What to Expect from Your OB-GYN

The Second Trimester

The Normal Pregnancy:

The second trimester (weeks 12 to 24) is when most pregnant patients feel their best. The miscarriage scare, cramping, and nausea recede, allowing some time before the third trimester brings its own set of concerns and discomforts. Fundal height and fetal heart tones are recorded each visit, with visit intervals ranging between every two to four weeks, depending on your doctor. Blood pressure, weight, and urine surveillance also continue.

The second trimester is normally a quiet time when the generalities of maternal and fetal health and appropriate fetal growth are observed. A free exchange of questions and answers during your visits addresses those things important to you as a prospective mother, and a caregiver's particular communicative skills will determine the quality of your education as it pertains to your particular pregnancy.

Between 15 and 20 weeks, you should expect to be offered an alpha-fetoprotein (AFP) test to screen for neural tube defects (such as spina bifida) and Down syndrome. If you're over 35, you will be offered an amniocentesis for genetic studies. (Other genetic studies are available at 10 weeks, such as chorionic villus sampling.)

New and strange pains come and go now as your growing baby competes for space. The baby will win, of course, so shortness of breath, ligament pains, nerve tingling, and other unusual effects occur around this time. Your doctor will begin to look for signs of preterm labor or, if there's a history of preterm deliveries, incompetent cervix.

Fetal movement, a sign of well-being, usually happens around eighteen weeks. Called "quickening," the movements become more organized over time, and an obstetrician will be wary of any decreased movement. Problems with movement or appropriate growth will prompt additional ultrasound studies to exonerate the health of your pregnancy.

The High-Risk Pregnancy:

Problems that can make you high risk in the second trimester include:

• The high-risk factors from the first trimester
• Incompetent cervix, increasing the risk of preterm delivery
• Bleeding (due to placental abruption or previa)
• IUGR (Intra-uterine growth restriction–a baby small for the corresponding gestational age
• Gestational diabetes
• Pregnancy-induced hypertension
• Sporadic or non-compliant prenatal care
• Preterm labor
• Kidney infection
• Premature rupture of membranes (or leaking)
• Abdominal tenderness of the uterus (possible infection of the pregnancy)