Having a baby is an exciting experience, yet pregnancy can also be a very stressful time of life. Our practice provides all of the necessary services to see you through every phase of your pregnancy.
Early and regular prenatal care can help keep you and your baby healthy throughout your pregnancy. By receiving prenatal care we are able to spot health problems early and provide the necessary treatment.
Your first prenatal appointment should be scheduled at approximately six weeks into your pregnancy. During the initial visit an ultrasound will be performed to help confirm your due date. A pelvic exam will be done to collect cultures and a pap smear if one has not been performed within the last six months. A breast exam may be performed. We will discuss the need for prenatal vitamins and folic acid. Any questions or concerns you may have will be addressed. You will also be given an order for routine bloodwork. This bloodwork will test for any potential concerns regarding anemia, toxoplasmosis, Rh typing, chicken pox, and possible thyroid or glucose issues.
You will then be seen at four week intervals until approximately 20 weeks of the pregnancy. At that time an ultrasound will be performed. You will be given an order to test for gestational diabetes and we will recheck your cbc to be sure you are not anemic. You visits will then reduce to every three weeks until approximately 28 weeks of the pregnancy. You will have another ultrasound between 28 and 30 weeks and if you are due for a Rhogam injection we will do so at the 28 week visit. We will reduce your visits to every two weeks after the 28 week visit then weekly after 35 weeks. At approximately 35 weeks of pregnancy we will perform a final ultrasound to confirm baby's weight, check amniotic fluid, and be sure baby is not breech. We will also have you begin undressing for weekly cervical checks. A Group B Strep culture will be collected at approximately 35 weeks of pregnancy.
During your routine visits we will be checking blood pressure and baby's heart rate. We will also be testing urine for protein and glucose. We will check to see if there has been weight gain. We will discuss any symptoms you may be having and any testing that is upcoming. If any complications or concerns arise we will address them and discuss what we will do to monitor you to ensure the best outcome for you and baby.
We will help to make recommendations for pediatricians in our area. We have information regarding classes through UHS to help with delivery, breast feeding, infant care, and even brother and sister classes. We are here to ensure you have a healthy pregnancy.
High Risk Pregnancy
About 75% of problems during pregnancy can be predicted by a patient's medical history and physical exam. However, problems arise in even the healthiest patients.
Patients may be considered high risk due to chronic health conditions such as diabetes or hypertension.
Problems with previous pregnancies including preterm labor or miscarriages could put you in the high risk pregnancy category.
Twin and triplet pregnancies are considered high risk.
At times other conditions that are unpredictable can happen, including gestational diabetes and hypertension.
If you have a high-risk condition, you will need to come to the office for frequent visits and testing (including ultrasounds and fetal non-stress tests).
At Santé, we offer several tests to monitor the continued well-being of your baby during your pregnancy.
The first is the use of ultrasound. Ultrasound allows us to monitor many things about your pregnancy, including the growth of the baby, the placenta and its location, the baby’s position, and some birth defects. Ultrasounds are routinely performed at your first pregnancy visit and again at 18-20 weeks, 28-29 weeks and around 36 weeks. Ultrasound is sometimes used more frequently in instances of high blood pressure, gestational diabetes, or other health issues. At times, we use a specific ultrasound, a biophysical profile, which ensures the baby’s well-being. It looks at specific parameters (fetal movement and tone, amniotic fluid level, and fetal breathing).
We also utilize another test called the non-stress test. This test monitors the pregnant mom’s contraction activity as well as the baby’s heartrate. We routinely perform this test around 38 weeks. The testing takes approximately 20-40 minutes, during which you will rest on a comfortable chair, pushing a button with any fetal movement.
In-office 4D ultrasound
Santé Women's Healthcare is proud to offer services accredited by the American Institute of Ultrasound in Medicine.
This accreditation clearly demonstrates that our practice has take the initiative to demonstrate that it meets or exceeds national standards in every aspect of ultrasound that is specified by the AIUM, including:
- Proof that the physicians have received specialty training.
- A sound program for ensuring that all ultrasound equipment is medically safe.
- Documentation that ultrasound procedures are thorough and complete.
- Evidence that the ultrasound equipment used is appropriate for the types of tests being performed, and that it is checked regularly to be sure it is in good working order.
- Very few private practices receive this accreditation and currently none of the local hospitals have achieved this level of excellence and received this accreditation. We are proud offer the best resources with technological advancements to meet all your OB-GYN needs. The images below were actually captured by our office staff utilizing 4D Ultrasound. This technology allows our providers and patients a better evaluation of a pregnancy's progression.
Frequently asked questions regarding Obstetric Ultrasound:
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What does the 1st Trimester Ultrasound tell us?
Usually between 6-8 weeks, as determined by blood work, an ultrasound is performed to check for fetal viability, number of babies, and to check ovaries and all maternal anatomy for any issues, such as ectopic pregnancy. It also gives us very accurate dating, which is compared to your last menstrual period and used to determine the correct due date. More often than not, this ultrasound is done transvaginally due to the greater sensitivity of it. The baby and its heartrate can be measured up to a week earlier by this method, usually starting at 6 weeks. However, it can also be possible to evaluate the baby transabdominally. The method used will be determined by you and your sonographer based on the criteria of last menstrual period, full or empty bladder, and patient preference. It is always best to come with a full bladder for this ultrasound. At the time of your first ultrasound during pregnancy, you will also receive a disk with images from the scan on it. This can be used to view the pictures on your computer at home. Please bring it with you to each ultrasound if you would like more pictures added to it as your baby grows.
What is the 1st Trimester Screening and what does it entail?
This is an optional ultrasound done between 11 and 14 weeks consisting of two parts. The first is an ultrasound, which is done to measure an area at the back of the baby’s neck, called the nuchal translucency. The second part is blood work that measures certain hormones in a mother’s body during this time in the pregnancy. The two combined give us an early screening for Down’s syndrome and several other chromosomal anomalies. The ultrasound can take some time to do because the baby’s position is a key factor in getting the measurement, and we all know that from the start babies can be very uncooperative! After the image needed is obtained, you will be given your order for blood work (from the sonographer) and can then take it to the lab. Again, it is recommended you have a full bladder for this ultrasound, if you and the doctor determine this is a good option for you.
When can we determine fetal gender and what is an anatomy survey?
Sometime between 18 and 22 weeks, an ultrasound called the fetal anatomy scan is performed. This is a very comprehensive exam to look at all possible fetal organs (such as the stomach, kidneys, bladder, brain structures, and umbilical cord), as well as measure the baby to make sure growth is appropriate, and check heart rate and placenta. It is also a good time to determine any issues there may be with your baby, such as poor growth or anomalies. Many things are looked at and evaluated during this ultrasound and it is probably the most important one. It is also possible at this time to determine (in most cases) if the baby is a girl or a boy. Sometimes the fetal position limits evaluation of gender, but there are several follow up ultrasounds done that can allow us another peek. A full bladder during this ultrasound helps us see and measure the cervix appropriately, so it is still important to drink plenty of water prior to your fetal anatomy scan.
How many ultrasounds will I have after the anatomy scan?
At approximately 28 weeks, another scan is ordered for follow up. At this time, the baby is reevaluated, checking weight, amniotic fluid level, and well-being. At this time, if the baby is in a good position, is when we would try to do 3D ultrasound. 3D (and 4D) ultrasound is position dependent so it can be difficult to get a good picture. Every attempt is made at this point in time to get good images of the baby’s face, but sometimes it isn’t possible. Attempts can be made at later ultrasounds as well.
At approximately 36 weeks, another follow up is done. At this time, we can get a good idea of how much the baby weighs and estimate how much they will weigh at the time of delivery. We also do what’s called the biophysical profile, or BPP. The BPP is a rating system that allows us to determine if follow up is needed. The four things measured are baby’s tone (flexion or extension of limbs), the baby’s gross body movement, the amniotic fluid volume, and the baby’s demonstration of practice breathing, which is seen when the diaphragm moves in a rhythmic manner, mimicking breathing. The baby is given a certain length of time to demonstrate these things and then graded as to whether they would need some extra follow up or not. The BPP is done in addition to the regular ultrasound.
Sometimes babies need more attention before 36 weeks. If the doctor thinks your baby needs more supervision, BPP’s can be done every week after 28 weeks, or even twice a week to check up on baby. Measurements are never done more than once every two weeks because the baby needs enough time to grow to make the measurements accurate.
Is ultrasound safe?
Ultrasound is a perfectly safe way to acquire images of your baby (or babies). It uses sound waves, not radiation, to create the images you see on the screen and there have been no known adverse effects to a fetus viewed with ultrasound.
This is just basic information on the types of ultrasounds done at Santé. The doctor and your sonographer can answer any other questions you might have about your ultrasound. It is our goal to make sure you have an enjoyable and anxiety-free exam.
Other Resources of information on our Ultrasound Services
Every attempt is made to ensure that delivery of your baby goes smoothly and safely. In some cases, the need arises to utilize a cesarean, or c-section, to allow safe delivery of your baby.
Sometimes this method of delivery is planned, in cases such as a prior c-section was performed, there are multiple fetuses, or the baby is in breech presentation. Sometimes, however, attempts at a regular delivery that are unsuccessful lead to the need for a c-section. Some examples of the need for c-section unexpectedly would be failure of labor to progress after an allotted amount of time, concern for baby's well-being, when monitoring shows that baby might be in distress during labor, or having a baby that is too large to pass through the birth canal.
During a c-section, you will be given anesthesia, most commonly with a spinal or epidural. The doctor then makes an incision in your abdomen, usually at the bikini line and transversely across your belly. From here, the baby is removed, the placenta is removed, and then your incision is closed using staples. You will be taken to a recovery room for a period of time and then taken to your regular room used for the duration of your stay in the hospital.
Approximately one week after your c-section, you will return to the office to have your staples removed. Recovery from c-section is usually a more lengthy process than a vaginal delivery, since you have had major surgery. Our office is here to ensure that you are as comfortable as possible during the healing process.