The 22-week prenatal appointment places you squarely in the middle of the second trimester, a time often marked by increased energy and noticeable fetal activity. This visit represents a significant checkpoint, moving toward a detailed assessment of fetal growth and development. The primary purpose is to monitor your physical well-being and conduct a comprehensive structural survey of the developing baby. Your healthcare provider gathers precise measurements and information that will inform the remainder of your care plan.
Routine Physical Assessments
The appointment begins with standard checks that provide insight into your current maternal health status. Blood pressure is measured to screen for emerging hypertensive disorders of pregnancy, such as preeclampsia.
Your weight gain since the last appointment is recorded and assessed against recommended guidelines, which helps ensure adequate nutritional support. A urine sample is collected to check for protein, an early indicator of preeclampsia, and for glucose, which may suggest a need for further diabetes screening. These recurring measures establish a baseline for the quick detection of subtle changes.
The provider uses a Doppler device to listen to the fetal heart rate, confirming the baby’s well-being. The heart rate typically ranges between 110 and 160 beats per minute. A manual check involves measuring the fundal height—the distance from your pubic bone to the top of your uterus. At this stage, the measurement in centimeters should roughly align with the number of weeks you are pregnant, offering a simple screen for uterine growth and amniotic fluid volume.
Detailed Fetal Anatomy Screening
The detailed fetal anatomy scan, sometimes referred to as the Level 2 ultrasound or anomaly scan, is a major part of the 22-week visit. This in-depth imaging procedure systematically examines the baby’s entire structure and organ systems. A sonographer captures images to confirm the absence of major structural anomalies and assess physical development.
The scan includes an examination of the fetal brain, ensuring the proper development of structures like the cerebellum and lateral ventricles. The sonographer visualizes the baby’s face to check the integrity of the lips and palate. They also survey the spinal column from the cervical to the sacral region to rule out neural tube defects, ensuring the central nervous system is forming as expected.
Particular attention is paid to the fetal heart. The sonographer confirms the presence of four distinct chambers and observes the flow of blood through the major outflow tracts. This cardiac survey provides a detailed look at the circulatory system. The abdominal organs are also checked, including the stomach, kidneys, and bladder, to confirm they are present and functioning to process amniotic fluid.
Measurements of the head circumference, abdominal circumference, and the length of the femur are taken to estimate the baby’s current weight and growth trajectory. These biometrics are plotted on a growth chart specific to gestational age. The scan also assesses the placenta’s position, noting its proximity to the cervix, and confirms that the umbilical cord contains the expected three vessels.
The volume of amniotic fluid surrounding the baby is measured. Both too little or too much fluid can indicate potential issues with fetal kidney function or swallowing. If the baby is positioned favorably, the external genitalia may be visible, allowing for the determination of the baby’s sex, if desired.
Key Consultations and Planning
After the physical assessments and the detailed scan, a significant portion of the appointment is dedicated to a consultation with your healthcare provider. This discussion focuses on your current symptoms and provides guidance for the remainder of the second trimester and beyond. You will be asked about “quickening,” the term for feeling the baby’s first distinct movements, and advised on how to monitor this activity.
The clinician will review common physical changes and discomforts typical of this stage. These include mild dependent edema (swelling in the feet and ankles due to increased blood volume), back discomfort, and leg cramps. Advice is offered on posture, stretching, and hydration to alleviate these symptoms. Round ligament pain, felt as a sharp or dull ache in the lower abdomen or groin, may also be addressed as the uterus continues its rapid expansion.
Planning for the next phase of care is a key aspect of this consultation. The provider will discuss the upcoming glucose tolerance test, which is typically scheduled between 24 and 28 weeks to screen for gestational diabetes. This conversation offers an opportunity to plan for the logistics of this screening. The visit concludes with a review of your overall health, allowing you to raise any concerns and confirm the scheduling for your next prenatal appointment.