Obstetrics
Obstetrics is the branch of medicine concerned with the care of mother and baby throughout pregnancy and childbirth. It also includes care for the mother in the weeks subsequent to birth. Obstetricians work to ensure that pregnancy culminates in the delivery of a healthy baby, without impairing the health of the mother.
In an obstetric practice, office visits are scheduled on a regular basis. These visits allow the provider to check the progress of pregnancy, screen for problems that commonly arise and manage health conditions the mother may have.
Routine Visits and Testing:
Weeks 6-10: History and Physical exam. Routine testing includes Pap test and cervical cultures for gonorrhea and chlamydia. Blood work includes testing for anemia, blood type, Hepatitis, Rubella, Genetics (Cystic Fibrosis and Sickle Cell Anemia), Syphillis and HIV. Often an ultrasound is done if definitive age of the pregnancy is unknown.
Weeks 11-14: An ultrasound and blood work is done for genetic conditions including Trisomy 21 (Down’s Syndrome) and Trisomy 18.
Weeks 18-20: An ultrasound is done for to check for fetal anomalies. At this point, the pregnancy has grown large enough to visualize the major organ systems in the fetus. It is also when we can determine fetal sex and confirm the due date.
Weeks 24-28: Blood work is obtained to check for Gestational Diabetes. Also at this time a patient may receive a shot of RhIG or Rhogam if her blood type is Rh negative (eg. AB negative). This prevents problems in subsequent pregnancies.
Week 36: A vaginal culture is taken for Group B Strep. This is a bacteria which may be present in the woman’s genital tract. It may be passed to the baby during birth and can cause problems for the infant. If this test is positive, antibiotics are given during labor to prevent this transmission.
Week 37: Repeat HIV testing. New York State mandates that we check all pregnant women for HIV within 28 days of the birth. This repeat test confirms that HIV has not developed during the pregnancy and that the baby will not be exposed to the HIV virus during the birth process.
Week 40 and beyond: Hopefully the baby has arrived by this point! However, should the pregnancy progress past its predicted due date, tests for fetal well being are often administered. These include listening to the fetal heart over a 20 minute period (Non-Stress Test) and Ultrasound to evaluate fetal well being.
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