Second trimester of pregnancy is a whole new story. The symptoms of first trimester like nausea, vomiting and frequency of micturition subside and new features are observed. As usual the features are divided into two kinds: signs and symptoms.
Signs are those features which examiner has to elicit. Symptoms are felt by the woman. Moreover, symptoms are first observed by pregnant lady and they usually represent as complaint or observations to the physician.
It is the feeling of life; that is, perception of active fetal movements by mother. Usually it is felt by 18th week. In multipara woman it is felt two weeks earlier (by 16th week). Of course, progressive enlargement of lower abdomen is seen.
Common Signs Of Pregnancy In Second Trimester
A tan, discoloration of a woman’s face; mainly forehead and cheeks; which appears by 24th week.
Changes In Breast
Breasts become more enlarged with prominent veins. Secondary areola appears by 28th week. Montgomery’s tubercles (One of the sebaceous glands on the areolae of the breast that lubricate the breast during breast-feeding) become more prominent and extend to secondary areola.
Colostrum (Milky fluid secreted for the first day or two after parturition) appears by 16th week. Variable degree of striae (Any of a number of tiny parallel grooves such as: the scratches) is seen.
It is a linear brownish black pigment zone in the mid line; near symphysis pubis (A growing together of One of the three sections of the hipbone). It appears around 28th week because of heightened secretion of melanocytes stimulating hormone.
They are slightly depressed linear marks of various lengths over lower abdomen; more towards flanks. They are thin and white in color and they appear due to stretching of skin and aldosterone production.
Assessment of Height of Fundus
It can be manually assessed by simple examinations. It is midway between symphysis pubis and umbilicus at 16 weeks. At 24th week it is at the level of umbilicus.
At 28th week it is at juncture of lower 1/3rd and upper 2/3rd of the distance between umbilicus and xiphoid process (Smallest of the three parts of the breastbone; articulates with the corpus sternum and the seventh rib). At 36th week it is at the level of xiphoid process.
Braxton Hick’s Contractions
The uterine contractions in pregnancy are named as this. They are spasmodic, painless contraction with no effect on dilatation of cervix. Palpation of fetal parts is possible by 28th week. It helps to identify position and presentation. Active fetal movements are felt at intervals by placing the hand over uterus as early as 28th week.
Fetal Heart Sounds
They can be heard by 18th to 20th weeks. The sounds resemble the ‘tick’ of the clock under a pillow. Location of the sound varies as per the position of the fetus. Normal rate is 140-160 beats per minute.
The bluish discoloration of vulva, vagina and cervix continues and cervix becomes more softened. Thus, in second trimester all above mentioned signs and simple examinations can be observed.