St Clare Medical Building on St Mary Medical Center Campus Langhorne PA  215-750-7771

Pregnancy Management

 

What follows are some thoughts on early pregnancy education and what to expect during your pregnancy and office visits.  We encourage you to log onto the Patient Portal for updated pregnancy information.  You can access the Portal here.

Prenatal Care

Goals – A planned program of observation, medical management and education aimed at making pregnancy and delivery a safe and satisfying experience.

 

Initial Prenatal Visit:

  • EDD – determination of due date
  • History
  • General Physical Exam
  • Pelvic Examination
  • Pap Smear (if not up to date), Gonorrhea Culture, Chlamydia Test
  • Routine Blood work
  • Urine Tests
  • Folder of information
  • Discussion with the physician reviewing a plan of care based on your individual medical history and  possible risk factors.

 

Revisits

-Mother: Blood pressure, weight, urine dipstick for protein and sugar

-Baby: Fetal heart rate, growth, position

 

This is your time for questions, discussion, plans, and education.

Write down your questions so you will not forget them at your next appointment time.

 

Special Studies/Tests

 

• Ultrasound - performed as needed. Usually at 6-8 weeks for size and dates, 11-13 weeks (if having a

           Sequential Screen), and 18-20 weeks for an anatomy scan.

 

• Sequential Screen – A 2 part screen that can help identify people who are at a higher risk of having a baby with certain birth defects, such as Down Syndrome, Trisomy 18, or open neural tube defects.  Timing is important.  Part 1 of this test is done at 10-14 weeks of pregnancy and includes a blood test combined with an ultrasound.  Part 2 is a blood test performed at 15-22 weeks.  The results of the combined tests will provide you with a final screening result.  A screening test DOES NOT provide a diagnosis.  This test is optional and is time sensitive.  If you are past 14 weeks, you may be offered a Penta screen at 15-19 weeks.

 

• Penta Screen – Blood test scheduled for 15-19 weeks.  Timing is important.  Performed as needed per patient desire or per medical recommendation based on patient history.  Helps determine risk of open neural tube defects (spina bifida, anencephaly, etc.) or risk of Down's Syndrome.  This is not a perfect diagnostic test, but it will let us know if your baby is at a substantially increased risk for these birth defects.

 

• You can find out what genetic tests are available through Genzyme Genetics at  www.mytestingoptions.com, which features test options week by week.

 

• Repeat blood count and blood sugar test - routine screening at 24-28 weeks.  You will drink a sweet liquid and then have your blood drawn one hour later.  There is no need to fast for this test.

 

• Antibody screen - blood test for Rh negative patients at 28 weeks.

 

• Rhogam injection - given to Rh negative patients at 28 weeks and following any significant bleeding episodes or invasive obstetrical procedures (i.e. amniocentesis, CVS).

 

• Screening for Group B Streptococcus - a vaginal culture is taken between 35-38 weeks to screen for this bacteria that is often found in the vagina and rectum.  This infection does not pose any threat to the mother, but it could be passed to the baby during birth.  This is prevented by administering antibiotics to the mother during labor.

 

Prenatal Vitamins & DHA (Docosahexaenoic acid)

Prenatal vitamins contain certain amounts of the vitamins and minerals necessary to promote a healthy pregnancy and proper fetal development. It is important to take your prenatal vitamin every day. Omega 3 fatty acids/DHA promotes healthy brain and eye development in infants. It also has many benefits to you, including cardiovascular health. You will be given a prescription for prenatal vitamins for the duration of your pregnancy and postpartum period.  If you choose to purchase over the counter vitamins check the contents to ensure you are giving you and your baby the best possible option. If you have any questions please talk with your physician

about it at your next visit.

 

Weight gain and distribution

 Average weight gain - 20 to 25 pounds

  •   Distribution of weight gain
  •   Placenta - 1 to 2 pounds
  •   Blood volume increase - 2 pounds
  •   Breast enlargement - 3 to 4 pounds
  •   Uterine muscle expansion - 1 to 2 pounds
  •   Lactation fat deposits - 7 to 10 pounds
  •   Fetus - 8 pounds
  •   Amniotic fluid - 1 pound

Exercise

All prenatal patients are encouraged to keep active and exercise.

If you are currently active you can probably continue your routine program.

Inform the office as to what type of program you are doing.

Prenatal Exercise Classes are available at Namaste located next door to our office.

Please call 215-702-3321 for more information.

 

Avoid the following activities while pregnant:

  •  Contact sports
  •  High impact aerobics
  •  Excessive weight lifting
  •  Hot tubs over 100 degrees

 

ALWAYS CALL THE OFFICE IF YOU ARE UNSURE OF WHAT TO DO, OR IF YOU EXPERIENCE ANY OF THE SYMPTOMS LISTED BELOW AT ANY TIME DURING YOUR PREGNANCY:

 

   1.  Vaginal bleeding

   2.  Gush or constant flow of water from your vagina. Severe headache - which does not respond to Tylenol, rest, shower, or massage

   4.  Marked swelling of feet, hands, and face

   5.  Constant or severe abdominal pain

   6.  Decrease or cessation of fetal movement

   7.  Fever higher than 100.4 degrees

   8.  Blurred vision

 

If you need them, the following medicines are allowed after the first 12 weeks of your pregnancy.  DO NOT TAKE ANY OTHER MEDICATIONS WITHOUT CALLING THE OFFICE FIRST.

 

Pain, fever or headache -Plain or Extra Strength Tylenol

 

Nasal congestion or colds -

1. Ocean Saline nose drops

2. Afrin Saline Mist

3. One teaspoon of salt in eight ounces of warm water –a few drops in nose as needed

4. Humidifier

5.  Claritin,  Zyrtec, Benadryl, Tylenol Cold & Flu, Plain Sudafed (may cause heart palpitations – use only if no relief from other cold meds.  DO NOT USE IF YOU HAVE HIGH BLOOD PRESSURE.)

 

Heartburn  -    Riopan, occasional TUMS or low sodium Rolaids, multiple small meals, a glass of water, and low fat foods

 

Cough -    Robitussin DM

 

Constipation -    One fruit per day, Metamucil, Citrucel, Colace, or Konsyl

 

Hemorrhoids -   Witch Hazel, Tucks, Preparation H and Anusol (use only occasionally)                  Increase fluids.

*Influenza Vaccinations may be given at any time during pregnancy

*TB Tine testing may be done at any time during pregnancy

*T-Dap Vaccinations will be given or recommended after 28 weeks

*Zika Virus testing will be performed as needed per CDC guidelines for patients who have traveled in the

  effected countries

 

Things to Expect in Pregnancy

 

1. Feeling as if you will get your period any minute with cramps.  This is normal in the first two months and only if the cramps are midline.

 

2. Right and left lower abdominal pulling sensations with occasional pain.  This is usually because of pulling of the round ligament between 10-22 weeks.  Pain on either side in early pregnancy should be evaluated unless a previous ultrasound verifies no ectopic tubal pregnancy.

 

3.  Nausea is a common symptom in early pregnancy.  As long as you keep fluids down, then there should be no emergency.  If you cannot keep broth down for more than one day, then please call the office.

 

4.  Leg cramps are common mid to late pregnancy.  They may be alleviated with either increased calcium (milk) or potassium (bananas) and with moderate exercise.

 

 

Childbirth Classes

  Classes are mandatory for all patients.  Some insurers will offer a rebate of some of the cost of the classes.

  Check with your insurance company.

 

Women’s Specialists of Bucks County, P.C. – 215-750-7771

  We offer Saturday classes once a month in the office. Please call to register early, as availability is limited.

  Our classes are instructed by Jane M. Dougherty, RN, CCE, IBCLC (Certified Lactation Consultant)

 

Hospital Classes - St. Mary Medical Center – (215)710-MOMS

                   Lower Bucks Hospital – (215)785-9824

 

Teen and Young Adult Childbirth and Parenting Classes – 215-348-9770 or online www.CHCInfo.org

  Child, Home & Community – multiple local locations please contact them directly for more information.

 

These options are available to you in this area.  Couples usually begin classes at 28-32 weeks.  You should call to schedule classes when you are about 25 weeks pregnant.  Classes can run from six to eight weeks and generally end two weeks prior to your due date.  Class approaches vary somewhat, but the goals of all are to provide couples with information to help them through the later stages of pregnancy, labor and delivery, the post partum period, and early parenthood.

 

Refresher courses are also available.  Understanding decreases fears and concerns.

 

Start reading about childcare and developmental aspects of childrearing.

 

 

Breastfeeding vs. Bottlefeeding

 

 We like to encourage breastfeeding as the most natural way to fulfill your baby's nutritional needs.  No artificial milk has successfully duplicated your ability to nourish your baby.  However, you must be comfortable with whatever decision your make.  Many bottle fed babies also grow into healthy, contented adults.

 

 LaLeche League - (610) 666-0359 www.lllusa.org/lllusa/wbw.html

 

 St Mary’s Lactation Consultant – 215-710-7638

 

 Breastfeeding Resource Center at St Mary – 215-639-6708  Located in Bensalem

 

 

 

Recommended Reading:

 

What To Expect When You’re Expecting  by: Eisenberg, Murkoff, and Hathaway

 

The Womanly Art of Breastfeeding

 

 

Read early in pregnancy.  Base your decision on facts and your own personal feelings.

 

Ask questions at your prenatal visits and childbirth classes.

 

Every pregnancy is a new experience.  No two are alike.  We want you to take an active part in this experience by keeping informed and understand the natural process of pregnancy and childbearing.

 

 

 

1203 Langhorne-Newtown Rd

St. Clare Medical Building, Suite #225

Langhorne, PA 19047

Call Us: 215-750-7771

Fax: 215-750-6935

Hours

Monday: 9:00am to 8:00pm

Tuesday: 7:30am to 4:00pm

Wednesday: 7:00am to 7:30pm

Thursday: 8:00am to 7:00pm

Friday: 9:00am to 4:00pm

 

Practice Policies

 

 

Phones available Monday through Friday from 8am to 4pm.

 

All other calls will be taken by our live operator answering service.

For medical emergency, call 911 immediately.