This is the beginning of the second trimester of pregnancy. The fetus has started to grow in size. The placenta is now developing even better and bigger in size and position of the placenta is now well determined. Amniotic fluid is also increasing to provide
Antenatal Visit form 14-21 weeks
Just like the other visit forms, it starts with the name of doctor or midwife, the date of examination being held. Other parameters like weight of the mother, her blood pressure, size of the uterus and pelvic or perineal examination are done.
Signs and symptoms
Its time when it is important to pay heed to the complaints of patient because she may reveal evident signs and symptoms of certain medical conditions in pregnancy like pregnancy induced diabetes mellitus; Pregnancy induced hypertension which can both lead to fetal compromise.
Ask the patient if she is suffering from nausea. She must get relieved by but only a certain percentage of females suffer from it throughout their pregnancy. Swelling of face, feet and ankle is also noticed. She may complain of increased body aches and urinary symptoms. She may complain of vaginal leaking which must be taken seriously.
Depending upon her symptoms, we do certain examination. As mentioned above, the physical examination generally and abdominal examination is also carried out.
Size of the uterus is measured from abdominal examination and correlated with her gestational age according to her last menstrual period.
Baby movements must be felt by the mother by 18 to 22 weeks of pregnancy, but they may or may not be visible or palpable on examination. We can confirm the fetal heart sound on sonic aid or through an ultrasound.
If the patient has complained of vaginal bleeding, leaking or discharge, we need to do her per speculum examination and take the sample to confirm it in the lab. We need it for the culture and sensitivity also. Amniotic fluid leaking can be confirmed by on spot dipsticks tests available in most of the well-equipped hospitals.
Abdominal ultrasound at this point is important because fetal anomalies are ruled out. The ideal gestation for an anomaly scan is 18 to 22 weeks. Downs syndrome, cardiac abnormalities, renal pyelectasis, esophageal defects, skull and brain defects and an-encephaly are all diagnosed at this time and mother should be counseled well in time.
Blood sugar test is done which is very important because normal pregnancy can bring about insulin intolerance from now onwards. If readings are high, we can go to further tests to confirm if she has developed Gestational Diabetes Mellitus.
Complete blood picture to check the status if hemoglobin
Urinary routine examination is also done. Females are prone to urinary infection in pregnancy.
Follow up instructions
About food, supplements, level of activity, and next follow up visit date is advised and written in the form.