Third Trimester Pregnancy Care — Weeks 29 to 40
The third trimester — from 29 weeks to delivery — is focused on fetal growth surveillance, preparation for birth, and proactive management of late-pregnancy complications. Conditions such as intrauterine growth restriction (IUGR), late-onset pre-eclampsia, gestational hypertension, placenta praevia, and abnormal fetal presentation are either first identified or actively managed during this period. At Balaji Horizon Women’s Hospital, third trimester visits are structured to ensure no high-risk feature is missed before delivery.
Fetal Growth Scans with Doppler — 28–32 and 34–36 Weeks
Serial fetal biometry (head circumference, abdominal circumference, femur length) combined with Doppler velocimetry of the umbilical artery and middle cerebral artery allows early detection of fetal growth restriction. A small-for-gestational-age fetus with absent or reversed end-diastolic flow in the umbilical artery, or a high MCA PI (brain-sparing pattern), indicates fetal compromise and requires accelerated monitoring and delivery planning. We perform third trimester growth scans on Voluson machines using INTERGROWTH-21 centile charts.
Pre-Eclampsia and Hypertension Surveillance
Blood pressure measurement, urine protein (dipstick and spot PCR), and symptom review are done at every visit. Women on aspirin prophylaxis are reviewed for compliance. Severe hypertension (≥160/110 mmHg) with headache, visual disturbance, or epigastric pain constitutes a hypertensive emergency requiring immediate assessment and antihypertensive treatment. Delivery planning for pre-eclampsia is individualised based on gestational age, fetal wellbeing, and severity of maternal disease.
Fetal Presentation and Position Assessment
Clinical abdominal examination at 36 weeks assesses fetal presentation (vertex, breech, transverse). Persistent breech at 36–37 weeks is offered external cephalic version (ECV) — a procedure to turn the baby to vertex under ultrasound guidance, with real-time fetal monitoring. Where ECV is declined, contraindicated, or unsuccessful, planned caesarean section is arranged. Our team counsels all women on breech options clearly and without pressure.
Birth Plan and Delivery Counselling
At 34–36 weeks, we discuss your individualised birth plan. For low-risk pregnancies, labour onset between 38–40 weeks is anticipated and natural labour onset is supported. Induction of labour is recommended for post-dates pregnancy (NICE guidelines: 41–42 weeks), pre-eclampsia, IUGR with Doppler abnormality, gestational diabetes on insulin, or prelabour rupture of membranes. The indication, process, and risks of both vaginal delivery and caesarean section are discussed transparently, ensuring informed decision-making.
Breastfeeding and Newborn Preparation
Antenatal breastfeeding education is provided at 34–36 weeks covering latch technique, colostrum, demand feeding, and common early challenges. Neonatal vitamin K administration, early skin-to-skin contact, and newborn screening tests are explained. Couples are also counselled on contraception planning post-delivery at this visit.
Book your third trimester care: Call +91 +91 97234 31544 | Balaji Horizon Women’s Hospital, Science City Road, Ahmedabad.