The second trimester of pregnancy, the middle period covering weeks 12 to 26, is another busy time for check-ups, tests and screening. Lets talk about the most common second trimester antenatal tests for women in good health having a ‘normal’ pregnancy. Extra tests and screening more often may be recommended by doctors depending on individual circumstances.
The three biggest fears during the second trimester are preeclampsia, gestational hypertension and gestational diabetes.
Preeclampsia is a condition that occurs only during pregnancy. Some symptoms of preeclampsia may include high blood pressure and protein in the urine, occurring after week 20 of pregnancy. Preeclampsia is often preceded by gestational hypertension. Testing the protein content in the urine can help detect preeclampsia.Preeclampsia affects at least 5-8% of pregnancies.
Gestational diabetes develops during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health.Glucose screening is a usually done towards the end of second trimester to rule out diabetes.
Blood pressure typically decreases during pregnancy due to new hormones in pregnancy and changes in your blood volume. Blood pressure usually reaches its lowest at 24 to 26 weeks of pregnancy. Some women have low blood pressure in their second trimester. As long as you feel well, it’s not a cause for concern.
High blood pressure can be dangerous during pregnancy. If your BP is high or increasing, your doctor may check you for other symptoms of gestational hypertension or preeclampsia. Many women have healthy babies despite high blood pressure during pregnancy, but others may become ill or give birth prematurely.
Each time you go in for a check-up, your doctor will check your Blood pressure and urine for the presence of protein and sugars. The greatest concern with protein in your urine is development of preeclampsia. This is high blood pressure with fluid retention in the body and excessive protein in your urine.
In some cases, you may be given medications to help lower your blood pressure.If your condition is serious, your doctor may want to admit you to the hospital for more thorough monitoring.
Screening for Gestational Diabetes
Typically done at 26 to 30 weeks, this is a routine test to detect pregnancy-induced diabetes, which can result in overly large babies, difficult deliveries and health problems for the woman and her baby.
What is glucose Tolerance Test ( GTT)
Doctors recommend that all pregnant women be screened for gestational diabetes using oral glucose tolerance test. For this test, you will have to drink a sugar solution. After set timings, you’ll have your blood drawn to check your sugar level.
If you have gestational diabetes, your body has trouble controlling the amount of sugar in your blood. Controlling your blood sugar level is important for a healthy delivery. You may need to make changes in your diet and exercise habits and if needed, take medication. Blood sugars come down to normal levels in most cases.
Ultrasounds are commonly offered at 10 to 14 weeks and then again at 18 to 22 weeks, although they may be done at any time during a pregnancy. An ultrasound may be offered for a variety of reasons, including verifying a due date, checking for multiple foetuses, investigating complications such as placenta praevia (a low-lying placenta), or slow foetal growth, or detecting malformations like cleft palate. During the procedure, a device is moved across the abdomen that transmits sound waves to create an image of the uterus and foetus on a computer monitor.
A detailed ultrasound scan, sometimes called the mid-pregnancy or 20-week scan or Anomaly scan is usually carried out when you are between 18 and 21 weeks pregnant.The mid-pregnancy anomaly scan looks for some physical abnormalities in the baby. The scan looks in detail at the baby’s bones, heart, brain, spinal cord, face, kidneys and abdomen.
Triple screen test
In select pregnant women, the doctor may recommend triple screen. In this test, the mother’s blood is tested for three substances. These are AFP,hCG, Estriol.
Screening test looks for abnormal levels of these substances and results are interpreted along with factors like the mother’s age, health history, and ethnicity. The best time for the test is between 16 and 18 weeks. You may want to discuss about the test and what it means for your current pregnancy if you get abnormal results. Discuss the options in case the test results come as abnormal, before you get it this test done.
You should see your doctor if you notice any abnormal signs or symptoms during your pregnancy like excessive weight gain, leg swelling, abdominal pain, severe headaches, reduced urinary output, dizziness, vision changes or excessive vomiting or nausea as these could be early signs of preeclampsia and gestational diabetes. Early intervention is necessary in these conditions.
Dr Prerna Gaur