Second Trimester Doctor Visits
By Julianne Deveraux
Step right up
Throughout your second trimester, you'll
continue to visit your doctor once a month -- as long as your pregnancy
is progressing normally. Each appointment probably will begin with you
stepping on the scale.
Monitoring your weight gain
your fourth, fifth, and sixth months, you should be gaining one-half to
three-quarters of a pound a week. By tracking your weight, your doctor
can estimate your baby's growth and watch for signs of preeclampsia.
Doctors stress that you should try hard to stay within a 25- to
35-pound weight gain. Straying too far from this guideline can lead to
By gaining too much weight:
- You put extra stress on your heart, which already is working overtime to pump your increased blood volume.
- You put additional stress on your joints, which pregnancy hormones have loosened and made lax.
- You increase your risk of developing preeclampsia, a serious condition that can be life-threatening.
- You'll be more likely to develop aches in your lower back.
- You may make labor and delivery more difficult because your baby will be big.
- Urinalysis This test, performed at each doctor's visit,
measures the protein and sugar in your urine. It will detect excess
protein, which can be a warning sign of preeclampsia. Urinalysis also
may be used to detect the presence of drugs or bladder infection.
- Triple marker test This blood screening usually is
performed between the fifteenth and eighteenth weeks of pregnancy. Part
of the test measures a specific protein, alpha-fetoprotein or AFP, in
your blood. If the AFP levels are high it may identify a neural tube
defect; if AFP levels are low (combined with abnormalities found in two
other tests) this may identify Down Syndrome.
- Rhesus (Rh)-antibody-level test (a blood test) for
rhesus negative women. Most people have a specific protein in their
blood called the Rh factor. Those who don't are Rh-negative. If a woman
tests Rh-negative, the father of the child also must be tested for his
Rh factor because problems arise when an Rh-negative woman conceives a
baby with an Rh-positive man. The tests are done about halfway through
the pregnancy, or at once if the woman has a bleeding problem.
Rh-positive baby's blood factor, also called an antigen, can stimulate
an intense immune response in his mother. The problem isn't so great
with a first pregnancy, where the mother's body hasn't yet built a
strong immune defense against her child's blood. But a second pregnancy
can be tragic. The mother's antibodies can cross the placenta and
terminate the pregnancy. Fortunately, a substance called Rh-immune
globulin, injected into the mother, can protect the baby.
- Ultrasound This test uses high-frequency sound waves to
visualize the unborn baby. It's been used for more than 25 years, and
it appears to be safe for both the mother and fetus.
today's obstetricians even have the capability of performing ultrasound
tests right in their offices. The doctor will coat your abdomen with
mineral oil or gel to minimize the loss of ultrasound waves where the
transducer meets the skin. Then she will move the transducer gently and
smoothly over your stomach, allowing the sound waves to pass through
into your abdominal cavity. The waves will bounce back to the
transducer, forming an image that's displayed as a picture on a
monitor. With a vaginal ultrasound, the transducer is placed in the
vagina to let the doctor see the early pregnancy sac and detect any
An ultrasound examination can detect a
pregnancy as early as six weeks after your last menstrual period and
show the baby's movements at approximately 12 weeks of gestational age.
- Extra test for older moms-to-be: Amniocentesis This
test of the fluid that surrounds your baby detects chromosomal and
other genetic disorders, such as Down syndrome, hemophilia, and
sickle-cell anemia. It usually is performed on women over 35 when
they're 15 to 16 weeks pregnant, and on women who have an abnormal
triple-screen result. The procedure is done by inserting a long, thin
needle through the abdominal wall to remove a sample of amniotic fluid.
This fluid then is genetically studied in the laboratory.