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| |    Is it Normal? The Second Trimester Weeks 14-26 by Marjorie Greenfield, M.D. reviewed by Elizabeth Brandewie, M.D. Bleeding Cramps Vaginal pressure Vaginal discharge Vomiting Shortness of Breath The second trimester is often called the honeymoon phase of pregnancy, because most women feel energetic and comfortable in their bodies. Still, some symptoms can occur which may be hard to judge. Which are signs of a problem and which ones are just your body going through its changes? Here is a list of common symptoms, and guidelines to help you decide if you need to see your doctor right away or if it can wait. Of course, if you think something out of the ordinary is going on or you are very worried, you should use your own judgment about seeking medical care. Vaginal Bleeding Bleeding is not common in the second trimester but may occur after a vaginal examination or intercourse. Can usually wait for office hours: Light bleeding or spotting after sex or after an internal examination. Call immediately: For bleeding like a period or bleeding accompanied by pain or pressure. Cramps Infrequent and irregular cramping is quite normal at any stage of pregnancy. Menstrual-like cramps are particularly common after having sex, when your bladder is full, or for a short time after exercising. Round ligament pain can feel like a crampy or sharp pain on one side or the other, and is normal. Can usually wait for office hours: If you are less than 20 weeks pregnant and are having regular cramping that stops with rest and drinking lots of fluids. Call immediately: Cramping associated with bleeding or watery discharge; persistent cramping that doesn't resolve with rest and drinking fluids, especially if you are beyond 20 weeks pregnant. Vaginal pressure The more babies you have had, the more likely you are to experience some vaginal pressure as your uterus grows. Occasionally, though, pressure can be a sign of premature dilation of the cervix or preterm labor. Can usually wait for office hours: A heaviness or pressure sensation in the lower abdominal or vaginal area that resolves when you lie down. Call immediately:.For a feeling of pressure within your vagina that doesn't resolve with rest. Vaginal discharge The normal vaginal discharge of pregnancy is thin, white, and odorless. Discharge that differs from this can be a sign of infection, or in rare cases a sign of a pregnancy complication like premature rupture of the membranes or premature dilation of the cervix. Can usually wait for office hours: Vaginal discharge that is itchy, irritating or malodorous. Call immediately: For vaginal discharge that is copious and watery, which might indicate that you have broken your water; for a mucous discharge with blood mixed into it, which can be an indication that the cervix is starting to open. Vomiting For some women, morning sickness persists into the second trimester. Heartburn can sometimes cause nausea and is usually relieved with antacids like Mylanta. New onset of nausea and vomiting this late in pregnancy is usually an intestinal virus, and should resolve within 48 hours. Can usually wait for office hours: Vomiting numerous times during the day that is interfering with daily functioning; vomiting with diarrhea and fever. Call immediately: Vomiting up blood; if you are unable to keep any liquids down for 6 hours or more; for dizziness or decreased urination that might be a sign of dehydration. Shortness of Breath A feeling of having to work a bit harder to get air is a common sensation in pregnancy. You may find that you sometimes have trouble with stairs or a brisk walk, or even completing a long sentence. The big concern here is that pregnancy is a time when your blood is very coagulable (clottable) and blood clots, which form in the veins of the legs or pelvis, may travel to the lungs, causing a pulmonary embolism. Pulmonary embolism, which usually causes severe shortness of breath and rapid breathing, is a medical emergency. Can usually wait for office hours:A sensation of shortness of breath that is tolerable and resolves with rest. Call immediately: Severe shortness of breath, especially if accompanied by a rapid heartbeat, chest pain, or lightheadedness. If you are so short of breath that you cannot speak comfortably, see your doctor or go to the nearest emergency room immediately.
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