evolution of the maternal image at the third trimester and c) an increase of the frequency of the graphical representation of the cephalic fetal presentation of the baby’s image at the third trimester. Significant correlations were observed between, on one side, the variables of soundmusic sensibility and the variables of the pregnancy drawings and, on another side, variables of prenatal maternal orientation. Significant correlations between sound-music sensibility, on one side, and prenatal maternal attachment and prenatal maternal orientation, on the other side, were found. Conclusion: It will be important to investigate about the representation of the imagined baby through maternal projective measures and the perception of fetal behaviour using sonograms as well as biophysical and hemodynamic measures.Keywords: Pregnancy, Drawing Pregnancy Scale, Sound-Music Representations in Pregnancy Scale, Maternal Pre-natal Attachment Scale, Placental Paradigm Questionnaire.

scholarly journals Juvenile granulosa cell tumour in the third trimester of pregnancy

2020 ◽  
Vol 9 (2) ◽  
pp. 861
Author(s):  
Jonathan Gaughran ◽  
Argha Datta ◽  
Judith Hamilton ◽  
Tom Holland ◽  
Ahmad Sayasneh
Keyword(s):  
Case Report ◽  
Granulosa Cell ◽  
Cell Tumour ◽  
Granulosa Cell Tumour ◽  
Third Trimester ◽  
Rare Finding ◽  
Histopathological Findings ◽  
The Third ◽  
In Pregnancy

This case report describes the rare finding of a granulosa cell tumour in the third trimester of pregnancy. The presentation, investigation, management, histopathological findings and subsequent follow up are detailed. The difficulties associated with such diagnoses in pregnancy are explored.

scholarly journals THE DIFFERENCE IN ADDITION OF BACK MASSAGE COMBINATION IN PREGNANCY EXERCISE IN IMPROVING QUALITY OF SLEEP IN THIRD TRIMESTER PREGNANT WOMEN

2018 ◽  
Vol 6 (2) ◽  
pp. 16
Author(s):  
Mezzi Wulandari Arenza ◽  
Ni Wayan Tianing ◽  
I Putu Adiartha Griadhi
Keyword(s):  
Sleep Quality ◽  
Pregnant Women ◽  
Control Group ◽  
Quality Of Sleep ◽  
Third Trimester ◽  
The Third ◽  
The Difference ◽  
In Pregnancy ◽  
Back Massage

ABSTRACTSleep disturbance in the third trimester pregnant women is caused by discomfort, an increasingly largeabdominal condition, back pain, frequent urination, fetal movement, heartburn, cramps in the legs, tiredness, difficultygetting started, and physiological changes. Sleep disorders result in decreased quality of sleep. Pregnant women whohave poor sleep quality are at risk of longer labor, cesarean delivery, premature birth, and even infant mortality. The aimof this research is to know the difference of pregnant exercise combination and back massage in improving the sleepquality of third trimester pregnant women. This research use experiment method with quasi experiment approach andresearch design is pre and post test with control design. Sample are 18 people, divided into 2 groups, 9 people intreatment groups given pregnancy exercise and back massage and 9 people in control group is given only pregnantexercise. Intervention is given 8 times. Pittsburgh Sleep Quality Index (PSQI) questionnaire used for measured of sleepquality. The result of different test of unpaired group, in the treatment group got difference of average 4,556 and controlgroup got difference mean 2,333 with p=0,004 (p<0,05). These results showed that there was a significant differencebetween the treatment group and the control group in improving the sleep quality of the third trimester pregnant women.In conclusion, there are differences in the addition of back massage combination in pregnancy exercise intervention inimproving sleep quality of third trimester pregnant women.Keyword : Pregnancy Exercise, Back Massage, Sleep Quality, Third Trimester.

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