Prenatal Care

Whether we’re discussing nutrition, emotional well being, physical changes, or birth preferences, our goal is to create a safe, nurturing environment where your questions are welcomed and your choices are respected. Each visit will cover something different but here is a summary of some common care needs we will address:

Ultrasounds

An in-house ultrasound will be performed on or around your first OB visit to confirm the baby's due date. Follow-up ultrasounds will be done at a maternal-fetal specialist’s office.

• A complete anatomy scan will be offered around 20 weeks to check growth and anatomy of the baby.
• Around 34 weeks, an ultrasound will be performed to assess the growth and position of the baby as well as to evaluate the amniotic fluid levels.

If you are interested in 4D ultrasounds, we recommend Teddy Bear Ultrasounds in Delray Beach, 561-496-0906.

Testing During Pregnancy

During your pregnancy, we will perform certain lab tests. These tests can help us find conditions that may increase the risk of complications for you and your baby. Some of these tests are done with a urine sample, while others use a blood sample or a sample of tissue taken from your vagina, cervix, or potentially rectum. Initial tests include:

• Pap smear
• Blood Type
• Antibody Screen
• Rubella Status
• Hepatitis
• RPR (to test for syphilis)
• HIV
• Complete Blood Count
• Urinalysis and Urine Culture

Glucose Test

Between 24 and 28 weeks’ gestation, a Glucose test will be given to screen for gestational diabetes. There are a few variations of Glucose testing and a few different ways to prep. If you’re getting the one-hour glucose test, you don’t have to do anything special to prepare. It’s fine to eat normally both the night before and the day of the test. You will be given a bottle containing 10 ounces of glucola to bring home and refrigerate. You need to drink the bottle 45 minutes prior to your appointment time and be sure to drink the glucola within 10 minutes! When you arrive at the office, please notify the front desk of the time when you finished drinking and they will notify the nurse.

If a three-hour Glucose test is needed, you’ll have your blood drawn first, then drink the sweet glucose drink. Then you’ll have your blood drawn three more times over the course of three hours. You should not eat for 8 hours prior to the test as only the three-hour test requires you to be fasting. Additionally, prior to the test you may be asked to follow a diet that is high in carbohydrates. This will all be discussed in detail with you by your provider.

At this time your Glucose test is done, we also check blood count and re-screen for STDs.

If you prefer not to drink the glucola beverage, there are several alternatives to discuss with your provider, most can be found locally or online:

• Santa Cruz Organic Concord Grape Juice
  • Drink 10 oz = 50gm over 10 minutes
• R.W. Knudsen Organic Concord Grape Juice
  • Drink 10 oz = 50gm over 10 minutes
• Fresh Test 50g Lemonade
  • Find this online at www.thefreshtest.com
  • Drink the entire package of Fresh Test and mix in 10g of water. This should be consumed within 10 minutes of starting the test.
• Glucoganics Organic Lemonade
  • Find this online www.glucoganica.com
  • Drink the whole bottle within 10 minutes of starting the test.

Group B Streptococcus (Group B Strep).

Between 36 and 37 weeks’ gestation, we will perform a vaginal/rectal swab for Group B Streptococcus more commonly referred to as Group B Strep. Based upon your results, a treatment plan will be discussed with your provider for your labor. For example, If you test positive, we may choose to administer antibiotics during labor to properly will protect your baby from GBS infection. More information on GBS is available at https://www.cdc.gov/groupbstrep

Genetic Testing Options

Prenatal genetic testing can give you some insight into whether your baby has certain genetic disorders. Listed below are a few of the screening options available:

A first trimester screen blood test as well as an ultrasound to measure nuchal translucency (neck-fold thickness – which can be associated with Down syndrome and other congenital abnormalities) and view the baby’s nose bridge and other physical markers for Down Syndrome.

+ Quad Screen is a blood test that looks at four different markers in your blood to estimate your risk of having a baby with Down’s syndrome, Trisomy 18, and neural tube defects (e.g. Spina Bifida). The test takes your ethnicity, your age, how far into your pregnancy you are, your weight, and your blood, and calculates your risk for having a baby with one of the aforementioned complications. It is typically performed around 16 weeks.

+ NIPT is a non-invasive prenatal a blood test for Down Syndrome and other chromosomal abnormalities that can be run as early as 10 weeks during a pregnancy. The results take about 1 week and include the gender, if you'd like. If you elect to have this test done, you will also need an AFP test at 16+ weeks gestation to screen for neural tube defects. Please verify your insurance benefits as this test may not be a covered benefit. You may call your insurance directly to check if it is covered through your policy. You may also contact Quest Diagnostics, the company that runs the QNatal test, 866-697-8378, to estimate your out-of-pocket cost.

Carrier Screening

Carrier screening is a type of genetic test that can tell you whether you carry a gene for certain genetic disorders. When it is done before or during pregnancy, it allows you to find out your chances of having a child with a genetic disorder. All patients will be offered carrier status for a large list of genetic conditions including:

• Cystic Fibrosis - affects about 1 in 3,300 people in the United States. It causes the body to produce abnormally thick mucus, leading to life threatening lung infections, digestive problems, diarrhea, poor growth and infertility. Individuals with mild CF may reach adulthood and be unaware that they have the disease. However, the average life span is 37 years.
• Spinal Muscular Atrophy - SMA is a severe, often fatal, disorder in which muscles involved in essential functions, such as breathing, eating, and movement, become progressively weaker and ultimately waste away. There is currently no treatment for SMA.
• Fragile X Syndrome - Fragile X Syndrome affects approximately 1 in 4,000 males and 1 in 8,000 females. The majority of males with Fragile X Syndrome have a significant intellectual disability. The spectrum ranges from learning disabilities to severe mental retardation and autism. About one third of the females affected with Fragile X syndrome have a significant intellectual disability. Others may have more moderate or mild learning difficulties.
• Duchenne Muscular Dystrophy (DMD) – DMD is a genetic disorder characterized by the progressive loss of muscle. It is a multi-systemic condition, affecting many parts of the body, which results in deterioration of the skeletal, cardiac (heart), and pulmonary (lung) muscles.

We recommend that you call your insurance company and talk to them about which tests are covered.