2546- Second Trimester
When does the second trimester occur?
13- 27 weeks
Fetal Viability
The ability for a fetus to survive out of utero
GA is significant here
Crown to Rump Measurement
16: 11.5-13.5, 100g
20: 16-18.5, 300g
24: 23, 600g
Fetal development: sensory
16: general sensory organs
20: nose and ears
24: can hear
Fetal development: Muscular
16: lightening, distinct bones
20: strong movements
Maternal Development: Cardio
increase in CO and BV
Maternal Development: Respiratory
Ribcage enlargement
URT: More vascularized, risk on infection
Maternal Development: Integumentary
Linea Niagra: Dark vertical liine on abdomen
20 wks: stretch marks
Hypertensive & pre-eclampsia
Visual distrubances
head aches
epigastric and abdominal pain
Comp: PROM
ROM before 37 weeks
comp: miscarriage
vaginal bleeding
severe abdominal pain
Comp: kidney stones
lower back and flank pain
Routine Prenatal Care
BP, wt, FH
Anatomy scan: 18-22 wks
Gestational Diabetes Mellitus
done between 24-28 weeks
50g glucose tolerance test with PG one hour after
Normal results: less than 7.8 mol/L
Neutral: 7.8-11 mol/L
Alternative test: 75g GTT
Abnormal and diagnosis right away 11.1 or greater
Amniocentesis
Transabdominal needle insertion to withdraw AF to collect fetal DNA etc
Recommend NIPT first