Second Trimester Routine Visits

by Dr. Gerard M. DiLeo

On the medical record, these rates are recorded. They typically slow down over the course of the entire record. FHR in the second trimester is usually from around 180 (early) to about 160-ish (later). By term, the FHR will be from 120 to 160. These are very fuzzy ranges and the FHR on the same baby can vary wildly as well, which is why you can't tell the gender from the FHR.

The FHR during the second trimester, especially before 21 weeks, can be irregular. Just as your baby's liver needs to mature to prevent jaundice and her lungs need to mature so as to breathe air, so too the electrical pathway of her little heart goes through maturation so as to correctly deliver the pulsations that'll drive the roughly two and half billion heartbeats after birth. Give or take a few. It's a quirk of normal maturation, but sometimes ultrasound views of the heart or Doppler audio will reveal a fetal cardiac arrhythmia that is absolutely terrifying. I've even seen a 20-week baby's heart stop cold for a moment, only to restart, the child hopping around like nothing happened. Although a developing baby may truly have a heart condition, fetal echocardiography can document otherwise for reassurance. These babies that give the second trimester cardiac frights almost always go on to have no problems at all.

Reflexes and Other Miscellaneous Recordings on the Prenatal Record

The prenatal record is a very personalized documentation, depending on your doctor. More than likely he has personalized it himself. The American College of Obstetrics and Gynecology has its own recommended record, but doctors for the most part design or choose the type they can most easily work with.

Your doctor may have other fields in the grid for things such as reflexes (hyperactivity of which is one of the signs of pre-eclampsia), nausea (mainly a first trimester occurrence), contractions (to watch for troubling preterm labor patterns), and fetal movement.

Fetal movement (FM) is made unnecessary by recordings of the FHR, but reports of a change in the amount of movement would qualify for a special notation, because your doctor is always on the look-out for decreased fetal movement as a sign of fetal jeopardy. This is different from a change in the type of movement, because as your baby gets bigger, you should expect the discrete kicks and flips to settle into more of a squirming and rotational quality - there's just less room for acrobatics.

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