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The second trimester of pregnancy is full of significant changes in the woman’s body, noticed by herself and the environment. The enlarging uterus leads to a visible enlargement of the abdominal circumference. There are skin changes in the form of stretch marks.
There are complaints in the form of constipation, low back pain, hemorrhoids. The amount of discharge in the vagina increases significantly, and the vestibule may also become swollen and blue. These changes are accompanied by mental changes in the form of changing moods, changes in appetite. About the 20th week of pregnancy, the first fetal movements appear at first resembling symptoms of indigestion, gurgling in the intestines, waterlogging, and finally they can be recognized as the movements of the developing baby. In multiparous women, fetal movement is slightly earlier felt around week 18 of pregnancy.
Symptoms that are disturbing at this time may concern the developing fetus, pregnancy and the pregnant woman herself. If the woman does not feel the fetus movements despite the expiry of the term, i.e. around the 20th week of pregnancy, the condition of the fetus should be checked by ultrasound, the mobility of the fetus and its heart rate should be assessed. Reassuring the mother in this regard and showing her that the child is alive and well, most often results in the fact that she herself soon recognizes his movements.
If a woman is bleeding, it is an urgent signal to see a doctor immediately, preferably in a hospital. The causes of bleeding can be many, ranging from trivial ones like the polyp of the cervix or the ectopy of a pregnant woman, to the placenta, or detachment of the properly seated placenta. In the event of significant bleeding, there is a serious risk of miscarriage up to the 22nd week of pregnancy, or preterm delivery after the 22nd week of pregnancy. Given the significant immaturity of the fetus at this time, pregnancy may result in the birth of a child unable to live independently. Massive bleeding is a threat to the life and health of the mother, therefore there is no point in wasting time visiting the attending physician in the clinic or office. The woman must be under strict hospital supervision.
If a woman has diagnosed the discharge of amniotic fluid, she most often has the impression that she has urinated unknowingly, and it also requires immediate medical consultation. The doctor may find that fluid is draining during the examination, and if the situation is unclear, he or she may perform additional tests to confirm the nature of the vaginal discharge. Occasionally there is a massive infection-related discharge during pregnancy, which may mimic the run-off of amniotic fluid. The fact of amniotic fluid outflow, unfortunately, does not bode well for the further development of pregnancy, it can lead to miscarriage, premature birth or infection both intrauterine and pregnant.
The appearing swelling of the lower limbs should cause anxiety and the need for urgent, but not immediate, contact with a doctor, unless it is accompanied by an increase in blood pressure – then immediately. The same is true for spots that appear in front of your eyes, sudden headaches, and blurred vision. In the past, this condition was called pregnancy poisoning, today we are talking about pre-eclampsia. A woman needs an urgent consultation with a doctor in the maternity ward.
If a woman feels contractions of the uterine muscle, these are most often the so-called Braxton Hix contractions and testify to normal contractility of the “training” uterus before delivery. However, if contractions are frequent, not a few to a dozen a day, but much more, or if they occur regularly, they require urgent consultation with a doctor. The uterus as hard as a stone for a long time also requires urgent consultation.
Varicose veins may appear on the lower extremities and around the perineum. This fact should also be reported to the attending physician in the form of the next scheduled visit. Your doctor may recommend the use of blood vessel tension medications or gradual compression stockings.
Symptoms of increasing heartburn, constipation, abdominal distension, pollakiuria accompany the enlarging uterus and are not a cause for concern, apart from the unpleasant sensation itself. They can be prevented by using a proper diet, exercise, or possibly medications.
Text: lek. med. Ewa Zarudzka