WHO Recommendations for Third Trimester Prenatal Visits
According to the WHO 2016 antenatal care model, pregnant women should have a minimum of 2 prenatal contacts during the third trimester (at 30 and 36 weeks), making the answer (e) 4 times incorrect based on WHO guidelines, though the evidence provided does not contain the specific WHO recommendation document.
Context and Clinical Implications
While the provided evidence does not include the specific WHO guideline document, I can address the broader context of prenatal care frequency based on available evidence:
Standard Prenatal Care Models
Traditional prenatal care in the United States consists of 12-14 visits per pregnancy, though evidence supporting this specific structure is limited 1
A reduced-frequency prenatal care model (OB Nest) with only 8 onsite appointments supplemented with 6 virtual visits demonstrated higher patient satisfaction (93.9% vs 78.9%) and lower pregnancy-related stress compared to usual care with 12 appointments 1
The OB Nest model maintained adherence to American College of Obstetricians and Gynecologists prenatal services and showed similar maternal and fetal clinical outcomes despite fewer in-person visits 1
Third Trimester Specific Considerations
Ultrasound monitoring: Routine third-trimester ultrasound screening in low-risk pregnancies has not shown evidence of improved antenatal, obstetric, or neonatal outcomes 2
High-risk pregnancies require more frequent monitoring: Multiple gestations need serial growth scans every 3-4 weeks starting from the anatomy scan, and monochorionic twins require weekly to biweekly monitoring 3
Group B Streptococcus screening: Testing should be performed between 36-37 weeks gestation 4
Important Clinical Pitfall
The question asks specifically about WHO recommendations, which differ from U.S. guidelines. The WHO 2016 model emphasizes a minimum of 8 contacts throughout pregnancy (reduced from the previous 4-visit model), with at least 2 contacts recommended in the third trimester. This represents a different philosophy than the traditional U.S. model of 12-14 visits 1, 4.
Quality of Care Considerations
Early initiation of prenatal care (at 10 weeks or earlier) improves outcomes regardless of total visit frequency 4
Well-coordinated prenatal care following an evidence-based process results in fewer hospital admissions, improved education, greater satisfaction, and lower pregnancy-associated morbidity and mortality 4