Alliance Obgyn Prenatal Obstetrical Care

Alliance Ob-Gyn Prenatal & Obstetrical Care
Good prenatal and obstetrical care is the single most important thing
you can do for your baby and yourself. Talk to your doctor or midwife
about your desire to become pregnant or, if you are already pregnant,
about the many changes you are experiencing and how to deal with
them. Mood swings, weight gain, problems sleeping, any changes in
food tastes, heartburn, and more, are all normal changes your body
may experience while you are pregnant. Maintain good prenatal health
and learn how to feel good about yourself, your pregnancy, and your
baby.

Please review the Alliance Obstetrical Patient Visit Guidelines below
and read about taking medications during your pregnancy. These
guidelines may differ with your depending on your obstetrical or
medical condition.

OBSTETRICAL PATIENT VISIT GUIDELINES

Weeks Visit Highlights
Initial Visit Orientation
General history and information
NOB Packet lab testing, risk screening
Resources, Prenatal Vitamins
Lab:
Blood type, Rh, Hepatitis, HIV,
Syphilis, Rubella, Cystic Fibrosis
Screening and other screening tests.
Visits will be scheduled as follows:
0-28 wks every 4 weeks
28-35 wks every 2 weeks
36 + wks weekly till delivery
10 12 weeks OB Complete physical exam - including

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PAP smear as indicated
Hear fetal heartbeat
Sonogram for dates
First Trimester screening option
Risk factors discussed follow up
plan implemented
15 20 weeks OB tummy check
Quad Screen
Schedule fetal anatomy ultrasound
@ 18 wks
20 weeks OB tummy check
Review sonogram and test results
Send in hospital admission forms
Last trimester information
Preterm birth prevention
Discuss Pediatrician list
Prenatal classes/Hospital tour
Glucose test for gestational diabetes
Hemoglobin test for anemia
3
rd
trimester HIV test
Antibody screen if Rh negative
Fetal movement
RHOGAM if Rh negative
30 34 weeks OB tummy check
Discuss contraceptive methods and
birth control options
Fetal movement counting
Preterm labor signs
Meet the doctors
Culture for Group B Strep (GBS)
Internal pelvic exam
Discuss Labor and delivery
37- 41 weeks Weekly OB tummy check
Discuss induction

MEDICATIONS DURING PREGNANCY

During your pregnancy we encourage that you do not drink alcohol or
take any medications other than those that are necessary. Most often,
small problems may be relieved with rest and relaxation and/or
adjustments to our diet.

It is recommended that you consult with us before taking any
medications and we request that you contact us beforehand. There are
a few medications, however, that we feel are safe to use with discretion.

FOR INDIGESTION, HEARTBURN and GAS: Heartburn may
be very common during pregnancy. Sometimes it is helpful to try and
determine when you experience indigestion. Is it before meals, when
you stomach is empty? Is it when you have just finished a large meal? Is
it in the evening? Is it in the morning or all of the time? Often this
situation is relieved by eating smaller, more frequent meals or avoiding
specific irritating foods and having less in your stomach at bedtime. In
addition, trying to remain upright for 2-3 hours after eating may be
helpful. If these suggestions do not relieve your symptoms, the use of
antacids is generally thought to be safe during pregnancy. Calcium
carbonate (TUMS and others) is probably the safest antacid, since the
baby and mother both need calcium to develop properly and maintain
health. We suggest you discuss this problem and the best method or
antacid that would be helpful. To relieve your symptoms, you may try;
TUMS, MYLANTA Tablets or Liquid, ROLAIDS, MAALOX,
GAS-X, TAGAMENT, ZANTAC, RIOPAN or MYLANTA (safe
to use for the first 12 weeks).

DO NOT USE PEPTO-BISMOL as this contains Aspirin.

If there is an increasing problem with heartburn or regurgitation after
meals, GAVISCON liquid or tablets may be quite helpful for these
symptoms.

FOR NAUSEA OR MORNING SICKNESS: Again, we suggest
that you consider your diet and the time of day that you eat your meals.
During pregnancy, it is thought that there may be an increase in gastric
stomach secretions, and perhaps a cracker or piece of toast before
getting out of bed may be helpful. You might also try eating smaller,
more frequent meals and try never to skip meals. EMETROL, an
over-the-counter product, is acceptable to use any time during
pregnancy for nausea or morning sickness. If none of these remedies
seem to help, the doctor maybe prescribes Vitamin B6.

FOR DIARRHEA: A clear liquid diet for 24 hours is recommended
followed by a soft, bland diet over the next 24-48 hours. The BRAT Diet
(i.e., bananas, rice, applesauce, and toast as well as crackers or oatmeal)
may be helpful. If dehydration and/or fever develop, please contact us
or your family doctor for evaluation of possible viral gastroenteritis.
KAOPECTATE is acceptable and may be used as directed and
IMMODIUM (one dose is acceptable). If it persists, please notify the
office.

FOR NAUSEA and VOMTING: For vomiting, due specifically to an
intestinal flue or GI irritation, it is recommended to take a clear liquid
diet for 24-36 hours. Basically any liquid that you can see through
would be considered a clear liquid. Patients may then proceed to
crackers, applesauce, bananas, and toast. Patients are recommended to
avoid any milk products for at least 48 hours and then eat a soft bland
diet for an additional 24 hours until the cramping has ceased. If you
cannot keep anything down for more than 48 hours, please call us or
your family physician. To summary, eat small frequents meals, drink
Ginger Ale or 7-Up soft drinks, broth or bouillon, sweet fruit syrup
from canned fruits (i.e., pears, peaches, etc.) hot tea (with lemon or
sugar), eat Jell-O gelatin. An addition, Vitamin B6 or Sea Bands
(form of acupuncture on wrists) may be beneficial.

DO NOT USE: Sweet N Low

FOR PAIN: Regular or extra-strength TYLENOL (acetaminophen)
is certainly safe and acceptable for all types of pain during pregnancy.

Do NOT use Aspirin, Motrin, Advil or Aleve products.

FOR DENTAL WORK: Local anesthesia (i.e. LIDOCAINE or
NOVACAINE), is always acceptable during pregnancy unless you are
allergic to these drugs. X-rays should be avoided until after pregnancy.

FOR CONSTIPATION: There are many reasons or causes for
constipation during pregnancy. Sometimes, it is due to the iron in your
vitamins, the increasing size of your uterus, the lack of bulk or roughage
and/or the lack of enough fluids in your diet. Try to increase the bulk
and roughage in your diet with bran cereal, whole wheat crackers,
wheat bread, leafy green vegetables, fresh and/or dried fruit. If these
suggestions do not seem to improve the situation, as Stool Softeners, you
may take METAMUCIL, FIBERMED, COLACE. As mild
laxatives, you may use SENOKOT, PERI-COLACE, or
DOXIDAN.

FOR HEMORRHOIDS: Usually when there is a problem with bowel
eliminations, hemorrhoids develop. Hemorrhoids are enlarged veins at
the rectal opening. Usually burning, itching, and irritation occur with
hemorrhoids. The treatment for this problem is keeping bowel
movements soft and regular, avoid straining and also avoid standing for
long periods of time. You may try taking warm tub baths two to three
times a day using WHICH HAZEL, TUCKS, ANUSOL
suppositories, or PREPARATIOIN H after bowel movements. This
will relieve the swelling and itching. Should you have significant rectal
bleeding, please let us know.

FOR HEADACHES: As you know, headaches may be caused by a
number of reasons such as stress, being overworked or overtired, or
changes in hormonal levels occurring during pregnancy. Be sure to get
enough sleep and take a break during daily activities. You may use
either regular or extra-strength TYLENOL (acetaminophen) for
something light to eat may also be helpful. You should call the office if
you have persistent, severe headaches that do not go away with
TYLENOL or, if your headache cause you problems with your vision,
such as spots in front of your eyes.
FOR COLDS, CONGESTION OR FLU: Although it is not always
possible to avoid this situation, it may be helpful to drink fluids, and get
plenty of rest. Most decongestants and antihistamines like
CHLORTRIMETON and SUDAFED (pseudo-ephedrine) have been
found to be safe and effective during pregnancy. (if you have a history
of increased blood pressure and have pregnancy induced hypertension,
consult with our physician before taking these products). After the
third month, DAMETAPP, ORNADE, ACTIFED, BENADRYL,
and almost all over-the-counter antihistamines/decongestant products
are considered safe and effective. For a stuffy nose, OCEAN NASAL
MIST nasal spray, or NASAL, is safe throughout pregnancy. For a
cough, we suggest any over-the-counter cough syrup with minimal
amounts of alcohol, such as CONTACT COUGH SYRUP. If you are
are less than three (3) months pregnancy, contact your doctor first
before using ROBITUSSIN (no more than 4% alcohol). For a sore
throat, you may use CHLORASEPTIC or CEPACOL gargle or
lozenges. SUCRETS and TYLENOL may also be helpful. These
products should only be used for a short time. If the cough or cold
persists, please consult your physician. Should your temperature rise
above 101 , you should either consult your family physician or contact
us so we may suggest further treatment as necessary. Other comfort
measures such as using a humidifier to relieve congestion, and/or
gargling with warm salt water for a sore throat may help as well.

MUSCLE CRAMPS: If you are having muscle cramps, particularly at
night, you may need to increase our intake of calcium per day. Any
over-the-counter calcium product is acceptable or you may need to
increase your milk or milk0containing foods in your diet. If these
muscle aches and pains are secondary to over-exertion or muscle strain,
warm, moist soaks may be helpful.

VAGINAL DISCHARGE: An increase in vaginal discharge may be
normal in pregnancy. This happens because of the increased hormones
in your blood when you are pregnant. Common relief measures can
include wearing cotton panties not nylon. Avoid wearing tight,
constricting clothing and always remember to wipe from front to back
after using the toilet. You should avoid douching and the use of
perfumed products like vaginal deodorants. Call the office if your
discharge has a foul odor, if you feel itching or burning, or if your
discharge is discolored (brown or green).

If you suspect that your partner has an infection or he is experiencing a
discharge, please call the office. If you notice any sores around the
opening of your vagina, you need to call the office as well.

If you have any questions about medications you may have taken or
need to take during this pregnancy, please do not hesitate to consult
with us.


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