Second Trimester Checklist
Current Guidance Update
Anomaly Scan
Anomaly scan is recommended at 18–22 weeks, assessing for neural tube defects, cardiac anomalies, facial clefting, and abdominal wall defects.
Gestational Diabetes Screening
A glucose challenge test or OGTT is recommended between 24–28 weeks in women with gestational diabetes risk factors.
Cervical Length Screening
Women with a prior preterm birth should undergo cervical length screening at 20 weeks, with cerclage considered if cervical length is under 25mm.
Iron & Folic Acid Supplementation
Iron and folic acid supplementation should continue throughout the second trimester to support maternal and fetal health.
Introduction
Second Trimester Appointments
16-Week Appointment
- Review of first trimester screening results
- Blood pressure measurement and urinalysis
- Discussion of serum screening results
- Initial birth planning discussion
- Anti-D prophylaxis for Rhesus-negative women
20-Week Anomaly Scan
Performed between 18 and 22 weeks, this comprehensive scan evaluates the brain and skull, facial structures, spine, heart, abdominal organs, kidneys, bladder, limbs, placental location, and amniotic fluid volume.
If any concerns are identified, referral to a fetal medicine specialist is recommended.
24–28-Week Appointments
- Blood pressure, urinalysis and symphysis-fundal height measurement
- Gestational diabetes screening (OGTT) for women with risk factors
- Repeat full blood count (FBC) for haemoglobin assessment
- Anti-D administration at 28 weeks for Rhesus-negative women
- Assessment of fetal movement patterns
Gestational Diabetes Screening
75g OGTT Screening
Gestational diabetes affects approximately 10–25% of pregnancies in the UAE. Screening is performed using a 75g Oral Glucose Tolerance Test (OGTT) between 24–28 weeks. Diagnosis follows WHO 2013 criteria: Fasting ≥5.1 mmol/L, 1-hour ≥10.0 mmol/L, 2-hour ≥8.5 mmol/L. Women with high-risk factors should be screened at booking and again at 24–28 weeks if the initial test is negative.
Fetal Development Milestones
Weeks 13–16
Facial expressions develop and external genitalia become differentiated.
Weeks 17–20
Rapid brain development continues, vernix caseosa forms and fetal movements become noticeable.
Weeks 21–24
Rapid weight gain occurs, surfactant production begins and viability threshold is approached.
Weeks 25–26
Brain folding develops further and the eyes become partially open.
Common Second Trimester Symptoms
Physical Symptoms
• Round ligament pain
• Backache
• Leg cramps
Other Changes
• Skin changes
• Mild oedema
• Braxton Hicks contractions
Warning Signs Requiring Urgent Assessment
Frequently Asked Questions
When should I feel the baby move?
First-time mothers typically feel movements between 18 and 22 weeks; women who have been pregnant before may notice earlier. A regular pattern should be established by 24–26 weeks; any sudden reduction should prompt same-day assessment.
Is it safe to travel in the second trimester?
Generally the safest time for travel. Long-haul flights carry a small DVT risk; compression stockings and regular mobilisation are recommended.
What does a low-lying placenta mean?
It does not necessarily indicate a problem at 20 weeks, as most migrate away from the cervix as the uterus grows. A follow-up scan at 32–36 weeks is arranged.
Conclusion
The second trimester combines important screening, monitoring, and clinical decision-making with the lived experience of a developing pregnancy. Adherence to a structured, evidence-based checklist ensures complications are identified early.
Sources & References
This article draws on guidance current at the time of writing from the following bodies and publications:
- ACOG (2024)
- RCOG (2024)
- NICE NG201 (2023)
- WHO (2024 ANC Model)
General reference bodies for women's health guidance:
RCOG
rcog.org.ukACOG
acog.orgFIGO
figo.orgWHO
who.intNICE
nice.org.uk⚠ IMPORTANT DISCLAIMER
This article is provided for general knowledge and reference purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. No medication, treatment, or change to your healthcare should be undertaken based on this content without first consulting a qualified doctor. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
Consult Dr. Ruby Rashmi
Specialist Obstetrician & Gynecologist, Dubai
