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The Second Trimester | Johns Hopkins Medicine

What You Need to Know

• During your second trimester prenatal visits, your health care provider will continue to check on your and your baby’s health, including monitoring the fetal heartbeat.
• The second trimester is the most physically enjoyable for most women. Morning sickness usually lessens by this time, and the extreme tiredness and breast tenderness usually ease up.
• Your fetus has now developed all its organs and systems and will now begin to grow in length and weight.
• You may be able to feel the movement of the fetus for the first time at around 20 weeks. This phenomenon is called quickening.
• A fetus born at the end of 24 weeks may survive in a neonatal intensive care unit.

Prenatal Visits During the Second Trimester

During your second and third trimester prenatal visits, your health care provider may check the following, depending on your current medical condition and the health of the fetus:

• Any current symptoms or discomforts

• Your weight

• Your blood pressure

• Urine test. This is done to find albumin, a protein that may indicate pre-eclampsia or toxemia, and glucose (which may indicate hyperglycemia).

• Growth, size and development of the fetus

• Size of the uterus. After approximately 12 weeks of gestation, the uterus can be felt through the abdominal wall.

• Height of the fundus (top of the uterus), starting at 20 weeks of gestation

• Fetal heartbeat

The Second Trimester: What to Expect

The second trimester marks a turning point for the mother and fetus. You will usually begin to feel better and start showing the pregnancy more. Your fetus has now developed all its organs and systems and will now begin growing in length and weight.

During the second trimester, the umbilical cord continues to thicken as it carries nourishment to the fetus. However, harmful substances also pass through the umbilical cord to the fetus, so care should be taken to avoid alcohol, tobacco and other known hazards.

During the second trimester, both your body and the fetus continue to grow.

Johns Hopkins Hospital Designated as Baby-Friendly

The Baby-Friendly Hospital Initiative, a global program launched by the World Health Organization and the United Nations Children’s Fund, has designated The Johns Hopkins Hospital as Baby-Friendly. This designation is given to hospitals and birthing centers that offer an optimal level of care for infant feeding and mother-baby bonding.

Learn more

The Second Trimester: Changes to Your Body

The second trimester is the most physically enjoyable for most women. Morning sickness usually lessens by this time, and the extreme tiredness and breast tenderness usually ease up. These changes can be attributed to a decrease in levels of human chorionic gonadotropin hormone and an adjustment to the levels of estrogen and progesterone hormones.

The following is a list of changes and symptoms that may happen during the second trimester:

• Appetite may increase.

• You may be able to feel the movement of the fetus for the first time around 20 weeks. This phenomenon is called quickening.

• The uterus grows to the height of the bellybutton around 20 weeks, making the pregnancy visible.

• The skin on the belly may itch as it grows, and there may be pain down the sides of the body as the uterus stretches. The lower stomach may ache as ligaments stretch to support the uterus.

• The need to urinate often may decrease as the uterus grows out of the pelvic cavity, relieving pressure on the bladder.

• Your nose may become congested, and you may experience nosebleeds. This is due to the increase in hormones (estrogen and progesterone) and blood flow that affect the mucous membranes and blood vessels in the nose.

• Your gums become spongier and may bleed easily. This is due to the increase in hormones (estrogen and progesterone) that affect the mucous membranes in the mouth.

• Varicose veins and hemorrhoids may appear.

• You may have a white-colored vaginal discharge called leukorrhea. (A colored or bloody discharge may signal possible complications and should be examined immediately.)

• The increasing weight gain may cause backaches.

• Skin pigmentation may change on the face or abdomen due to the pregnancy hormones.

• Heart burn, indigestion and constipation may continue.

The Second Trimester: Fetal Development 

Now that all the major organs and systems have formed in the fetus, the following six months will be spent growing. The weight of your fetus will multiply more than seven times over the next few months, as the fetus becomes a baby that can survive outside of the uterus.

By the end of the second trimester, your fetus will be about 13 to 16 inches long and weigh about 2 to 3 pounds. Fetal development during the second trimester includes the following:

• The fetus kicks, moves and can turn from side to side.

• The eyes have been gradually moving to the front of the face, and the ears have moved from the neck to the sides of the head. The fetus can hear your voice.

• A creamy white substance (called vernix caseosa, or simply vernix) begins to appear on the fetus and helps to protect the thin fetal skin. Vernix is gradually absorbed by the skin, but some may be seen on babies even after birth.

• The fetus is developing reflexes, like swallowing and sucking.

• The fetus can respond to certain stimuli.

• The placenta is fully developed.

• The brain will undergo its most important period of growth from the fifth month on.

• Fingernails have grown on the tips of the fingers and toes, and the fingers and toes are fully separated.

• The fetus goes through cycles of sleep and wakefulness.

• Skin is wrinkly and red, covered with soft, downy hair (called lanugo).

• Hair is growing on the head of the fetus.

• Fat begins to accumulate in the fetus.

• Eyelids are beginning to open, and the eyebrows and eyelashes are visible.

• Fingerprints and toeprints have formed.

• Rapid growth is continuing in fetal size and weight.

• The 20th week marks the halfway point of the pregnancy.

A fetus born at the end of 24 weeks may survive in a neonatal intensive care unit.

Second trimester of pregnancy | Chicco.ru

Russian

In Attesa

Tips to help you prepare for the second trimester of pregnancy

The second trimester falls on the period from the 4th to the 6th month of pregnancy, namely from the 14th to the 27th week.

For a future mother, the second trimester is, as a rule, the calmest stage of pregnancy, when the manifestations of toxicosis disappear. During this period, a woman's pregnancy becomes noticeable, and her body continues to change. What changes occur in the body in the second trimester and what sensations can they be accompanied by?

• Abdominal and breast enlargement : The abdomen grows as the uterus enlarges. The chest is also slowly but surely increasing. nine0026
• Skin changes : skin may darken due to increased production of melatonin; this is most noticeable in the areolas of the nipples, and a dark vertical line (linea nigra) may appear on the abdomen. All these changes are temporary and after childbirth, as a rule, disappear.
• Leg cramps and pain : in this case, it may be advised to stretch the calf muscles before going to bed, drink more water and not forget about physical activity; there are special exercises that can be done during pregnancy . It is also recommended to wear comfortable shoes and avoid tight, squeezing socks.
• Back pain : back pain during pregnancy due to poor posture due to weight gain and belly growth.

Weight gain becomes more noticeable from the 4th month: the rate of weight gain increases in the second trimester and then decreases in the third trimester, when weight gain is mainly due to active growth of the fetus . As a rule, at this stage, weight gain is 300-500 g per week, but this is a very individual indicator and may vary. nine0003

The general recommendation is to adhere to the principles of a healthy and balanced diet: eat small portions but often, favor light foods, consume as much dietary fiber as possible and drink plenty of water to maintain optimal water balance. Drinking enough water improves its circulation in the body of a pregnant woman, helping to cope with fluid retention, characteristic of the second trimester. For the same purpose, it is recommended to reduce salt intake. Often at this time, a woman develops digestive disorders, constipation and drowsiness. If these symptoms appear, you should consult a gynecologist. The doctor will check if they are caused by any disease and will advise how to alleviate them. nine0003

In addition to standard blood tests, one of the most important tests in the second trimester is morphological ultrasound (diagnosis of fetal abnormalities), which is usually performed from the 19th to the 21st week of pregnancy. Procedures such as amniocentesis or chorionic villus sampling may be performed during this period to diagnose fetal chromosomal abnormalities.

The beginning of the second trimester is traditionally considered one of the calmest. Walk more. Walking is very helpful. Sit down to rest only when you are tired. Movement in the fresh air improves the supply of oxygen to the fetus, which is very necessary for its normal development.

Nausea disappears, appetite improves. Do not eat a lot of salty, refuse marinades, smoked meats, if you have not done this before. The increased need of the child's body for proteins and vitamins begins. The daily diet should include meat or fish (boiled or stewed), dairy products, especially cottage cheese, eggs. Do not forget about vegetables, fruits, greens. An excellent source of vitamin C is sauerkraut (rather than salted) cabbage. Salads from carrots, cabbage, beets, apples, green radish should be on your table every day. nine0003

At 17-20 weeks you will feel your baby's first kicks. From them you can determine how comfortable the baby feels. Intense tremors are a signal of lack of oxygen. Maybe you haven’t walked for a long time or, on the contrary, you are engaged in hard physical labor. Get out into the fresh air or lie down to rest and you will immediately feel how the child has calmed down.

But the lack of movement is an alarm. See a doctor immediately!

The fetal need for calcium sharply increases - intensive growth of the skeleton has begun. If you don't have enough free calcium in your body right now, you could lose your teeth. To prevent this from happening, start taking calcium supplements in consultation with your doctor. nine0003

At this time, toxicosis of the second half of pregnancy may occur, the child suffers greatly from it. Therefore, if the doctor suggests hospitalization, do not refuse. Toxicosis can, if not be avoided, then at least reduce its manifestations. Be sure to follow your diet. Completely exclude salty, smoked, fried, spicy, canned food, chocolate. Do not eat a lot of grapes and drink fresh milk. Limit flour and rich products. As before, your diet should include boiled meat and fish, oatmeal and buckwheat porridge, vegetables and fruits

Periodically, once a week, check for fluid retention in the body. It is allowed to release liquid 200-300 ml less than what was drunk. If little urine is released, this is a signal of latent edema and the onset of toxicosis.

It is very good if you can measure your blood pressure at home. Show the results of measurements at the next visit to the doctor. Both high and too low pressure should alert. With low pressure, blood sluggishly crosses the placenta, and the baby does not receive enough nutrients. nine0003

Do not neglect blood tests - it is important not to miss the development of anemia. In this case, you will be prescribed iron supplements and multivitamins. The diet should include beef liver, tomato juice, buckwheat porridge, apples, preferably Antonovskie (they contain more iron than other varieties).

Women who are at risk of giving birth to a child with a genetic pathology (those who have severe hereditary ailments in their families), as well as women over 35 years old (they have an increased likelihood of having a child with Down syndrome) are referred for a consultation by a geneticist.

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