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The Second Trimester
Changes in Your Body
Most women find the second trimester of pregnancy easier than the first. But it is just as
important to stay informed about your pregnancy during these months.
You might notice that symptoms like nausea and fatigue are going away. But other new,
more noticeable changes to your body are now happening. Your abdomen will expand as
you gain weight and the baby continues to grow. And before this trimester is over, you will
feel your baby beginning to move!
Many of the aches and pains you had in the first trimester may continue. So remember to
follow the tips from Pregnancy Basics to help prevent and ease these discomforts.
Some of the following aches and pains may make their first appearance during the second
trimester:
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Pain in the abdomen, groin and thighs
Backaches
Shortness of breath
Stretch marks
Skin changes
Tingling in hands and fingers
Itching on the abdomen, palms and soles of the feet — Call your doctor if you have
nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These
can be signs of a serious liver problem called cholestasis of pregnancy.
Weight Gain
Everyone gains weight at different rates. On average, it is normal to gain about one pound
per week, or about three to four pounds per month during this trimester.
By the end of the second trimester your baby will weigh about 1 3/4 pounds and be about
13 inches long. With this growth comes the development of fingers, toes, eyelashes and
eyebrows. Around the fifth month, you might feel your baby move! By the end of this
trimester, all of your baby's essential organs like the heart, lungs and kidneys are formed.
2nd Trimester Tests and Procedures
During the second trimester, you should continue to see your doctor for prenatal care. Most
pregnant women have monthly office visits with their doctor or midwife until the end of this
trimester.
During the second trimester your doctor can use an ultrasound to see if your baby is
developing in a healthy way and to find out your baby's sex. You also will be offered
screening tests to look for genetic birth defects.
Birth defects result from problems with a baby's genes, inherited factors that are passed
down from the mother and the father at conception. Genetic birth defects sometimes occur
in people with no family history of that disorder. Women over the age of 35 have the
greatest chances of having a baby with birth defects.
Some of the diagnostic and screening tests your doctor might suggest in the second
trimester include:
Amniocentesis
This test is performed in pregnancies of at least 16 weeks. It involves your doctor inserting
a thin needle through your abdomen, into your uterus and into the amniotic sac to take out
a small amount of amniotic fluid for testing. The cells from the fluid are grown in a lab to
look for problems with chromosomes. The fluid also can be tested for AFP. About 1 in 200
women have a miscarriage as a result of this test.
Chorionic Villus Sampling (CVS)
This test is performed between 10 and 12 weeks of pregnancy. The doctor inserts a needle
through your abdomen or inserts a catheter through your cervix in order to reach the
placenta. Your doctor then takes a sample of cells from the placenta. These cells are used in
a lab to look for problems with chromosomes. This test cannot find out whether your baby
has open neural tube defects. About one in 200 women have a miscarriage as a result of
this test.
Maternal Serum Screening Test
This blood test can be called by many different names, including multiple marker screening
test, triple test, quad screen and others. This test is usually given between 15 and 20 weeks
of pregnancy. It checks for birth defects such as Down syndrome, trisomy 18 or open neural
tube defects. Doctors take a sample of your blood. They check the blood for three
chemicals: alpha-fetoprotein (AFP) (made by the liver of the fetus) and two pregnancy
hormones, estriol and human chorionic gonadotropin (hCG). Sometimes, doctors test for a
fourth substance in the blood called inhibin-A. Testing for inhibin-A may improve the ability
to detect fetuses with a high risk of Down syndrome.
Higher levels of AFP are linked with open neural tube defects. In women age 35 and older,
this test finds about 80 percent of fetuses with Down syndrome, trisomy 18 or an open
neural tube defect. In this age group, there is a false positive rate (having a positive result
without actually having a fetus with one of these health problems) of 22 percent. In women
younger than age 35, this test finds about 65 percent of fetuses with Down syndrome, and
there is a false positive rate of about 5 percent.
Targeted Ultrasound
The best time to get a targeted ultrasound is between 18 and 20 weeks of pregnancy. Most
major problems with the way your baby is formed can be seen at this time. Some physical
defects such as clubbed feet and heart defects may not be seen.
Your doctor also can use ultrasound to see if your baby has any neural tube defects, such as
spina bifida. In most cases, if you want to find out the sex of your baby, you can ask your
doctor during this test. This is not the most accurate test for Down syndrome. Only one in
three babies with Down syndrome have an abnormal second trimester ultrasound.
Source: Office on Women's Health, U.S. Department of Health and Human Services
Updated: January 2006