Pretend you are a teacher preparing a quiz for the text I will provide. 
            Each quiz question should follow the format below. 
            Ensure that you carefully recheck the questions and answers for accuracy. 
            The output should be a ready-to-use list of dictionaries for the Python eval function:

            [

                    "question": "WRITE THE QUESTION HERE",
                    "options": ["A) OPTION_1", "B) OPTION_2", "C) OPTION_3", "D) OPTION_4"],
                    "answer": INDEX_OF_CORRECT_ANSWER_IN_OPTIONS_LIST,
                    "explanation": "EXPLAIN WHY THE ANSWER IS CORRECT"

            ]

            Text:
            on of the Lower Uterine Segment

Starts at 12 weeks as the isthmus expands to form a 10cm segment by term.

4. Cervical Changes

Hypertrophied, soft, and bluish in color.

Mucous plug forms to block the cervical canal.

5. Vaginal and Vulvar Changes

Vagina becomes soft, warm, and moist.

Vulva softens and turns violet, with potential for edema and varicosities.

6. Breast Changes

Tenderness and tingling in the early weeks.

Breasts enlarge and develop nodularity by the second month.

Pigmentation of the areola deepens, and Montgomery’s follicles become visible.

Colostrum secretion begins after the third month.

7. Skin Changes

Increased pigmentation (e.g., linea nigra, chloasma).

Stretch marks (striae gravidarum) develop, later turning into striae albicans.

Increased blood flow and activity of sweat and sebaceous glands.

8. Hematologic Changes

Blood volume increases by 40%, while red cell mass increases by 20%.

Results in physiological anemia due to hemodilution.

9. Cardiovascular System

Resting heart rate increases by 10-15 beats per minute.

Blood pressure decreases in the second trimester due to peripheral vasodilation.

10. Respiratory Changes

Dyspnea may occur due to diaphragm elevation and heightened sensitivity to CO2.

11. Gastrointestinal Changes

Common symptoms: nausea, vomiting, excessive salivation (ptyalism).

Altered appetite with possible cravings or aversions (pica).

Constipation and heartburn are frequent.

12. Urinary System

Increased renal blood flow and filtration rate by 50%.

Ureters dilate due to progesterone and pressure from the uterus.

Frequent urination occurs due to bladder pressure.

13. Musculoskeletal Changes

Increased lumbar lordosis to balance the growing uterus.

Loosening of pelvic joints due to relaxin and progesterone.

14. Endocrine Changes

Enlargement of the pituitary, thyroid, parathyroid, and adrenal glands.

15. Weight Gain

Typical gain is 10-12kg, with maternal tissues accounting for 6kg and the fetus, placenta, and fluid accounting for 5kg.

16. Metabolic Changes

Water retention increases due to sodium retention.

Pregnancy is diabetogenic, with a risk of renal glucosuria.

17. Diagnosis of Pregnancy (First Trimester)

Symptoms: amenorrhea, nausea, vomiting, breast changes, and frequent urination.

Signs: uterine enlargement, cervical softening, and vaginal color changes.

18. Pregnancy Tests

Urine tests detect hCG one week after a missed period.

False positives can result from conditions like proteinuria or trophoblastic disease.

19. Ultrasound

Gestational sac visible by 4-5 weeks of amenorrhea.

Fetal heartbeats detected by week 7.

20. Second Trimester Features

Morning sickness and urinary symptoms decrease.

Fetal movements (quickening) felt between 16-20 weeks.

21. Skin Changes During Second Trimester

Pronounced pigmentation: linea nigra, chloasma, and striae gravidarum.

22. Fetal Signs in Second Trimester

Palpation of fetal parts and movements by week 20.

Fetal heart 

            Quiz: