Third Trimester

LAB TESTS

You should plan to have your testing for gestational diabetes and anemia completed at 28 weeks. If you have not received an order by 28 weeks of pregnancy, please talk with your provider. If your initial test for gestational diabetes is elevated, we will arrange an additional three-hour diabetes test. If anemia is detected on your blood work, we recommend starting an additional iron supplement. These can be purchased over the counter at any drugstore. We recommend 45 mg of slow-release iron to be taken every other day. You should not take the iron with your prenatal vitamin (take one in the morning and one in the evening).

RHOGAM INJECTION FOR PATIENTS WHO ARE RH NEGATIVE

Your Rh status will be tested with your initial blood work. Patients that are Rh negative may require a Rhogam injection at 28 weeks. You do not need the injection if you are Rh positive. You also do not need the injection if you are Rh negative and the father of the baby is also Rh negative. If you are Rh negative and if we have not confirmed the father's blood type or the father is Rh positive, Rhogam will be ordered to be given at 28 weeks. Please ask us if you are unsure of your blood type, or if you are Rh negative and Rhogam has not been ordered.

PERTUSSIS VACCINATION

We recommend that all pregnant women receive the Tdap vaccine for pertussis. Pertussis is the virus that causes whooping cough. There has been an increase in whooping cough outbreaks. Infants that develop whooping cough can require hospitalization and can develop life-threatening respiratory illnesses. You can help protect your infant against whooping cough by being immunized during each pregnancy between 27 and 36 weeks. Other individuals that will be living in the house with your baby or who will be having frequent contact with your baby should have had the vaccine within the last 10 years. Please ask us if you have additional questions about the Tdap vaccine. Please notify your provider if this test has not been offered to you after 28 weeks.

CHOOSING A DOCTOR FOR YOUR BABY

If you have not already chosen a doctor to care for your baby after your delivery, you will want to make that decision soon. Please let us know when you have made this decision so we can include that information in your prenatal chart. The nursery at Sentara Martha Jefferson Hospital will notify that provider when your baby is born.