Ultrasound in the second and third trimesters of pregnancy

In the second and third trimesters, ultrasound begins to reveal not only what the fetus looks like, but also how it functions physiologically. Some minor asymmetries of the brain or heart are not developmental errors, but signs of an organism that temporarily adjusts its architecture to conserve energy and oxygen. These adaptations may appear and disappear without leaving traces, and their diagnostic value lies precisely in their transient nature.
🧬The placenta, often assessed only briefly, can indicate functional changes much earlier than commonly believed — through subtle variations in texture and degree of maturation, even before Doppler flow alterations occur. In the third trimester, fetal breathing movements reflect not only preparation for extrauterine life, but also the maturity level of neurological centers, sometimes being more sensitive to metabolic stress than classical biometric parameters. At the renal level, contours and echogenicity may fluctuate without pathological significance, while the stability of amniotic fluid remains a more reliable indicator of fetal functional balance. Viewed in this way, late ultrasonography becomes less a tool of “confirmation” and more a means of reading biological adaptation in real time.

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