Comprehensive diagnostics of the mother’s body in the second trimester of gestation.
It includes diagnostic procedures aimed at assessing the speed of the baby’s development by comparing the gestational age according to the protocols of the Ministry of Health of Ukraine.
The second trimester of pregnancy lasts from 14 to 21 weeks of gestation
In medicine, screening means identifying risk groups of pregnant women who may need a more detailed examination.
Screening is performed at 16-18 weeks of pregnancy
Why undergo diagnostics in the second trimester?
Since the risk of having a baby with various anomalies at the chromosomal and gene levels is always present, ultrasound and biochemical analysis is recommended for all pregnant women.
The specialists of the IVMED Family Source clinic have compiled a group of factors that require an examination:
- The age of the future mother is 35 years and older, the future father is 45 years and older
- Identified genetic diseases in family members
- Children with chromosomal and genetic defects were born
- There was also a history of pregnancy failure or miscarriage
- A pregnant woman suffered infectious diseases in the early stages of pregnancy when she took illegal drugs.
What is included in the second trimester diagnostics?
- Triple test – biochemical analysis of biological material (blood) for the level of AFP, hCG and estriol
- Ultrasound of the fetus – assesses the appearance, condition of internal organs, especially the placenta and chorion (amniotic fluid)
- Cordocentesis – additional analysis of amniotic fluid (if indicated)
Reference values of AFP
AFP is a protein compound that is produced in the organs of the fetal gastrointestinal tract.
A reduced AFP may indicate the following pathologies:
- Down syndrome
- Edwards syndrome
- Fetal death
- Incorrect determination of pregnancy duration
Increased AFP:
- Malformations of the nervous system in the fetus
- Nonunion of the anterior abdominal wall
- Umbilical hernia
- Meckel’s syndrome
- Esophageal atresia
- Fetal liver necrosis
| Weeks of pregnancy | Normal values of AFP, U/ml |
| 13-15 | 15-60 |
| 15-19 | 15-95 |
| 20-24 | 27-125 |
Reference values of hCG
At 15-25 weeks of pregnancy, hCG levels are normal: 10000-35000 mIU / ml
Reference values for estriol
Free estriol
is a hormonal substance produced in the placenta and liver of the fetus. If gestation proceeds normally, the amount of the substance is constantly increasing.
Low estriol levels may be the reason:
- diagnosis of Down syndrome
- diagnosis of fetoplacental insufficiency
- high risk of preterm labor
- infection of the fetus
- fetal anencephaly
- fetal adrenal hypoplasia.
Elevated levels of estriol provide grounds for diagnosis:
- multiple pregnancy
- diseases of the urinary system and liver pathologies in pregnant women.
| Weeks of pregnancy | Normal indicators of estriol |
| 15-16 | 5.4-21,0 |
| 17-18 | 6.6-25,0 |
| 19-20 | 7,5-28,0 |
Preparing for the second trimester screening
To ensure that the results of ultrasound and biochemical blood test are as objective as possible, doctors strongly recommend following the preparation recommendations:
- Dietary regimen: exclude chocolate products, seafood and citrus fruits, fried and fatty foods from the diet.
- It is not recommended to eat 12 hours before the biochemical blood test.
- When performing transabdominal ultrasound, it is necessary to fill the bladder.





