Congratulations! This is an exciting time in your life and we are looking forward to caring for you and your baby throughout your pregnancy and delivery. For many women this will be a time of many changes to look forward to and can even cause some anxiousness along with happiness. We hope to partner with you in your care and help to answer your questions and concerns. Thank you for choosing us to take this journey with you.
What do I do when I’ve had a positive home pregnancy test?
The pregnancy tests that are available to purchase today are usually very reliable. Most women do not need to have a urine or blood pregnancy test done in the office. If you have particular concerns, bleeding, or pain be sure to call your physician so they can help determine if you need to have further testing or an appointment with a healthcare provider. Please call our office to schedule your first obstetrical appointment.
What will happen during my first appointment?
We attempt to schedule your first appointment after at least 8 weeks of pregnancy. This means that the person you speak with will ask you for the first day of your last menstrual period. They will then find an appointment time with your healthcare provider for a date between 8 and 12 weeks following the last period. This is the ideal time for most women to have the first ultrasound examination. This visit will be longer than most other visits to your physician. It’s a good idea to make sure you can comfortably spend at least 2 hours at the office if needed.
During your first obstetrical visit to our office an ultrasound examination will be done before your appointment with your healthcare provider. The ultrasound images are used by your doctor to determine and accurate due date as well as reassurance that things are progressing normally with your pregnancy. You will be asked to review your medical history, any medications you may be taking, any past pregnancy history, and the family history for yourself and the father of the baby if those are available to you. It’s a good idea to mention any supplements or medications you have taken since your last period, even if you stopped taking them when you found out you were pregnant. Let the physician or the nurse know if you believe you have recently been exposed to any particular illnesses. This information will allow your physician to identify any issues that may affect your pregnancy and discuss them with you.
Your doctor will perform a physical exam. If you’ve had a gynecologic exam or “annual” exam in the past, you will find this exam very similar. Often a cervical culture will be done using a soft swab to look for infection and a Pap smear may be performed. Some women experience a small amount of red or brown vaginal spotting after this is done. This is expected since the tissue there bleeds very easily during pregnancy for many women. This is not harmful to you or your baby.
During this visit you will be asked to save a urine specimen in a special sterile container. This sample will be used to check for bladder infection that may otherwise not be noticeable to you. A number of blood tests will be ordered to check your blood type, for any infections that may be present, your immunity to certain diseases that can be serious during pregnancy, and to make sure that you do not need additional iron supplementation.
Gestational diabetes is a condition that occurs in some women during pregnancy when their body is not able to produce enough insulin to control blood sugar (blood glucose levels). Insulin is the hormone the body produces which helps glucose move into the cells where it can be turned into energy. During pregnancy, the cells of the body naturally become more resistant to insulin in order to make more nutrients available in your bloodstream to support your baby’s growth. Your body then must make more insulin to keep your blood sugar normal but in some women this increase is not enough. The result is gestational diabetes.
How gestational diabetes may affect your baby
It is important to follow your healthcare providers recommendations to keep your blood sugar controlled and within the desired range through the remainder of your pregnancy. If not treated, certain risks to both you and your baby are increased. High blood pressure and preeclampsia are more common in women with gestational diabetes.
Your baby’s growth may be more closely monitored during pregnancy to determine is your baby is becoming very large (called macrosomia) and increasing the chances of a cesarean birth. Babies of mothers with untreated or uncontrolled diabetes may experience problems with low blood sugar after delivery, breathing problems, and increased incidence of jaundice.
Women diagnosed with gestational diabetes will be taught how to use a glucometer (device used to test blood sugar levels) and asked to keep track of their blood sugars. An appointment will be made with a dietician so that you can learn the best diet and exercise routine to keep your blood sugars within the normal range and you may see a specialist (called an endocrinologist) to determine if your blood sugars can be controlled by diet and exercise alone or if you may need additional insulin during your pregnancy to help decrease risks to you and your baby.
Your physician will likely order special testing and more frequent appointments in the latter part of your pregnancy to make sure both you and your baby are doing well. Two of these tests that may be performed in the office are called non-stress test (NST) and biophysical profile (BPP).
During your hospital stay when your baby is born
Your healthcare provider will determine how often your blood sugar is to be checked by the hospital staff during your labor and your blood sugar level may be checked the morning after your baby is born to determine if you have any special needs during or immediately after delivery. Your baby’s blood sugar levels will be checked for a period of time after being born as well. This will allow the hospital staff to make sure that your baby’s blood sugar does not become dangerously low from producing too much insulin and that your baby’s body is able to regulate blood sugar properly.
What happens with gestational diabetes after my baby is born?
For most women, gestational diabetes goes away after the baby is born. Some women diagnosed during pregnancy with gestational diabetes may have actually had mild diabetes before pregnancy that had not been diagnosed. For those women, the diabetes does not go away after pregnancy. Women diagnosed with gestational diabetes do have a higher risk of developing diabetes later in life or continuing to be insulin resistant. It is important to have the testing recommended by your healthcare provider following pregnancy to monitor for these conditions.
High blood pressure (also known as hypertension) may be chronic (present before 20 weeks of pregnancy or continuing for more than 12 weeks after delivery) or what is known as gestational or pregnancy induced hypertension (occurring in the second half of pregnancy which goes away after delivery). Your health care provider will monitor your blood pressure during each visit of your pregnancy to make sure it stays within normal range.
Because blood pressure can vary from moment to moment for a variety of reasons, if your blood pressure is above normal for one reading it will be rechecked later to be sure it returns to a normal range.
Controlling your blood pressure during pregnancy is important to the health of both you and your baby. Some women may need medication that is safe to take during pregnancy to control blood pressure and prevent serious health risks for both mother and baby. If high blood pressure is not controlled it can mean less blood flow to the placenta. The placenta provides your baby with all of the oxygen and nutrients needed for proper growth and development. Without adequate blood flow the baby may not grow properly, may be born early, or in some very severe cases may not survive. A woman’s risk also increases for complications such as damage to the kidneys, heart failure, stroke, preeclampsia, or detachment of the placenta from the uterine wall (known as placental abruption).
Your physician may ask you to monitor your blood pressure at home and report your readings on a regular basis. You may need more frequent appointments or special testing to allow your physician to detect any problems early. Your baby’s growth may be monitored by ultrasound. It is important to report any vision changes, severe headaches, upper abdominal pain, or rapid weight gain to your physician immediately.
Springfield Clinic ultrasound services are accredited by the American Institute of Ultrasound in Medicine (AIUM), an association dedicated to promoting the safe and effective use of ultrasound.
Accreditation means our practice has met nationally accepted standards and has demonstrated consistent excellence in patient care. Actual cases and reports have been reviewed by the AIUM and show that both the performance and the interpretation of ultrasound examinations offered by physicians and meet or exceed nationally accepted standards.
Our team of Registered Diagnostic Medical Sonographers has many years of experience in the areas of Obstetric and Gynecologic Ultrasound. They have all achieved a level of competency in both technical procedures and patient care. Both the physicians and sonographers in the practice receive continuing medical education in ultrasound to enhance their knowledge and keep their skills current. Effectively and safely meeting the growing needs of our patients is our number one priority.
Pelvic ultrasound may be performed to assist the physician in evaluating pelvic pain, abnormal bleeding, masses felt on exam, intrauterine device placement, or for comparison to prior imaging studies to evaluate changes. Obstetrical ultrasound may be used for initial confirmation of pregnancy, evaluating the thickness of the cervix, in combination with select genetic tests to assess risk, careful measurement and evaluation of all viewable organ systems, and to check on the well-being of your baby when medically indicated later in pregnancy.
Both 3 dimensional imaging and Doppler imaging to assess blood flow can be utilized if medically indicated to assist with evaluating a suspected or known medical condition.
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