The 24-week prenatal appointment marks the approximate midpoint of the second trimester and prepares you for the final stages of pregnancy. This visit is typically your last monthly check-up before the frequency of appointments increases. The focus is a comprehensive assessment of both maternal health and fetal development, ensuring a stable trajectory as you approach the third trimester. This appointment includes standard checks alongside a specific laboratory test to screen for a common pregnancy complication.
Routine Prenatal Measurements and Checks
The appointment begins with routine checks that monitor your overall health status. A nurse or medical assistant will record your current weight to assess the rate of maternal gain since your last visit. Your blood pressure will also be taken to check for potential hypertensive disorders.
A urine sample is collected at each visit to screen for protein and glucose. The presence of protein can signal kidney function changes or the beginning of preeclampsia. Detecting glucose in the urine may suggest high blood sugar levels that warrant further investigation.
The physical examination includes the provider using a handheld Doppler device to confirm the fetal heart rate, which should be 110 to 160 beats per minute. The provider will also measure your abdomen using a tape measure to determine the fundal height. This measurement, taken from the top of the pubic bone to the top of the uterus, should approximate your gestational age, meaning around 24 centimeters is expected at 24 weeks gestation.
Understanding the Glucose Screening Test
The 1-hour glucose challenge test screens for Gestational Diabetes Mellitus (GDM). GDM is a temporary form of diabetes that develops when the body cannot produce enough insulin to manage rising blood sugar levels. The test is performed between 24 and 28 weeks, as this is when hormone levels that interfere with insulin function peak.
For the screening, you will drink a sweetened liquid that contains 50 grams of glucose. Fasting is not required for this initial screen, but you should only drink water after finishing the solution. A blood sample is drawn one hour later to measure how effectively your body processed the sugar load.
A blood glucose level below 140 milligrams per deciliter is considered a passing result. If your result is elevated, the next step is a 3-hour glucose tolerance test to confirm a diagnosis of GDM. Identifying this condition is important because careful management reduces the risk of complications, such as having a larger-than-average baby.
Fetal Milestones and Maternal Symptom Review
The provider will inquire about fetal movement, often called quickening, which is becoming more pronounced around this time. The baby is growing rapidly and weighs over a pound, making movements more consistent and noticeable. Providers assess fetal growth through the fundal height measurement and by reviewing the baby’s overall size and development.
The provider will also review any symptoms you are experiencing. Common discomforts around 24 weeks include heartburn, which results from the growing uterus pushing up on the stomach. Minor swelling, known as edema, may occur in the feet and ankles due to increased blood volume and pressure on veins. Other symptoms include back pain and sharp pains in the lower abdomen caused by the stretching of the round ligaments that support the uterus.
Preparing for the Third Trimester
The 24-week appointment is a natural point to discuss upcoming changes in your prenatal care schedule. You will schedule your next visit in four weeks, but soon after, appointments will increase in frequency. The standard schedule shifts to bi-weekly visits starting around 28 weeks, and then moves to weekly appointments from 36 weeks until delivery.
The provider will also review and educate you on the warning signs of certain complications. This includes symptoms that could indicate pre-term labor, such as persistent contractions or unusual vaginal discharge. Information regarding the Tdap (tetanus, diphtheria, and pertussis) vaccine may be provided, as it is recommended between 27 and 36 weeks of pregnancy to pass protective antibodies to the baby.