 	        			Changes in Your Body

Most women find the second trimester
of pregnancy to be easier than the first
trimester, but it is important to stay informed
about your pregnancy in this stage too. While you
might notice that symptoms like nausea and fatigue
are going away, you will see other new, more
noticeable changes to your body. Your abdomen will
expand as you gain weight and the baby continues
to grow. And before this trimester is over, you
will feel your baby beginning to move! Many of the
other symptoms you had in the first trimester
might also continue, like constipation or leg
cramps, so it is important to keep doing all of
the healthy things you have already learned to
help prevent or treat those symptoms. Here are
some things you might experience during this
trimester:

Aches and Pains

As your uterus and abdomen expands, you might feel
pains in your abdomen, groin area, or thighs. You
also can feel backaches or aching near your pelvic
bone from the pressure of the baby's head, your
increased weight, and the loosening joints in
these areas. Lying down, resting, or applying heat
can help resolve some of these aches and pains. If
pains do not get better after rest, it is best to
call your doctor.

Shortness of Breath

As your baby gets bigger inside your body, there
will be increased pressure on all of your organs,
including your lungs. You might begin to notice
that you are short of breath or might not be able
to catch your breath. Try taking deep, long
breaths and try to maintain good posture so your
lungs have room to expand. You might be able to
breathe more freely at night by using an extra
pillow or by sleeping on your side.

If you sleep on your left side, you will relieve
pressure on major blood vessels that supply oxygen
and nutrients to the fetus. If you have high blood
pressure, it is even more important to be on your
left side when you are lying down.

Stretch Marks and Other Skin Changes

Pregnant woman holding her bellyYou might have
heard stories from family members or friends about
the dreaded stretch marks from pregnancy. Stretch
marks are red, pink, or purple streaks in the
skin, usually over the thighs, buttocks, abdomen,
and breasts. They are scars caused by the
stretching of the skin, and usually appear in the
second half of pregnancy. Only about half of all
pregnant women get stretch marks though. They can
start out as pink, reddish brown, or dark brown
streaks, depending on your skin color. While
creams and lotions can keep your skin well
moisturized, they do not prevent stretch marks
from forming. Most stretch marks fade after
delivery to very light lines.

Besides stretch marks, you might notice other skin
changes in the second half of your pregnancy. You
might notice that your nipples are darker than
before becoming pregnant, or that you have a dark
line on your skin that runs down your abdomen from
your belly button to your pubic hairline, called
the linea nigra. You also might have blotchy brown
pigmentations on your forehead, nose or cheeks.
These skin changes are called melasma or chloasma.
They are more common in darker-skinned women.
These skin changes are caused by pregnancy
hormones, and most of them will also fade or
disappear after delivery.

Tingling and Itching

Tingling and numbness of the fingers and a feeling
of swelling in the hands are common during
pregnancy. These symptoms are due to swelling of
tissues in the narrow passages in your wrists, and
they should disappear after you deliver your baby.
It also is common to feel itchy as your pregnancy
progresses. Pregnancy hormones and your stretching
skin, especially over your abdomen, probably are
to blame for most of your discomfort. About 20
percent of all pregnant women have some kind of
itching. And many pregnant women also get red and
itchy palms and soles of their feet. Only in rare
cases do pregnant women develop a condition called
cholestasis of pregnancy, which is itching along
with nausea, loss of appetite, vomiting, jaundice
and fatigue. This condition is a sign of a serious
liver problem. In general, itching most often goes
away after delivery. In the meantime, you can
relieve itching with moisturizers. You can also
use only gentle soaps, and avoid hot showers or
baths that can dry your skin. Try not to get
over-heated since heat rash can make the itching
worse.

Changes in Your Baby

By the 26th week, your baby will weigh about 1¾
pounds and be about 13 inches long. With this
growth comes the development of your baby's
features, including fingers, toes, eyelashes, and
eyebrows. Around the fifth month, you might feel
your baby move! By the end of this trimester, all
of your baby's essential organs like the heart,
lungs, and kidneys are formed.

Prenatal Care

Visits and Tests

UltrasoundDuring the second trimester, your doctor
will be able to see if your baby is developing in
a healthy way and possibly see your baby’s sex.
You will be offered screening tests to look for
genetic birth defects. Birth defects result from
problems with a baby’s chromosomes, part of his or
her genes, which are passed down from both the
mother and the father at conception. Even though
most babies are born healthy, many genetic birth
defects occur without a family history of that
disorder. The risk for birth defects increases the
most at the age of 35 and older. These are some of
the tests that your doctor might offer you:


Screening Tests
Screening tests do not involve any risk to the
fetus or to the mother. Screening tests give
results in fractions or odds of having a birth
defect, based on the mother’s age. So, although
you will not receive a “yes” or “no” answer, women
under the age of 35 will find out if their risk is
as high as that of a 35 year old woman. For women
over age 35, the tests help them find out if the
risk for their age is increased or decreased.

    *

      Targeted ultrasound – The best time to
receive this test is between 18 and 20 weeks of
pregnancy. Most major problems with the way your
baby might be formed can be seen at this time.
Some physical defects such as clubbed feet and
heart defects may not be seen. Your doctor also
will be able to see if your baby has any neural
tube defects, such as spina bifida. In most cases,
if you want to find out the sex of your baby, you
can ask your doctor during this test. This test is
not the most accurate for finding out whether your
baby has Down syndrome. Only 1 in 3 babies with
Down syndrome may have an abnormal 2nd trimester
ultrasound.
    *

      Maternal serum marker screening (“the triple
test”)–This test which looks for birth defects
such as Down syndrome, trisomy 18, or an open
neural tube defect, is usually given between 15
and 20 weeks of pregnancy. It involves giving a
sample of your blood to look for 3 chemicals
produced by the pregnancy: alpha-fetoprotein (AFP)
(made by the liver of the fetus), and two
pregnancy hormones, estriol and human
gonadotropin. Higher levels of AFP are linked with
open neural tube defects. In women age 35 and
over, this test finds about 80% of fetuses with
Down syndrome, trisomy 18, or an open neural tube
defect. In this age group, there will be a false
positive rate (having a positive result without
actually having a fetus with one of these health
problems) of 22%. In women under age 35, this test
finds about 65% of fetuses with Down syndrome, and
there is a false positive rate of about 5%.
    * Nuchal translucency screening (NTS) – This
new type of screening is offered between 11 and 14
weeks of pregnancy. It involves an ultrasound exam
to look at the thickness at the back of the fetus’
neck combined with a blood test by sticking your
finger to look at two proteins produced by the
pregnancy. This test finds 90% of cases of Down
syndrome and 97% of cases of trisomy 18. The false
positive rate is about 5%. This test is not yet
widely used, and not all doctors have access to
it. In some cases, health insurance might not
cover it. In England and in the United States,
doctors who use the test feel that it is a good
option for many women.

Diagnostic Tests
Diagnostic tests can give definite answers about
whether your baby has a birth defect. But, unlike
screening tests, they are invasive or present a
risk of miscarriage. Amniocentesis and chorionic
villus sampling (CVS) are the two most commonly
used. Both tests are more than 99% accurate for
finding these problems. These tests also can tell
you your baby’s sex. In most cases, results take
about two weeks.

    *

      Amniocentesis – This test is performed in
pregnancies of at least 16 weeks. It involves your
doctor inserting a thin needle through your
abdomen, into your uterus, and into the amniotic
sac to take out a small amount of amniotic fluid
for testing. The cells from the fluid are grown in
a lab to look for problems with chromosomes. The
fluid also can be tested for AFP. About 1 in 200
women have a miscarriage as a result of this
test.
    *

      Chorionic villus sampling (CVS) – This test
is performed between 10 and 12 weeks of pregnancy.
It involves your doctor inserting a needle through
your abdomen or inserting a catheter through your
cervix to reach the placenta. Your doctor will
then take a sample of cells from the placenta that
can be grown in a lab to look for problems with
chromosomes. This test cannot find out whether
your baby has open neural tube defects. About 1 in
200 women have a miscarriage as a result of this
test.

When to Call Your Doctor

Woman talking on the phoneNow is a good time to
learn the signs of pre-term or premature labor.
Premature labor occurs when a woman has labor
before she reaches the 37th week of pregnancy, or
three weeks before her due date. If you and your
doctor see any symptoms of pre-term labor early,
there is a better chance of stopping it. If
symptoms are not treated, they can progress to
repeated contractions that might cause the cervix
to dilate (open) and cause an early birth of the
baby. Premature babies need intensive care in the
hospital after birth to help with their breathing,
feeding, and regulation of body temperature.

Any woman can have pre-term labor, but some women
have a higher risk because of problems with the
uterus or placenta, or because of having had a
pre-term birth with another pregnancy. Don't
forget to drink plenty of water to keep from
becoming dehydrated, especially in warm weather,
since dehydration can cause pre-term labor.

Call your doctor right away if you have any of the
following symptoms of pre-term labor:

    *

      Contractions — You may or may not have pain,
but your abdomen or stomach will get very hard (a
feeling like it is tightening) and then relax, on
and off.
    *

      Menstrual-like cramping — You may or may not
be uncomfortable with these cramps, but they feel
like the cramps you can get before or when you
start your menstrual period.
    *

      Gas-type pains — Feels like sharp pains in
your stomach, or like a stomach virus. You also
can have diarrhea or nausea.
    *

      Low pelvic pressure — Feels like the baby is
putting a lot of heavy pressure down very low
inside.
    *

      Low backache — Can be a strong or a dull
ache.
    *

      Blood from your vagina — Can be either light
spotting or more blood like during a menstrual
period. Blood can be red or brown in color.
    *

      Increased discharge from your vagina — Much
more discharge than what you are used to during
your pregnancy. Can even be a sudden gush of a lot
of water, or a small trickle or leak of water that
is continuous. Discharge can be watery, pinkish,
or brownish in color.

Caring For Yourself

Make sure to continue the healthy behaviors that
you learned in your 1st trimester to care for
yourself and the precious life inside of you.

Weight Gain

Everyone gains weight at different rates, but on
average, it is normal to gain about one pound per
week, or about three to four pounds per month
during this trimester.

This page last updated: January 2005

Source: Womenshealth.gov
Source: Womenshealth.gov