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Second trimester, provider appointment #1 (week 16)

Now that you’re in the Second Trimester, your prenatal appointments will become shorter, only about 15 minutes each. These visits will begin like any other, with your healthcare provider checking your weight and blood pressure to make sure that all is progressing smoothly.

Your healthcare provider will probably measure the height of your uterus, which can very much help to determine how big Baby is growing. Your healthcare provider will also listen to his heart rate with a fetal doppler. In addition, if you did not undergo any screening at your last appointment, your healthcare provider may recommend that you take a test like the quad screen, which can identify possible cases of chromosomal, or other developmental abnormalities. The quad screen tests the blood for the following substances:

  • Alpha-fetoprotein (AFP): Produced by the fetus, AFP is a protein that when found in excessive amounts can indicate a neural tube disorder like Spina Bifida, and in deficient amounts, a chromosomal abnormality (Down Syndrome, Edwards Syndrome).
  • Human chorionic gonadotrophin (hCG): A hormone produced by the placenta, abnormal levels of hCG can indicate a chromosomal disorder like Down Syndrome or Edwards Syndrome.
  • Estriol: Produced by both Baby and placenta, abnormal levels of estriol can indicate a chromosomal disorder.
  • Inhibin-A: A protein produced by both baby and mom, of which high levels of which can indicate a chromosomal abnormality.

If any of these readings comes back irregular, your physician will discuss with you options for additional confirmatory genetic testing like an amniocentesis, a diagnostic test performed between weeks 16-20 that samples your amniotic fluid for more conclusive results about any chromosomal abnormalities. The amniocentesis is an invasive procedure, and involves a small risk of miscarriage (1 out of every 350 or so), but can diagnose conditions as opposed to just screening for them.

Your healthcare provider may also have you schedule your routine 20-week anatomy ultrasound at this time, which is often immediately before your next prenatal visit.


Reviewed by Dr. Jamie Lo
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Sources
  • Sir John Dewhurst. Dewhurst’s Textbook of Obstetrics and Gynaecology. 8th ed. Keith Edmonds. John Wiley and Sons Ltd, 2012. Print.
  • “Maternal Serum Alpha-Fetoprotein (MSAFP).” Penn Medicine.the University of Pennsylvania, 12/9/2012. Web.
  • Leann Mikesh, PhD. “hCG Levels After a Miscarriage.” Livestrong. Livestrong, 4/16/2015. Web.
  • Mayo Clinic Staff. “Prenatal testing: Is it right for you?.” Mayo Clinic. Mayo Clinic, 8/22/2015. Web.
  • Mayo Clinic Staff. “Prenatal testing: Quick guide to common tests.” Mayo Clinic. Mayo Clinic, 8/8/2015. Web.
  • “ACOG’s Screening Guidelines on Chromosomal Abnormalities.” ACOG. American College of Obstetricians and Gynecologists, 5/7/2007. Web.

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