Pregnancy is accompanied by progressive physiological, metabolic, haematological and cardiovascular changes that vary across gestation. Antenatal care provides an important opportunity for detecting deviations from expected physiological changes and identifying conditions that may threaten maternal and fetal wellbeing. Although antenatal care coverage is an important measure of maternal-health service utilization, the clinical value of antenatal care depends substantially on the systematic measurement and interpretation of maternal and fetal indicators throughout pregnancy. This study therefore proposes to examine the pattern and clinical significance of selected maternal health indicators across the first, second and third trimesters among pregnant women attending antenatal care at Braithwaite Memorial Hospital, Port Harcourt, Nigeria. Objective: To determine whether selected maternal health indicators differ significantly across pregnancy trimesters and to examine their clinical significance for maternal health surveillance during antenatal care. Methods: A hospital-based analytical cross sectional study were conducted among pregnant women attending antenatal care at Rivers State University Teaching Hospital (RSUTH) between age bracket (15-45) years, Port Harcourt. Eligible participants were categorized according to gestational age into first trimester (≤12 weeks), second trimester (>12–28 weeks) and third trimester (>28 weeks). Data were obtained via clinical measurements and review of antenatal records. Selected indicators include maternal age, gestational age, body mass index, weight, blood pressure, pulse rate, haemoglobin/packed cell volume, urine protein, serum albumin where available, and selected. Descriptive statistics was use to summarize participant characteristics and indicator distributions. Differences among trimester groups was examined using appropriate parametric or non-parametric tests, while multivariable regression models were used to assess factors independently associated with abnormal indicator values. Statistical significance was set at p<0.05. Expected significance: The study will provide trimester-specific evidence regarding maternal health indicators and identify indicators that may be particularly useful for routine surveillance and early identification of pregnancy-related abnormalities. Findings support improved antenatal monitoring, risk stratification and cliinical decision-making in secondary/tertiary maternal-health settings in Port Harcourt.

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