2nd trimester of pregnancy: exams, ultrasound, what to do?

From the start of second trimester of pregnancy, pregnant women are generally less prone to symptoms in the first few months. This leaves a little respite to rest, take care of yourself, and re-energize. From the 4th to the 6th month of pregnancy, you will be followed, each month, with medical examinations, and in particular screening for gestational diabetes, to be done between the 22nd and 26th week of pregnancy. The 2nd ultrasound, called morphological ultrasound (around 22 SA) will make it possible to know the sex of the baby but also to detect any morphological anomalies. You will finally be able to announce to those around you that you are pregnant with a girl or a boy. This second trimester of pregnancy is also an opportunity to learn about childcare, but also your stay in maternity. Don’t forget to declare your pregnancy to your employer. Here is all our advice on the 2nd trimester of pregnancy, with recommendations from midwife Anh-Chi Ton.

When does the 2nd trimester of pregnancy begin?

The 2nd trimester of pregnancy begins from the 4th month of pregnancy (at 14 weeks or 16 SA) and ends at the end of the 6th month of pregnancy.

What weeks in the 2nd trimester of pregnancy?

The second trimester of pregnancy begins at 14th week of pregnancy (or 16th week of amenorrhea 16 weeks). It ends at the end of the 6th month, more precisely at 26th week of pregnancy (28 WA or week of amenorrhea).

What medical follow-up in the 2nd trimester of pregnancy?

Contrary to what is often imagined, it is not obligatory for the mother-to-be to ensure the follow-up of her pregnancy with a gynecologist. On the contrary, there are several possibilities. “Pregnancy monitoring can take place in the chosen maternity unit, either by an obstetrician-gynecologist or by a midwife if the pregnancy is going well.“, explains Anh-Chi Ton. Consultations can also be outsourced to a town practice with a gynecologist, midwife or general practitioner if the pregnancy is normal. A formula that more and more maternities are offering to unclog their services, provided that the pregnancy goes well.

“Early prenatal care takes place from the 4th month and allows you to set up birth preparation sessions

What tests and appointments in the 2nd trimester of pregnancy?

If the mother-to-be only has one consultation in the first trimester, follow-up will intensify in the second trimester at the rate ofone appointment per month. “Early prenatal care takes place from the 4th month and allows you to set up birth preparation sessions“, explains the midwife. Each month, the pregnant woman will therefore meet the specialist who monitors her for a obstetric consultation, of which Anh-Chi Ton details the course. Essential appointments to ensure that the pregnancy goes well.

Paraclinical examination

• Taking blood pressure, very important for screening for pre-eclampsia
• Urine dipstick (albuminuria and glycosuria)
• Weight gain

Examination

• Active movements of the fetus
• Uterine contractions: frequency, intensity…
• Other functional signs: loss of amniotic fluid, metrorrhagia, functional urinary and digestive signs, sleep status, possible pain.

Physical examination

• Fundal height measurement
• Palpation of the uterus: fetal presentation (upside down or other position?), flexible or contractile uterus
• Listen to heart sounds
• Possible vaginal examination, not systematic and only in case of clinical signs
• Possible treatments: Not systematic, depending on the case: pregnancy vitamins, paracetamol, phloroglucinol, compression stockingsiron supplementation, anti-hemorrhoid drugs
• Recommendations: vitamin D (cholecalciferol) 1 vial 100,000 IU around 28 weeks

What blood tests in the 2nd trimester of pregnancy?

During the first trimester, several blood samples are normally taken: blood group determination, trisomy 21 screening, serologies for toxoplasmosis, rubella, HIV, hepatitis B and C, syphilis TPHA-VDRL, and possibly CMV. “What hasn’t been done can always be done in the second quarter“, indicates the midwife. In addition to a toxoplasmosis serology every month if the pregnant woman is not immunized, certain exams must be done in the second trimester :

• At the 6th month, for all women, a platelet NFS control to check that there is no anemia,
• If the woman is Rhesus negative and her partner positive, the fetal genotype can be determined by maternal blood test. If the baby is Rhesus positive: RAI (irregular agglutinins) every month. An injection of anti-D immunoglobulins is then proposed around 28 SA.

When is the 2nd trimester ultrasound?

Is the second trimester of pregnancy what takes place second ultrasound. The one during which you will find out the sex of your baby, but which is above all very important to ensure its proper development. “It takes place around 22 SA, more or less a week, and its objective will be to detect possible morphological anomalies by taking several biometric measurements.“, explains Anh-Chi Ton. The doctor will take the measurement of the cranial perimeter, the abdominal perimeter, but also the length of the femur. Thanks to all of these measurements, he will also be able to give an estimate of the fetal weight. He will observe the cerebral echostructure, the kidneys, the heart, the digestive system. He will also observe the location of the placenta, the amount of amniotic fluid and determine the blood flow of the renal and umbilical arteries using Doppler.

When to screen for gestational diabetes?

Expectant mothers generally dread this very important examination. Between 22 weeks of pregnancy (24 WA) and 26 weeks of pregnancy (28 WA), the doctor or the midwife can finally prescribe to his patient (it is not obligatory) screening for gestational diabetes on risk factors:

• if she is over 35,
• a BMI greater than 25,
• personal history during a previous pregnancy,
• or if there is diabetes in the family in the first degree.

The examination takes place in two stages, first a measurement of fasting blood sugar, then during an OGTT, i.e. an oral induced hyperglycemia, one hour then two hours after ingestion of a standard amount of glucose.

What to eat in the 2nd trimester of pregnancy?

During the second trimester of pregnancy, future mothers must continue to eat a balanced diet and stay well hydrated. As a reminder, it is recommended not to exceed between 11 and 16 kilos during pregnancy. Certain cheeses, as well as raw meats and charcuterie are to be avoided, while alcohol and tobacco are prohibited.

What to do in the 2nd trimester of pregnancy?

In addition to the monthly examinations to be done each month, as well as the morphological ultrasound, the second trimester of pregnancy is also an opportunity to start learning about the childbirth preparation coursein order to know what suits you best, but also on the maternity choice where you want to give birth. Also remember to contact your complementary health insurance to check what the care during your stay in the maternity ward. Finally, from the 4th month of pregnancy, you can also declare your pregnancy to your employer. During the second trimester of pregnancy, future mothers already take the opportunity to learn about the custody methods. If you want to enroll your child in a crèche, for example, be aware that some cities make forms available at the start of the year for the start of the school year in September. Finally, even if you still have time, take advantage of this 2nd trimester of pregnancy to take stock of what you need to baby equipment.

Thanks to Anh-Chi Ton, midwife.