Prenatal care schedule
Your first prenatal appointment should take place when you are about eight weeks pregnant (eight weeks after your last menstrual period). At this appointment, Dr. Valaoras or Dr. Lewis will perform a transvaginal ultrasound to confirm pregnancy and check viability. Routine bloodwork will also be drawn.
During a typical pregnancy, you will see a doctor:
- Every four weeks until you are 28 weeks. Your weight and vital signs will be checked, and your belly will be measured for growth. Your baby's heart rate will also be checked.
- Every two weeks from 28 weeks until 36 weeks. Your weight and vital signs will be checked, and your belly will be measured for growth. Your baby's heart rate will also be checked.
- Every week from 36 weeks until delivery. These appointments will include the checks above, and will also include cervical checks to get a better idea how you are progressing and when you might go into labor.
You will alternate between appointments with Dr. Valaoras and Dr. Lewis. By the time you deliver, you will know both doctors well.
Mandatory and optional prenatal testing
Tests and screenings during your pregnancy can identify potential problems with your health and your baby's health.
Early tests include:
- Standard early tests for anemia, blood type and blood antibodies, Rubella vaccination status and infections including bladder infections.
- Mandatory testing for sexually transmitted infections including syphilis, hepatitis B, gonorrhea and chlamydia. These are required by these tate. YOu will also be offered a test for HIV.
- Pap tests. This will be performed during your pregnancy if you are due to have this test.
- Cystic fibrosis screening. If you are found to carry this gene mutation, testing will be offered to the father of your child. CF can only be present in a baby if both parents are carriers.
- Sickle cell screening. This is performed on all African-American or Hispanic patients to check for sickle cell trait. Sickle cell can only be present in a baby if both parents are carriers.
- First trimester genetic screening. This involves a specialized vaginal ultrasound and blood tests, and allows parents to find out if their baby is at risk for Down Syndrome or Trisomy 18. This test gives results earlier than the traditional Quad Screen (see next).
- Quad Screen (AFP). Done between 15 and 20 weeks gestation, this blood test can assess the risk of having a baby with Down Sydnrome, Spina Bifida or other neural tube defect, abdominal wall defects and Trisomy 18. About 70% of babies with Down Syndrome and Trisomy 18 are discovered, and 90% with neural tube defects are discovered with this testing. If positive, further testing including amniocentesis might be recommended.
- Amniocentesis. This test involves using a thin needle to extract amniotic fluid from the uterus. The fluid is analyzed to learn about the baby's genetic makeup and identify potential abnormalities. There is a one in 250 chance of miscarriage with this procedure.
- Ultrasound. Between 18 and 22 weeks, an ultrasound can identify adequate growth and can detect certain problems.
Testing between 26 and 28 weeks includes:
- Diabetes screening. You will drink a beverage one hour prior to your appointment. Make it cold and drink it fast! Your blood sugar will be checked one hour after you have this drink. If you fail, you will be given a three-hour version of this test.
- Anemia testing. Iron-deficiency anemia is common and easily treated.
- Rhogam. This is not a test, but an injection. It is given if you have an Rh-negative blood type. The injection prevents your blood antibodies from attacking your baby.
Testing between 35 and 37 weeks includes:
- Group B Strep Culture. A swab taken from the outside of your vagina and the space between your vagina and your rectum identifies the presence of Group B Strep bacteria. This bacteria typically causes no symptoms in women but can cause infection in your baby. If you test positive, you will receive antibiotics during labor.
- HIV, Syphilis, Gonorrhea and Chlamydia. These are state-mandated tests.