The 20-week prenatal visit is a significant milestone, marking the approximate halfway point of the pregnancy. This appointment often includes the detailed fetal anatomy scan, which provides a comprehensive assessment of the baby’s development and the health of the pregnancy environment. Preparing specific questions about the scan results and the logistics for the second half of the journey ensures you leave the appointment well-informed.
Questions About the Anatomy Scan and Fetal Development
The 20-week ultrasound, or fetal survey, is a detailed evaluation of the baby’s structural development. Inquire about the development of specific organ systems visible at this stage. Ask whether the four chambers of the heart, the two kidneys, the entire spine, and the brain’s main structures, like the cerebellum, appear structurally typical.
Ask about the biometric measurements taken, such as head circumference, abdominal circumference, and femur length, which calculate the estimated fetal weight. Inquire what percentile the baby’s growth falls into, noting that 10 to 90 is usually considered the expected range. Also, ask about the position of the placenta, specifically if it is lying low near or covering the cervix (placenta previa), which may require a follow-up scan later.
Check the status of the amniotic fluid, often measured using the Amniotic Fluid Index (AFI). Ask for the measured level to ensure it is within the normal range, as levels that are too high (polyhydramnios) or too low (oligohydramnios) can indicate an issue. If any findings were inconclusive or concerning, ask what specific follow-up procedures are recommended, such as a repeat scan or a referral to a specialist.
Questions About Current Maternal Health and Symptoms
The second trimester often brings new physical changes and discomforts. Ask your provider if your pace of weight gain is appropriate based on your pre-pregnancy Body Mass Index (BMI). For those with a healthy BMI, the typical recommendation is to gain about 0.5 to 1 pound per week during the second and third trimesters.
Discuss common second-trimester symptoms like leg cramps, which often occur at night. Inquire about strategies for managing heartburn, caused by pregnancy hormones relaxing the valve between the stomach and esophagus, and for handling back pain resulting from the growing uterus shifting your center of gravity.
Quickening, the first perception of fetal movement, typically occurs between 16 and 22 weeks. Ask your provider when you should expect to feel regular movements and what the initial sensations might feel like. Also, clarify the immediate warning signs that require urgent attention, including persistent headaches, sudden swelling in the hands or face, or unexplained vaginal bleeding or fluid leakage.
Planning for the Second Half of Pregnancy
The 20-week visit is an ideal time to plan for upcoming tests and appointments. Discuss the Gestational Diabetes Test (glucose challenge screening), typically scheduled between 24 and 28 weeks. Inquire about the preparation required, which involves drinking a glucose solution and having a blood draw an hour later.
If your blood type is Rh-negative, ask about the Rh immunoglobulin shot (RhoGAM), usually administered around 28 weeks. This shot prevents your body from forming antibodies against the baby’s Rh-positive blood, protecting future pregnancies.
Ask about the anticipated schedule for your third-trimester appointments, as frequency increases from monthly to every two weeks starting around 28 weeks, and then weekly from 36 weeks until delivery. Begin discussions about childbirth preparation, asking for recommendations for classes and hospital tours. Clarify the topics for an early birth plan discussion, such as pain management options.