Second trimester of pregnancy [Tips and studies]

In the second trimester the nausea subsides and since the tummy is not yet so big the mother feels much more comfortable, she may even forget that she is pregnant, but don’t worry, your baby is there.

Maintaining a healthy pregnancy requires careful monitoring and attention to detail. Dr. Carlos Monsalve from Creafam explains some of the care you should take during the second trimester.

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In the previous video we talked about the importance of having at least one review consultation before deciding to get pregnant and the care to take during the first trimester. The first trimester goes from week 1 to 13 and if you remember correctly in week 12 the Screening of the first trimester is carried out. This study helps us to rule out chromosomal diseases. Now we have reached the 2nd trimester that goes from week 14 to week 28. The baby from week 14 is already over 9 centimeters and is perfectly well formed, it really looks like a miniature baby. You will notice that you will feel much more comfortable. In the first trimester there is the effect of nausea, vomiting. By the 2nd trimester these discomforts are usually gone and then they still don’t have such a big belly, so they often feel that they are not pregnant but don’t worry that your baby is there. They will begin to perceive the movements of the babies between the 20th and 22nd week before that, it is very unlikely that they will perceive these movements. Some mothers refer to these movements as little bubbles, others say that they are like a little fish, like a little worm that is running around. they will perceive that at night when they are calm and rested. Now yes, in this second trimester from week 20 you will begin to notice the tummy and it may even be advisable to buy a pregnancy bra and slightly looser clothing. The skin will begin to stretch and to avoid itching and stretch marks you have to keep it very well hydrated. We recommend that after bathing you apply cream on the tummy and breasts.

Until a few weeks ago, in the first trimester the embryo was fed by a nutrient bag called the yolk sac. Now from the 2nd trimester the baby is going to be fed through the placenta and you as mothers, with a good diet are going to help that placenta to provide better nutrients and oxygenation to the baby. At this stage, the mother and the baby begin to share food and although it is often said that in pregnancy you have to eat for two, not really, it is not about the mother eating twice as much. It is about the mother having an adequate diet that is nutritious, that she is healthy and the weight gain, that is, the increase in her weight, the mother is expected to gain one kilo per month. Sure, this can vary depending on your height, build, and the number of babies. It is not the same if they bring a baby or if they bring 2 babies or 3 babies, but if the weight increase is different from what is expected, this may indicate a poor diet.

What would be an adequate diet?

Well in this there are many ways. Ideally, a nutritionist could advise you on an adequate diet, but these are some tips to increase protein intake, preferably from fish, chicken, meat and seeds. Consuming 2 to 4 eggs a week always helps To avoid constipation, eat a diet rich in fiber, such as vegetables and cereals. Drink at least 2 liters of water daily. To avoid heartburn, you must avoid foods rich in fat, irritants such as coffee, chocolate, soft drinks, and citrus and spicy foods.

And the exercise?

Regarding exercise, there are 3 fundamental aspects: Avoiding risks of falls, protecting the back and strengthening the legs. To strengthen the legs we are going to recommend walking 20 or 30 minutes a day, it is more than enough. If it is within our possibilities, we can do prenatal yoga or pilates. Swimming, an excellent exercise to strengthen all the muscles of the back Right now in the 2nd trimester we can still have face up positions. Why? Because the baby’s weight is still not very great, once the baby’s weight is greater than one kilo, it is recommended not to have so much face-up position because this will compress certain vessels that will cause their blood pressure to drop.

Other recommendations

From the second trimester, circulation will begin to be affected, so we have to do certain situations or certain movements to avoid varicose veins, to avoid congestion, to prevent your legs from swelling. Some recommendations are going to be, that they do not spend more than 30 minutes in the same position if they have already been standing for 30 minutes, then sit down, if they have been sitting for more than 30 minutes get up and walk around a bit If they are women who are sitting for a long time due to the issue From work I will always recommend that you wear low compression stockings, this will help you improve your circulation. In the afternoons that you get home, always remember to raise them a little, that helps improve your circulation and those hot days where you have been standing or sitting for a long time, then getting home and using a massage or cold compresses help to improve your circulation. . To protect your back, avoid standing for too long.and. Please, when you bend over, bend over, reflecting on your knees, do not bend over behind your back. If your tummy is a little bigger, ask for help when you go to the supermarket, ask for help, let things happen to you. Do not carry heavy things, it is never recommended to carry more than 10 kilos. It is always important to reduce the risks of falls and to avoid them remember, if there is a railing, hold on to it when going up or down the stairs, avoid climbing on stools or chairs to reach high things. Do not wear high heels, they are starting to get used to low heels or tennis shoes and please, when walking, see where you are walking because with the distractions of the telephone, people can have an accident that can affect their pregnancy.

Important studies for the mother

In this 2nd trimester there are certain important studies for both the mother and the baby. Speaking of the mother, between week 24 and 28 blood tests must be done to study: Complete blood count, blood chemistry, the test for gestational diabetes and the urine test In the 2nd trimester, the amount of circulating fluid in the mother increases, which is why hemoglobin tends to drop, then what is a physiological anemia can occur, so it is important to detect if there is any anemia in order to correct it promptly.

The blood chemistry or the test for gestational diabetes should be done to any pregnant woman, between the 24th and 28th week, this will calculate the risk that a woman may have to present gestational diabetes and thus be able to correct it very early and avoid future risks to the baby.

The urine test is very important because, as we have discussed before, urinary tract infections are the main causes of abortion, the main causes of membrane rupture and the main causes of premature births. Urinary tract infections are commonly asymptomatic, so it must be done periodically throughout the pregnancy. Not only does it help us to detect urinary tract infections, it also helps us to detect risks of premature preeclampsia, that is, when we find protein in the urine and the mother’s blood pressure begins to rise, it is a source of alarm that we have to put a lot of attention.

Gestational diabetes is a complication that, as its name indicates, can only occur during pregnancy, that is, a woman prior to pregnancy had no problems with sugar, metabolized it well and has no knowledge of diabetes, but there are women who during pregnancy they do not metabolize those sugars well and those sugars generate what is diabetes during pregnancy. 90% of gestational diabetes is controlled with food, with diet, there are very few that will require medical treatment such as insulin to carry out this control, but its detection is very important to avoid future risks for the baby. Some early symptoms of preeclampsia are: High blood pressure, swelling of the hands, legs, face, feet or as we mentioned before; protein in the urine.

Let’s talk a bit about the mother’s blood type when a mother is OR rh negative or hers is rh negative and the father is positive it means that the baby can be positive or negative. When our concern? When a baby is positive and the mother is negative, but we won’t know that until the baby is born. But there are certain blood studies that must be done to the mother to determine if there is a risk that the mother is creating antibodies, that is, defenses against the baby’s blood that was positive. With which… It’s called CUMS , is a blood study that must be performed in the first and second trimester. If at any time this study is altered in the 2nd trimester, it is very important to apply a vaccine to prevent these antibodies from affecting your baby.

Important studies for the baby

Now, in the special studies for babies there are two that we can do during the 2nd trimester. One is the morphological study. We can do that between week 18 and 23. This study helps us to detect anatomical problems in the baby. We will see all his bone development, his brain, his face, his organs, hands, feet, kidneys, liver, gallbladder. Obviously we will know the sex of your baby with full certainty. So, it is a study that should be recommended to all pregnant women because there is no other study that will give them more peace of mind about how their baby is. As we have talked about the special studies for the baby: Screening of the first trimester, morphological study between week 18 and 23, there is another study that is carried out between week 26 and 30, which is fetal echocardiography. We at Creafam commonly perform it at week 28. This study is very important and helps us to detect heart problems in the baby, his heart anatomy. See that he doesn’t have any heart disease. Why is this important? If at any time we detect any alteration in the baby’s heart, even if we cannot do something at that moment, we can be very prepared for the time of birth. Have all the complete equipment to care for your baby. A cardiologist, sonographer, heart surgeon if necessary

What are our risk data during pregnancy, in the 2nd trimester?

One would be colic, pain, contractions… It would not be normal. One sporadically, it could be, but if they have colic continuously it is not normal. Two, liquid leakage, it is not normal. A membrane rupture can be a high rupture or a frank rupture where a lot of fluid or very little fluid can come out in either of the two situations. No bleeding in the 2nd trimester is normal either. Any alarm data that is: Fluid output, contractions or bleeding is important to see your doctor. After week 20 we already perceive the baby’s movements but they are not always strong and they are not constant and they are not all day. That is why it is not going to be a sign of risk, currently. We always recommend these 3 important studies regardless of whether they are our patients or outpatients. As outpatients, you can come to us to perform the first trimester screening, the morphological study and the fetal echocardiography. If they wish, from any moment of their pregnancy we can support them in accompanying them on this path of pregnancy until the birth of their baby.

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“Now that you know everything you need to take care of during the second trimester, come see us because you and your baby will receive the best Maternal-Fetal care here at Creafam”

Dr. Carlos Monsalve
Dr. Carlos Monsalve
Specialist in gynecology and obstetrics

Perinatology, invasive techniques and obstetric ultrasound.
Hospital Universitario La Fe, Valencia, España.

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