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Contemporary Women's Care Pregnancy Health Library
An extensive library of pregnancy information from Contemporary Women’s Care, a unique group of all women board-certified physicians, nurse practitioners and nurse midwives serving Tampa, St. Petersburg, Clearwater, Dunedin, Largo, Seminole, Safety Harbor, Palm Harbor and the surrounding areas in Florida.

• About Your Pregnancy
  Congratulations! We are here to make this important event a pleasant and memorable one. The doctors and staff at Contemporary Women’s Care take pride in delivering quality care as well as healthy babies.
  
  Proper obstetrical care is very important to your health and the health of your baby. Obstetrical care at Contemporary Women’s Care begins with two appointments.
  
  The first appointment will be with an OB Coordinator and one of our three Midwives. This is a unique presentation we call OB Orientation. OB Orientation includes a small group interactive educational session, a private and personal one-on-one history with focused counseling where you’ll have the opportunity to get your questions answered, and prenatal lab forms you will need. You will also be given “The Baby” CD, an interactive CD loaded with great information for expecting parents. This first appointment will last approximately 1.5 hours.
  
  The second appointment is for your physical examination. Normally this appointment will be one week later and can be set with the provider of your choice, either one of our physicians or one of our midwives. You are encouraged to bring any family members you wish to your obstetrical appointments. We realize this is a very important time for each of you.
  
  For answers to many of the common questions during pregnancy, please see our Pregnancy Library.
  
  Although each physician at Contemporary Women’s Care has her own patients, we work as a team and we’re all your obstetritions. Each doctor’s preference is to provide continuity of care, with the additional flexibility patients often need. What this means is a physician is always available for office care, hospital care or after hours emergencies.
• AFP4 or Maternal Serum Screening
  The maternal serum multiple marker test is a prenatal screening test using blood from the mother that can help identify women who may be carrying a baby with certain types of birth defects (such as neural tube defects, Down syndrome, and trisomy 18 syndrome).
  Important Facts
  
  Maternal serum multiple marker test is sometimes called triple test, AFP plus, enhanced AFP, AFP3 test or triple screen prenatal risk profile (PRP). More recently, blood is being tested for four markers and the test may be called the quad screen or AFP4, etc.
  
  The test is a simple blood test on the mother’s blood and poses no threat to the mother or to her baby.
  
  This is a voluntary test. If you have any questions about the test, you should discuss them with your physician.
  
  Although the test can detect some common health conditions, a normal result does not guarantee a healthy baby.
  
  An abnormal test does NOT always mean there is a problem with the baby. It simply means that other tests may be suggested.
  
  Abnormal results are usually followed by other diagnostic tests, including high resolution ultrasound or amniocentesis.
  
  The results of this test help to give you and your physician the knowledge to provide the best care and preparation that you need for the birth of your baby.
• Amniocentesis
  Amniocentesis is offered to women 35 years of age and older and is performed between 16-20 weeks of pregnancy as an in-office procedure. To perform the procedure, your doctor guides a thin needle through your abdomen and uterus. A small sample of amniotic fluid is withdrawn and sent to a lab.
  
  In the lab, cells from the baby that were taken from the amniotic fluid are grown in a special culture. This usually takes about 10-12 days. Next, the chromosomes in these cells are studied under a microscope. This shows if there is an extra chromosome (as in Down syndrome) or other chromosomal defects.
  
  Complications from amniocentesis are uncommon. Side effects may include cramping, vaginal bleeding, infection and leaking amniotic fluid.
• Basic Guidelines for Your Pregnancy
  Your Pre-Obstetrical counseling appointment will include:
  
  * History taken by nurse
  * Prenatal information given
  * Prenatal vitamins
  * Blood work RX given
  
  Your initial visit will routinely include:
  
  * Physical examination including pelvic exam, pap smear and cultures
  * Blood work-results discussed
  * Due date established
  * Genetic testing discussed if 35 years or older
  * Finances discussed
  
  The following regular appointments will include these checks.
  
  * 12 weeks:
  o Fetal heart should be heard.
  
  * Approximately 15 weeks:
  o For women who will be 35 years of age or older at the time of delivery, an amniocentesis is done if desired.
  
  * 16 -18 weeks:
  o An AFP (alpha fetoprotein) blood test is offered (blood drawn from the mother). This test helps determine the possibility of spinal cord defects and other abnormalities.
  
  PLEASE READ PAMPHLET GIVEN AT FIRST VISIT PRIOR TO THIS TIME.
  
  * 20 weeks:
  o Before your 20th week of pregnancy pre-register at your hospital. An ultrasound may be done to determine baby’s well-being as well as to gather information on baby.
  
  * 25 -28 weeks:
  o Glucose test-blood sugar test is done to see if your body is metabolizing sugar properly or if further testing is needed. This is only a 1 hour screening test but, may require a 3 hour test if sugars are elevated.
  o Prepared childbirth class should be taken.:
  + Different types and places are offered to suit your needs.
  + Please register before your 7th month.
  o Hospital tour and registration comes with the childbirth classes, or call the hospital for an appointment.
  
  * Near term:
  o Weekly visits at 36 weeks.
  o From 38 weeks on, pelvic exams may be done to check for cervical changes and baby’s position.
  
  * Post term:
  o Further exams may include non-stress test to check fetal heart and contractions. Ultrasound may be done to determine baby’s well being.
  
• Bleeding Gums
  During pregnancy, the extra hormones in your body may cause your gums to swell and bleed. Floss and brush regularly, using a soft toothbrush, to keep your teeth in good shape. Having a dental checkup early in pregnancy is a good idea to be sure your mouth is healthy. Local anesthesia, if needed, does not pose a risk during pregnancy. Dental x-rays should only be done if necessary and with your abdomen shielded.
  
  In addition to bleeding gums, bloody noses occur frequently and are of no concern either.
• Chicken Pox Exposure
  Most adults are immune to chicken pox, either from having the disease or by forming immunity from a mild exposure. If you have had chicken pox in the past, you and your baby are protected. If you are not sure, ask your doctor to check your immunity with a blood test. If this shows positive immunity, you are both protected. If it shows no immunity, an injection of a medicine called Varicella Immune Globulin (VZIG) may be given to prevent chicken pox. In order to be effective, this injection must be given within 72 hours of exposure.
• Colds and Allergies
  Colds come and go throughout our life, even when we’re pregnant — and they’re not fun! Many things can relieve symptoms at home, sometimes eliminating the need for an office visit.
  
  * Use a cool mist vaporizer/humidifier at night. This moistens the air you breathe to keep secretions flowing.
  * Salt water gargles. Use one teaspoon of salt in a cup of warm water every four hours while awake to cut the mucus in the back of your throat and relieve mild soreness.
  * Avoid dairy (milk, cheese, yogurt, etc.,) to minimize thick mucus.
  * Any brand of saline nose drops (NOT regular Afrin or Neo-Synephrine) are okay in the morning and at night and will help moisten secretions.
  * Tylenol (plain) two tablets every four hours if necessary for aches (maximum of six tablets in 24 hours.)
  * Take your temperature daily — call us if your temperature is greater that 100.4 Fahrenheit.
  * Coughing can be relieved with one teaspoon of honey and 2-3 drops of lemon juice. Hold this in your mouth until the honey thins and then swallow. If coughing interrupts sleep or causes vomiting, call the office. You may try Robitussin DM, an over-the-counter cough medication.
  * Increase fluids (especially water) to two quarts a day.
  * Get extra rest.
  * Ac