Second Trimester (13-28 weeks)
3-6 months.
1. Subjective symptoms
2. Objective symptoms
1. Subjective symptoms
a. Abdominal examination
1. Inspection
Linea nigra; dark pigmented line made from symphysis pubis to xiphisternum visible at 20th week.
Striae; (both pink and white)
Visible in lower abdomen (side stretch mark).
2. Palpation
a. Fundal height
Increased, enlargement of uterus.
Height of uterus is midway between symphysis pubis and umbilicus at 16 weeks.
Level at umbilicus at 24th week.
b. External ballottement
Through abdomen put hand on abdomen (20th week).
Feeling for movable object.
3. Auscultation
Doppler ultrasound device; 12 weeks
Fetoscopy; 18-20 weeks
Uterine Souffle;
Two other sound can confuse with fetal heart rate.
1. Maternal souffle; mother blood to placenta.
2. Fetal souffle; fetus blood to mother.
Rush of blood through umbilical artery.
General Examination
1. Chloasma
Pigmentation of forehead, nose, cheek (24 weeks).
2. Change in Breast
1. Enlargement of breast
2. Prominent veins under skin
3. Secondary areola appears 20th weeks
4. Montgomery's tubercles prominent, extend to secondary areola.
5. Colostrum become think and yellowish (16th weeks).
Vaginal Examination
1. Bluish discoloration of valva, vagina, cervix (softening of cervix).
2. Internal ballottement (16-28th week)
Through vagina; insert the right hand finger.
2. Subjective symptoms
1. Quickening; feeling of life inside womb.
2. Progressive enlargement
Investigation
1. Sonography (18-20 weeks)
Placental localization
Fetal anatomy; detect malformation, fetal cardiac motion
Integrity of cervical canal
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