The Last Three Months of Pregnancy: Essential Care, Risks and Support
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### The Last Three Months of Pregnancy: Essential Care, Risks and Support The last trimester of pregnancy, from 28 to 40 weeks are the most important and sensitive phases for both mother and baby. During this period the baby grows rapidly, the mother’s body undergoes major changes and the chances of certain complications increase. Because of this, prenatal care must be intensified with regular checkups, monitoring and emotional support. Two of the most common health concerns during this time are high blood pressure and gestational diabetes, along with conditions like anemia. #### High Blood Pressure in Pregnancy High blood pressure often develops after 28 weeks and is especially dangerous during pregnancy. Unlike normal hypertension, pregnancy-induced high BP can interfere with the functioning of vital organs of the women such as the kidneys, liver, brain, heart and blood vessels. When BP is 140/90 mmHg or above, the condition is known as Gestational Hypertension. If this elevated BP begins to affect the mother’s organs, it progresses to Pre-eclampsia, a more serious condition that can lead to Eclampsia, characterized by seizures. Severe cases may even result in HELLP syndrome, kidney failure or placental abruption, where the placenta separates from the uterus and cuts off blood supply to the baby. This leads to death of the baby inside the uterus. To detect these conditions early, pregnant women should visit their gynecologist every two weeks after 28 weeks. At each visit, BP must be recorded accurately and urine should be checked for albumin, an important indicator of pre-eclampsia. Extremely high systolic values (160–200) increase the risk of bleeding inside the brain. Hence, timely detection and treatment are critical. #### Gestational Diabetes (GDM) Gestational diabetes typically appears after 26 weeks. Women who are overweight, have a family history of diabetes or have previously delivered a large baby are at higher risk. GDM is usually diagnosed with a Glucose Challenge Test at 26 weeks, followed by repeat tests at 32 and 36 weeks, even if initial results are normal. During High blood sugar levels, glucose passes through the placenta to the baby, increasing fetal weight and causing metabolic changes. This may reduce fetal movements and in severe cases it is a risk to the baby’s life. Excessive fetal weight also makes normal delivery difficult, increasing the likelihood of a cesarean section. Babies born to mothers with GDM may experience low blood sugar levels and jaundice soon after birth. They must be fed properly and if breast milk is insufficient, doctors may recommend formula milk to stabilize their glucose levels. #### Anemia in late Pregnancy Anemia is also commonly seen during the seventh month and beyond. As blood volume increases during pregnancy, hemoglobin levels may drop, causing fatigue, breathlessness and complications during delivery. Therefore, iron-rich foods and iron with other vitamin supplements become essential during this stage. #### The Importance of Family Support Beyond medical care, emotional and physical support from partners and family members plays a major role. Understanding the mother’s physical discomfort and mental stress during the last trimester helps her feel confident and cared for. Such support not only creates a positive environment but also contributes to the well-being of the unborn child. The last trimester is truly a golden period and with proper care, monitoring and support, pregnancy can be a joyful and healthy experience for every mother. Dr. Lakshmi Ammal Consultant Gynaecologist SUT Hospital, Pattom