What No One Told You: Complications & the Second Trimester

Complications to Watch for During Your Second Trimester

In part one of our series, “What No One Told You About Having a Baby,” Dr. Andrew Stahler, an obstetrics and gynecology specialist with Baptist Medical Group, discussed what you need to know about preconception care and the first trimester of pregnancy. Today, we sat down with Dr. Elizabeth McAdory, a board-certified OB-GYN at MOGA in Southaven, MS, to talk about potential complications that can arise during the second trimester and what to watch out for as you enter this phase of your pregnancy.

Common Second Trimester Complaints

One issue some women may experience in their second trimester is bleeding, though this doesn't always mean something is wrong. "Bleeding doesn't necessarily mean there's a problem," said McAdory. "If it's light bleeding and it goes away quickly, this is very normal and common. Heavier bleeding that looks more like a period, lasts for a long time, or is accompanied by stomach cramps can be a cause for concern, though, and you should get checked out by your doctor." Another common complaint in the second trimester is round ligament pain. The round ligaments are located in the pelvis and help support the uterus. "As the baby grows it starts to stretch everything out, and those ligaments can start to pull and cause a sharp pain down the side of the abdomen or even into the groin area," said McAdory. "This can be concerning if you're not expecting it, but it's completely normal."

Gestational Diabetes

Gestational diabetes can be a serious concern during pregnancy. For some women, hormones present during pregnancy can cause the body to make less insulin or not respond as well to insulin, making the body behave like it is diabetic during pregnancy. To screen for gestational diabetes, health care providers typically use a two-step process. First, your physician will have you consume a drink containing 50 grams of sugar and then check your blood sugar one hour later to see how your body responded. If your blood sugar is in a normal range (typically less than 140 mg/dL), you do not have gestational diabetes. If your blood sugar is higher than normal, that's still not enough to diagnose you with gestational diabetes. Next, your physician will test your blood sugar while fasting, then have you consume a drink containing 100 grams of sugar and check your blood sugar every hour for three hours. If you fail two of these four blood sugar tests, you have gestational diabetes, and your health care team will begin counseling you on how to manage it. If it's not closely monitored and controlled, gestational diabetes can cause high blood sugar that can affect your pregnancy and your baby's health. It also puts the baby at higher risk of being overweight, which can put the mother at greater risk for Cesarean-section delivery or potential complications during a vaginal delivery. "The good news with gestational diabetes is that it goes away at the end of the pregnancy," said McAdory. "You will have a higher risk later in life for developing Type 2 diabetes, though. So, you want to continue to eat healthy and exercise regularly. Do all of the things you would do to prevent diabetes in the future."

Hypertension (High Blood Pressure)

While physicians monitor for high blood pressure throughout a pregnancy, it's especially important to keep an eye on it during the second trimester. "If we know you have high blood pressure before you're 20 weeks pregnant, it most likely means you have chronic hypertension, meaning you have high blood pressure outside of pregnancy," said McAdory. "If you have high blood pressure after 20 weeks, then it's typically a pregnancy-related issue." Women who have hypertension during pregnancy face a higher risk for developing worsening blood pressure problems at the end of the pregnancy, including preeclampsia and gestational diabetes. Physicians will typically check blood pressure at every prenatal visit to monitor for these conditions.

Family History Matters

Having a good understanding of your own health and your family history can help you and your health care team know what to watch out for in your second trimester. "Typically, you get an ultrasound at 20 weeks to look for any signs of birth defects," said McAdory. "It's helpful to know if your family has a history of birth defects or genetic issues, because we can specifically focus on those areas in the ultrasound or offer you additional screening tests." Patients with preexisting conditions like diabetes or high blood pressure, patients who are overweight, and patients with a family history of diabetes can also be at a higher risk for gestational diabetes. If health care providers know this ahead of time, they can begin screening for the condition earlier in the pregnancy. "It's also good to know about any issues the patient had with previous pregnancies," said McAdory. "There's going to be a higher risk for that to happen again, so we want to start screening for problems earlier."

The Good News

Round ligament pain and light bleeding aside, McAdory says many women actually feel better in their second trimester than their first. "Many women tend to get more energy than they had in the first trimester," said McAdory. "Your nausea usually gets better or completely goes away, and you're just a lot more comfortable. It's still important to keep up with your prenatal appointments in the second trimester, though! These give us the opportunity to detect possible problems early in the pregnancy." To learn more about Baptist DeSoto maternity offerings, view the full-service listing. If you need a doctor for your pregnancy journey, see a list of physicians here.