COMPLETE PRENATAL CARE

Our office offers complete prenatal care for women both before and during pregnancy.  It is used to ensure a healthy pregnancy for both the mother and developing baby.  Complete prenatal care can promptly help detect and treat problems, prevent complications and help in referring women to appropriate specialists when necessary.  In the United States, prenatal care has resulted in a reduced number of maternal deaths, miscarriages, and birth defects.

Treatment

It is recommended that all women considering pregnancy visit their doctor for a pre-pregnancy healthcare checkup.  Otherwise, women should contact their doctor as soon as they suspect they are pregnant.  Receiving prenatal care is especially important for women with high-risk pregnancies.

At your first visit, your doctor will assess your overall health and review your medical history.  Bring a list of your current medications for your doctor to review.  In some instances, certain medications may be harmful to a developing baby and are substituted with a similar medication that is not.  Your blood pressure, height, and weight will be measured and your doctor may conduct a pelvic examination.  Blood and urine tests may be conducted as well.  Your doctor will recommend prenatal vitamins, including folic acid.  Folic acid can help significantly reduce the risk of neural tube defects such as spina bifida.

Your doctor will determine an appointment schedule to closely monitor your pregnancy.  Generally, monthly appointments are used for the first six months of pregnancy.  Appointments are usually every two weeks during the seventh and eighth months and weekly in the ninth month of pregnancy.  Women with high-risk pregnancies will have more frequent appointments.

Your blood pressure, blood and urine will be tested periodically throughout your pregnancy.  Routine ultrasound testing is most commonly performed at about the 20th 34th week of pregnancy.  Some doctors may use ultrasound more frequently than others.  Ultrasound is also used if a problem is suspected.

Prenatal testing helps to ensure that problems in a pregnancy receive prompt attention. It enables you to communicate with your doctor and discuss any concerns.  You should follow your doctor’s instructions carefully and attend all of your appointments.

In-office ultrasound:

An ultrasound, or sonogram, is an imaging test used to create pictures of internal organs and structures.  Ultrasound may be used to examine a woman’s reproductive organs, including the uterus, ovaries, cervix, and vagina.  An obstetric ultrasound is used to monitor a pregnancy.  A trans-vaginal ultrasound uses a transmitting device that is placed in the vagina to provide detailed images.

An ultrasound uses a small device that is placed on the skin or a wand that is inserted into the vagina.  The device transmits sound wave information that is translated into pictures on a monitor.  Particular images may be saved on the computer or printed out.  There are no known risks associated with ultrasound.  Unlike X-rays, ultrasound does not involve radiation.

High-Risk Pregnancy

All pregnancies have some degree of risk, but high-risk pregnancies are more hazardous to the mother and developing baby.  A pregnancy may be termed high-risk if you have a medical condition or if you develop one during pregnancy.  With careful medical monitoring and management, most women with high-risk pregnancy deliver healthy babies.  It is very important to follow your doctor’s instructions and attend all of your appointments.

Pre-existing medical conditions that constitute a high-risk pregnancy include heart disease, high blood pressure, kidney problems, autoimmune disorders, diabetes, cancer, substance abuse, sexually transmitted diseases, and HIV or AIDS.  Gestational diabetes, preeclampsia, eclampsia, or preterm labor, conditions that may develop during pregnancy can make a pregnancy high-risk.

Treatment

As part of Complete prenatal care, it is recommended that all women considering pregnancy visit their doctor for a pre-pregnancy check-up.  Otherwise, women should contact their doctor’s as soon as they suspect they are pregnant.  Receiving prenatal care is especially important for women with high-risk pregnancies.  Depending on your condition, your obstetrician or gynecologist may refer you to a high-risk maternal and fetal medicine specialist.

Your doctor will assess your overall health, will recommend prenatal vitamins and will determine an appointment schedule to closely monitor your pregnancy.

Women with a high-risk pregnancy may receive more ultrasounds, tests and office visits than women without high-risk pregnancy do.  This allows your doctor to evaluate and treat complications promptly.  In some cases, women with a high-risk pregnancy may need to have a C-section or be induced for labor.

A cesarean section

(C-Section) may be planned in advance or may become necessary during labor.  A cesarean section involves an incision in the abdomen through which the baby is removed.  Cesarean sections are becoming more common in the United States and may be used if a vaginal delivery is not safe for the mother or baby.

Certain medical conditions in the mother, including high blood pressure, kidney disease, diabetes, active herpes, preeclampsia, eclampsia, or a previous cesarean section may necessitate the surgery. Certain conditions in the baby may also require the surgery, including a fetal illness or abnormality, a head that is too large to fit through the vaginal canal or a difficult fetal position, such as feet first.  A cesarean section may also be necessary if the placenta is blocking the cervical opening (placenta previa) or if the placenta separates from the uterine wall (abruption placenta.)

Some cesarean sections may not be planned in advanced and may be necessary if the mother or baby experience distress during delivery.  This may occur if the labor fails to progress or if the cervix does not dilate after 16-18 hours.  It also may be necessary if the umbilical cord is compressed and there is a risk to the baby’s oxygen supply.

Procedure

In emergency situations, general anesthesia may be used.  In most cases, spinal anesthesia will be used so that you will not feel pain below your waist but will be awake for the birth of your baby.  A cesarean section is a short procedure and can usually be performed within half an hour. You will be able to hold your baby within minutes of his or her birth.

After the surgeon makes the abdomen incision, the uterine wall will be opened.  When the fetal membranes are ruptured, the amniotic fluid will rush out.  The surgeon will carefully lift your baby out.  The umbilical cord is then cut and the placenta is removed.  Your surgeon will use stitches to close the uterus and the abdominal wall.

Women who receive a cesarean section may spend a few more days in the hospital to recover than those that do not. Your doctor will probably want you to be as active as possible but may temporarily restrict lifting activities.  After about four or five days, your stitches are removed.

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