3rd Trimester Routine Tests & Office Visits

There are a number of tests that are recommended for screening in all obstetric patients. We follow the recommendations of ACOG (American College of Obstetricians and Gynecologists) and the CDC regarding recommended testing.

Every visit:

▪ Urine screen—We are checking the urine for the presence of glucose (sugar) and protein. Large amounts of sugar can be a sign of diabetes. Protein in the urine can be a sign of infection, kidney disease, or preeclampsia (high blood pressure associated with pregnancy).

▪ Fetal heart rate check—we will check for the baby’s heart rate at every visit. Early on we may not be able to heart it through the belly. In this case, we detect the fetal heart rate with ultrasound.

▪ Weight—we will follow your weights throughout the pregnancy. Please see the section: Weight Gain for more information on healthy weight gain during pregnancy.

▪ Blood pressure

30 weeks

We typically recommend performing the 4D ultrasound sometime around 27-31 weeks. This is an optional exam, but many patients are pleased with the pictures we are able to provide. Please see section labeled “4D ultrasound” for further details of this (LINK).

32 weeks:

▪ Hemoglobin—this is a test to check a red blood cell count. If low levels of red blood cells are found, this is consistent with anemia. Prenatal vitamins have iron in them to help treat and prevent anemia. Your doctor may recommend supplementation with more iron if these levels are low.

▪ Syphilis—syphilis is a sexually transmitted infection that can be passed to the baby. If it is not treated, it can cause serious problems to the baby. Syphilis can be treated and cured during pregnancy with penicillin.

35 weeks:

GBS screen; see section: 35 week Group B Strep Screening

36-40 weeks:

You will come to the office weekly. We will start doing cervical exams to see if the cervix is starting to dilate. If you are scheduling an induction, we will also schedule that around this time.

When your physician checks you, several things are being assessed:

▪ Cervical dilation—how open is the cervix? This is a number, measured in centimeters, typically between 1 and 4 (until you move into active labor).

▪ Cervical effacement—how much has the cervix shortened? The cervix is typically around 4 centimeters long. At the end of the pregnancy, it will become shorter and thinner. This number is a percentage from 0-100%

▪ Fetal station—this is a measurement of how far down the baby’s head is in the pelvis and is a number from -4 to +4.

▪ Fetal presentation—we can assess on exam what body part is presenting, in other words, whether or not the head is down.

As an example of above, when the cervix is fully dilated and the mother is ready to begin pushing, the usual exam is 10/100%/+2.