WEEK 28Trimester 3•Baby: Eggplant
Third Trimester Entry & Central Nervous System Maturation
Estimated Length37.6 cm
Estimated Weight1.00 kg
Fetal Morphogenesis & Anatomy Highlights
- •Fetus opens and closes eyelids; pupils demonstrate light reflex.
- •Brain tissue volume increases exponentially; cerebral sulci and gyri become pronounced.
- •Fetal bone marrow has completely assumed primary hematopoiesis from spleen and liver.
- •Surfactant production increases, though preterm delivery still carries risk of respiratory distress syndrome (RDS).
Same-Day Assessment / Urgent Care
Week 28 Urgent Red Flags
Immediate clinical evaluation or presentation to Winnipeg Obstetric Triage (HSC / St. Boniface) is indicated if:
- •Generalized severe pruritus, especially prominent on palms and soles without rash (Cholestasis of Pregnancy / ICP - check total serum bile acids)
- •Severe persistent headache, scotomata, visual blurring, right upper quadrant pain (Preeclampsia with severe features)
- •Decreased fetal movement
Women's Hospital HSC Triage: 204-787-8600 | St. Boniface: 204-237-2263
Clinician Perspective • Physiological & Screening Protocols
Maternal Physiological Adaptations
Third trimester begins. Maternal diaphragm displaced upward. Cardiac output peaks at 40-50% above baseline.
Expected Clinical Symptoms
Shortness of breath on mild exertion (diaphragm elevated by 4 cm)Pelvic girdle relaxation (symphysis pubis dysfunction pain)Restless legs, insomniaFrequent urination resumes
Clinical Investigations & Screening Schedule
- ✓Rh-immunoglobulin (WinRho SDF 300 mcg / 1500 IU IM) administered to all unsensitized Rh(D)-negative mothers.
- ✓Tdap immunization (tetanus, diphtheria, acellular pertussis) to maximize transplacental IgG transfer for neonatal protection.
- ✓Repeat antibody screen and CBC for anemia.
Upcoming Visit Horizon: Prenatal visits shift to every 2 weeks (28, 30, 32, 34, 36 weeks).