Obstetrics Welcome Packet

Transcription

1 Obstetrics Welcome Packet

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3 Welcome! The obstetricians/gynecologists and certified nurse-midwives of Northwestern Memorial Physicians Group (NMPG) are dedicated to providing you with the highest quality and compassionate healthcare. Our physicians are on the medical staff of Northwestern Memorial Hospital and provide hospital-based obstetrical services and deliveries at Prentice Women s Hospital, which is located on the medical campus. A world-class healthcare facility, Prentice was opened to patients in October of 2007 and was designed with your comfort and well-being in mind. This 17-story building features patient-focused amenities such as private rooms with a view, room service meals and interactive televisions with Internet access and health information. Prentice has long been recognized for excellence in obstetrics and serves as the Midwest s largest birthing center, with the capacity to deliver up to 13,600 newborns a year.

4 Physicians At NMPG, we believe that the safest and most fulfilling birth experience for you includes having a provider from our office present during your labor. One of our providers is responsible for the care of our laboring patients at all times. We ensure timely office visits and maximum bedside care during your labor and delivery. Melissa Auger, M.D. Dr. Auger received her undergraduate and medical degrees from Tulane University. She completed her residency in Obstetrics and Gynecology at Prentice Women s Hospital where she was chief resident. In addition to general obstetrics and gynecology, Dr. Auger has a special interest in minimally invasive surgery, office-based procedures and adolescent healthcare. She believes in open communication and a physician-patient partnership. Catherine Chen, M.D. Dr. Chen received her undergraduate degree from Hope College and attended University of Chicago s Pritzker School of Medicine for her medical education. She completed her residency in Obstetrics and Gynecology at Prentice Women s Hospital. She believes that patient communication and education are necessary to providing quality care. Brian P. Foley, M.D. Dr. Foley joined NMPG after being in private practice for 12 years. Dr. Foley earned his undergraduate degree from the University of Notre Dame, his graduate degree from Georgetown University and his medical degree from Loyola University s Stritch School of Medicine. He completed his residency training at St. Francis Hospital in Evanston, Illinois. He is also an assistant professor of clinical Obstetrics and Gynecology at Northwestern University s Feinberg School of Medicine. Dr. Foley believes that patient education and open patient-physician communication are the keys to quality healthcare. Timothy Garvey, M.D. Dr. Garvey graduated from Yale University with a degree in economics and political science. After several years as a management consultant he earned a medical degree from the University of Illinois. He completed his training in Obstetrics and Gynecology at Prentice Women s Hospital. His focus is on forming an active partnership with patients. He is interested in both normal and complicated pregnancy, as well as laparoscopic surgery. Alexander Lin, M.D. Dr. Lin received his undergraduate and medical degrees from the University of Michigan. He continued his postgraduate training in Obstetrics and Gynecology at Prentice Women s Hospital, where as chief resident, he was honored by the Chicago Maternity Center as the outstanding resident in His practice style is driven by his strong belief in patient education. Dr. Lin s special interests include minimally invasive surgery and ultrasound. Robbye D. McNair, M.D. Dr. McNair earned her undergraduate degree from Tougaloo College in Tougaloo, Mississippi. After attending Johns Hopkins University School of Medicine and School of Hygiene and Public Health, she completed her residency at Prentice Women s Hospital. Her special interests include family planning, adolescent health, obstetrics and preventive healthcare. Dr. McNair believes that communication and education are the keys to sharing in the healthcare relationship between patients and their provider. Scott Moses, M.D. Dr. Moses pursued his undergraduate studies at Columbia University in New York where he obtained his Bachelor of Science in biology. He also earned a Bachelor of Arts in philosophy at the Jewish Theological Seminary. He received his medical degree from the University of Illinois. He completed his residency in Obstetrics & Gynecology at Prentice Women s Hospital. He has also completed a fellowship in Reproductive Ethics at Northwestern University and in Clinical Medical Ethics at University of Chicago and is an assistant professor of Medical Ethics and Humanities at Northwestern University. Ann Starr, M.D. Dr. Starr completed her undergraduate studies at Tulane University in New Orleans, Louisiana. After attending Washington University in St. Louis for her medical education, she completed her residency at Prentice Women s Hospital where she served as chief resident. She believes that patient communication and education are fundamental to a successful healthcare relationship. All physicians are Board Certified or Board Eligible.

5 Nurse-Midwives Our practice believes that certified nurse-midwives are a valuable addition to obstetrical and gynecological healthcare. Our nurse-midwife specialties include pregnancy, labor, postpartum, breastfeeding support, gynecology, contraception and health maintenance. We offer unique experiences for labor and delivery including the option of water birth and encourage patients to design the birth that best meets their needs. Ariel Derringer, CNM Ariel Derringer received her Bachelor of Arts in biology at Barnard College of Columbia University. She completed her masters in nursing at Yale University. Julie Omar, CNM Julie Omar received her Bachelor of Science degree in nursing from Michigan State University. She continued her education in nursemidwifery by completing her Master of Science degree from the University of Illinois. Sara Eggemeier, CNM Sara Eggemeier received her Bachelor of Science degree in nursing from Wayne State University. She continued her education in nurse-midwifery by completing her Masters of Public Health at Boston University. Amy Willetts, CNM Amy Willetts received her Bachelor or Science degree in nursing from the University of Michigan. She continued her education at the University of Illinois in Chicago where she completed her Master of Science degree. Carol Hirschfield, CNM Carol Hirschfield is the director of nurse-midwifery services at NMPG. She received her Bachelor of Science degree in nursing from Northwestern University and completed her Master of Science degree at Georgetown University. Jennifer Lynch, CNM Jennifer Lynch received her Bachelor of Science degree in nursing from Saint Louis University and her Master of Science degree from the University of Illinois Chicago.

6 Appointment Schedule What to do after you find out you re pregnant Call insurance company to notify them of your pregnancy. (Weeks 1-12) Register for prenatal classes if you are interested. (Weeks 20-24) Fill out hospital pre-admission forms. (Weeks 30-34) Select a pediatrician. (Weeks 30-34) Appointment Schedule and Reminders Weeks Appointments Tests Concerns and Reasons to Call 1-14 Every 4 weeks Prenatal Labs (CVS) (1st trimester genetic screen) Miscarriage, bleeding, pelvic pain Severe vomiting Every 4 weeks (MSAFP) (Amnio) Bleeding, abdominal or pelvic pain Heavy discharge or pelvic pressure 20 Childbirth education classes sign-up Every 4 week Meet other MDs or CNMs Ultrasound Glucose CBC Bleeding, abdominal or pelvic pain Frequent abdominal cramps Every 2 weeks Meet other MDs or CNMs Bleeding, abdominal or pelvic pain Frequent abdominal cramps Persistent headache, visual changes Decreased fetal movement Every week Strep culture Persistent and consistent hard contractions Bleeding, leaking fluid Headache, visual changes Decreased fetal movement 6 weeks after delivery Postpartum visit Signs of depression Breast infection Heavy bleeding

7 Helpful Hints Morning (All Day) Sickness Helpful Hints Always try to keep something in your stomach, starting from the minute you wake up. Eat small amounts frequently. Chew gum. Take Vitamin B6, Unisom, Dramamine or Emetrol as directed. Use Sea Bands or other pressure point bands. Common Over-the-Counter Medications That Are Safe to Take During Pregnancy Anusol HC (Hydrocortisone cream) Benadryl (Dyphenhydramine) Chlor-Trimeton (Chlorpheniramine) Colace (Docusate Sodium) Maalox or Mylanta (better than TUMS - also safe) Robitussin (any of the over-the-counter types) Sudafed (Pseudoephedrine) Tylenol (Acetaminophen) 2-4 times a day topically (hemorrhoids) 25-50mg every 6 hours as needed (antihistamine) 4mg every 6 hours as needed (antihistamine) 100mg twice a day (stool softener) 30 minutes after meals (antacids) 10ml every 4 hours as needed (cough) 60mg every 6 hours as needed (non-drowsy decongestant) 6 hours as needed (headache, pain, or fever) Total dose not to exceed 4000 mg every 24 hours Common Over-the-Counter Medications to Avoid Unless Otherwise Directed Aspirin Advil, Motrin, Nuprin (Ibuprofen) Aleve (Naproxen)

8 Prenatal Testing Ultrasonography A first trimester ultrasound may be performed to visualize your baby s heart beat and to confirm your due date. We will also offer an ultrasound examination to be done when you are between 20 and 22 weeks. The purpose of the ultrasound is to screen for major birth defects, determine the position of the placenta and assess the growth of your baby. Laboratory Testing Complete Blood Count (CBC) Screen identifies different types of anemia and platelet abnormalities. Blood Type and Antibody Screen looks for potential incompatibility between your blood and your baby s blood. HIV testing is offered and strongly recommended. Aside from the obvious importance to your health, identification of an HIV infection will also aid the prevention of transmission to newborns. Rubella testing is done to confirm immunity to German measles. If you are non-immune, you should avoid exposure to infected individuals. A rubella vaccination should be obtained after delivery. Varicella (Chicken Pox) testing is recommended if you are unsure whether or not you have had chicken pox. If you are non-immune, you should avoid exposure to infected individuals. A varicella vaccination should be obtained after delivery. Syphilis testing is important. Syphilis can cause severe birth defects if undetected. Urine Culture tests for urinary tract infections, which are more common in pregnancy, usually less symptomatic and can lead to kidney infections if left untreated. Group B Streptococcus Culture is done between 35 and 37 weeks. We follow the guidelines recommended by the American College of Obstetricians and Gynecologists to administer antibiotics during labor for all pregnancies at risk for an infection. Cystic Fibrosis is a life-long illness that is usually diagnosed in the first few years of life. This disorder causes problems with breathing and digestion. Cystic Fibrosis does not affect intelligence. Cystic Fibrosis testing may not be covered by your insurance. The estimated carrier risk is as follows: Ashkenazi Jewish 1/25, Non- Hispanic Caucasian 1/25, African American 1/65 and Hispanic- American 1/46. If your occupation or social circumstances predispose you to other infectious diseases such as Tuberculosis, Fifth Disease or Toxoplasmosis, additional testing may be appropriate. Hepatitis B is a virus, which can lead to liver disease and liver cancer. Special precautions are taken at the time of delivery to prevent transmission to your baby if you are found to be a carrier. Hepatitis C testing will be performed for those patients interested in a water birth. Gonorrhea and Chlamydia DNA probes are used to screen for infections of the cervix which can infect a newborn.

9 Genetic Testing Genetic Testing Genetic testing can be performed to detect chromosomal anomalies such as Down syndrome as well as individual diseases caused by gene mutations such as Cystic Fibrosis or Tay-Sachs disease. Testing is generally categorized as being either a screening test or a diagnostic test. Screening tests are recommended for the general population thought to be at low risk. They are non-invasive tests, which pose no immediate risk to you or your pregnancy. Screening tests determine whether or not you are at normal or higher than expected risk for a given condition. Screening tests do not determine for certain whether your baby will have a specific problem. First Trimester Screening First trimester screening is a combination of maternal blood and fetal ultrasound, which is used to screen for Down syndrome and Trisomy 18. Specific risk levels for these conditions are calculated by taking into account your age and the levels of two biochemical markers which appear in your blood. An ultrasound measurement of a thin layer of fluid found at the back of the fetal neck is also used. Compared to second trimester screening, first trimester screening has a better detection rate with fewer false positives; however, open fetal defects such as spina bifida are not tested. Since this screening is not yet widely available, please check your insurance coverage. Second Trimester Screening Maternal serum screening is the standard screening test for Down syndrome, Trisomy 18 and open fetal defects such as spina bifida. Specific risk levels for these conditions are calculated by taking into account your age and the levels of four hormones being produced by the pregnancy, which appear in your blood. This test is performed between 15 and 21+ weeks. Diagnostic tests will be offered to patients believed to be at elevated risk who would benefit from more direct testing. Diagnostic tests determine whether or not the condition you are testing for is present. They are invasive tests, which test the pregnancy directly and may cause a miscarriage. CVS Chorionic Villus Sampling (CVS) is a diagnostic test which involves sampling cells from the placenta. It is performed between 10 and 12 weeks gestation. Using ultrasound guidance, a needle is placed via the vagina or the abdomen into the placenta. Cells from the placenta, which are derived from the fertilized egg, are then analyzed for Down syndrome or other genetic diseases. Amniocentesis Amniocenteses is a diagnostic test which analyzes the amniotic fluid surrounding the fetus. It is performed after 15 weeks gestation. Using ultrasound guidance, a needle is placed through the abdominal wall into the uterus. Approximately 20ml of amniotic fluid is withdrawn. The fluid can be analyzed to determine if a fetus has an open fetal defect such as spina bifida. The fetal cells in the fluid can be analyzed for Down syndrome or other genetic diseases. Sequential Screening Sequential screening is the newest screening option for Down syndrome, Trisomy 18 and open fetal defects such as spina bifida. It is a method of combining both First Trimester and Second Trimester screens. If you are African American, Jewish, French Canadian, Cajun or have a family history of particular genetic diseases such as Cystic Fibrosis, other screening tests may be appropriate.

10 Comparison of Available Tests First Trimester Second Trimester Chorionic Villus Amniocentesis Screening Screening Sampling Type of Test Screening Screening Diagnostic Diagnostic Who All patients All patients Patients who are found Patients who are found to be at increased risk to be at increased risk When weeks weeks weeks After 15 weeks What Down syndrome, Down syndrome, Numeric and gross Numeric and gross Trisomy 18 Trisomy 18, structural chromosomal structural chromosomal open fetal defects anomalies anomalies, open fetal defects How Mom s age, ultrasound Mom s age, Under ultrasound Under ultrasound measurement of and biochemical guidance placental guidance amniotic baby s neck fold and markers in mom s cells are withdrawn fluid is withdrawn biochemical markers blood from the uterus with from the uterus with in mom s blood a needle a needle Percentage 85% 81% 100% 100% of Down Syndrome correctly detected Likelihood 5% 5% N/A N/A test will show elevated risk of Down Syndrome Risks False positives False positives Chance of miscarriage Chance of miscarriage and false negatives and false negatives following procedure following procedure Cost Approximately Approximately Approximately Approximately $650, not always $400, almost $2,000, please $2,000, please covered always covered check coverage check coverage

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12 Obstetrics and Gynecology 680 North Lake Shore Drive, Suite 810 Chicago, Illinois (312) Northwestern Memorial is an equal opportunity employer that welcomes, respects and serves with dignity all people and does not discriminate, including in hiring, or employment, or admission, or access to, or treatment in its programs or activities on the basis of race, color, gender, national origin, religion, disability, handicap, age, Vietnam or other veteran status, sexual orientation or any other status protected by relevant law. To arrange for TDD/TTY, auxiliary aids and foreign language interpretation services, call the Patient Representative department at , TDD number Issues related to the Rehabilitation Act of 1973 should be directed to the director of Employee Relations or designee at December Northwestern Memorial Physicians Group For more information about Northwestern Memorial Physicians Group, please visit