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Pregnancy – 2nd Trimester

The period between 13th to 27th weeks of gestation is referred to as the 2nd trimester. The health concerns related to the first trimester such as morning sickness and fatigue fade away during this time and you tend to feel more energetic. During this trimester, your baby grows rapidly and starts developing organs.

 

Changes in your body

Although the unpleasant symptoms of the first trimester such as nausea may have subsided, there are a lot of new changes that you would experience in the second trimester.

  1. Visible pregnant belly: Owing to expansion of the uterus, your pregnant belly would be distinctly visible now.
  2. Experience fetal movements: Around 20-25th week of pregnancy, you would experience mild baby kicks.
  3. Itchy Belly: This is caused due to the stretching of your skin that occurs in order to accommodate the expanding belly.
  4. Increased urge to urinate: As the uterus expands, it exerts pressure on the bladder. This leads to an increase urge to urinate.
  5. Backache: Owing to your increasing waistline, your back muscles needs to work more to maintain stability and posture. This added workload on your back muscles result in backache.
  6. Swelling of the feet: Your enlarged uterus presses upon the abdominal blood vessels which results in swelling of the extremities.
  7. Breast Enlargement: The breasts start preparing for lactation and thus there is an apparent increase in the size of your breasts.
  8. Skin and hair changes: The change in your hormones during pregnancy may make your skin glow and your hair, thicker and long. Increase in melanin may result in brown spots in the face.

Tests during the 2nd trimester

Regular health check-ups throughout pregnancy are necessary to monitor the growth and development of the fetus. During the second trimester, your gynec would advise you to undergo certain blood tests, urine examination and ultrasound tests.

  • Urine tests

Your urine sample would be assessed using chemically prepared testing strips for the following:

  1. Urine glucose levels: Maternal diabetes can have adverse effects on the fetus as well. Owing to high sugar, the fetus grows larger than normal, may have jaundice and may be delivered preterm. Therefore, urine glucose checks are necessary to maintain healthy sugar levels.
  2. Assessment of albumin levels- Pregnancy induced hypertension is a life-threatening condition for the mother as well as the fetus. It may cause growth retardation in the fetus and premature delivery. Increased levels albumin in urine would indicate pregnancy induced hypertension.
  3. Assessment of kidney infection: Presence of pus, WBC or blood in urine is indicative of kidney infection.

Urine culture and sensitivity tests: A woman’s susceptibility of developing urinary tract infection increases during pregnancy. If left undiagnosed, this may lead to kidney infection which can cause complications such as early labor and low birth weight. In this test, your urine sample would be cultured in a specific nutrient medium to assess for various infections.

  • Blood tests

Your blood sample would be collected and will be tested for the following:

  1. Complete blood picture (CBC): Your doctor would recommend for a complete blood picture (CBC) test to observe the levels of blood components (RBCs, WBCs & platelets). Low levels of white blood cells indicate infection. Hemoglobin levels and red blood cell levels are regularly checked throughout pregnancy to detect anemia.
  2. Thyroid stimulating hormone (TSH) levels: Pregnancy is a major stress for the thyroid gland and its size increases during pregnancy. With increase in the size of thyroid gland there is a proportional drop in the TSH levels. However, excessive increase or decrease TSH levels may disrupt thyroid functions.

 Normal Levels and interpretation:  

Parameter Normal Levels during second trimester Interpretation
Urine glucose 0 to 15 mg/dL Increase would indicate gestational diabetes
Urine albumin 2.6 – 4.5g/dL Increase would indicate gestational hypertension
Hemoglobin Less than 10.5g/dL Decrease would indicate anemia
Thyroid stimulating hormone 0.2-3.0 Increase would indicate hyperthyroidism and decrease would indicate hypothyroidism.

 

Glucose Tolerance Test: This test is done to detect gestational diabetes which commonly occurs during the second trimester. In this test, first a sample of your blood is taken to test your initial blood sugar levels. Following this, you would be given a sugary drink and then you would be giving a blood sample again for testing sugar levels after 2 hours. A sugar level of more than 200mg/dl in the second blood sample is an indication of diabetes.

Ultrasound: During the second trimester, the ultrasound investigation is usually prescribed between 18th – 22nd weeks of pregnancy. The ultrasound scan done during the second trimester is useful for:

  • Identifying structural abnormalities in the fetus such as cleft palate
  • Assessing the levels of amniotic fluid.
  • Confirming multiple gestation.
  • Monitoring the growth and position of the fetus

Amniocentesis: Amniocentesis is an invasive diagnostic procedure, which is done between 15 – 20 weeks to detect genetic diseases and chromosomal abnormalities such as Down’s syndrome. In this procedure, a small amount of amniotic fluid is collected and evaluated.

Maternal Serum Screening: Maternal marker tests are a series of tests done in the second trimester to evaluate a woman’s risk of carrying a baby with chromosomal anomalies. It includes- double marker test, triple marker tests and quadruple marker test.

The Double marker test assesses the levels of the human chorionic gonadotropin(hCG) and Pregnancy Associated Plasma Protein. The levels of these components help to detect Down’s syndrome and trisomy 18 in fetus. This test is done between 10-13 weeks of pregnancy.

The triple marker test assesses the levels of alpha-fetoprotein, a protein produced by the fetus, hCG and estriol which are the hormones produced by the placenta. This test helps in detecting genetic defects such as Down’s syndrome and neural tube defect such as spina bifida. This test also detects multiple pregnancy. This test is done in between 14-20 weeks of pregnancy.

The quadruple marker test assesses the levels of alpha-fetoprotein, hCG, estriol and Inhibin A, which is a protein produced by the placenta and ovaries. The chances of identifying pregnancies with Down syndrome is considerably more with this test. This test is done between 15-20 weeks of pregnancy.

At Apollo Diagnostics

  • We are using the technology which is approved by Fetal Medicine Foundation, U.K.
  • Risk evaluation for Trisomy 21, 18 & 13 with individual cutoff and Risk Ratio
  • Unique & easy to interpreted Report Format with Graphical Risk analysis

Reference report format

DISORDER RISK RATIO RISK CATEGORY SCREEN RESULT
DOWN’S SYNDROME 1:96363 LOW NEGATIVE
EDWARD’S SYNDROME 1:100000 LOW NEGATIVE
PATAU’S SYNDROME 1:100000 LOW NEGATIVE
TURNER’S SYNDROME NON-HYDROPS 1:100000 LOW NEGATIVE

Cordocentesis: It also known as percutaneous umbilical blood sampling (PUBS) is a prenatal test, in which a sample of fetal blood is analyzed to check for fetal abnormalities. In this test, a thin needle is inserted into the umbilical cord with the help of an ultrasound to collect the fetal blood sample. Chromosomal aberrations such as Down syndrome and blood disorders such as fetal hemolytic disease can be accurately determined by this test.

 Dietary tips for a healthy second trimester

  1. Avoid eating spicy foods as it can cause heart burn.
  2. Stay hydrated by drinking plenty of water and fluids.
  3. Avoid caffeine to minimize the symptoms of nausea and vomiting.
  4. Include fiber rich foods to overcome constipation during pregnancy.
  5.  Include a diet rich in iron and protein.

 Why choose Apollo Diagnostics?

We have the expertise of 34 + years in healthcare. Our labs are equipped with EQUAS (External Quality Assurance System) and loaded with full automated machines to ensure error free reports, with a quick turnaround time, and at an affordable price. For your convenience, we offer free home collection of samples.

For appointments, please call 4444 2424. 

References

  1. The Second trimester of Pregnancy.http://www.healthline.com/health/pregnancy/second-trimester#overview1Accessed on 28.09.17
  2. Second Trimester of Pregnancy. http://www.webmd.com/baby/guide/second-trimester-of-pregnancy#1. Accessed on 28.09.17
  3. Best Home Remedies For Acidity When You are Pregnant. https://www.wellinghomeopathy.com/fertility-treatment/best-home-remedies-for-acidity-in-pregnant/. Accessed on 28.09.17


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