Obstetric

Obstetric Services

Ogeechee OBGYN offers comprehensive obstetric services including:

• Routine pregnancy care
• High-risk pregnancy care
• Screening for chromosomal anomalies and genetic disorders
• In office ultrasound, including 3D/4D ultrasound
• Non-Stress Test (NST) Clinic
• Cesarean and Vaginal Birth After Cesarean (VBAC)
• Postpartum Support

Prenatal Testing

Initial Prenatal Labs: 

• Type & Screen: Determines your blood type and Rh factor
• CBC (Complete blood count): Screens for blood problems such as anemia
• Urinalysis: Checks for kidney disease or bladder infections
• Ferritin: Screens for iron deficiency
• HBsAg: Screens for Hepatitis B
• HCV: Screens for Hepatitis C
• HIV: Screens for Human Immunodeficiency Virus
• Rubella: Screens for immunity against German measles
• RPR: Screens for syphilis
• STI: Screens for chlamydia, gonorrhea, and trichomoniasis
• Pap Smear: Screens for cervical cancer

Additional Lab Testing:

• AFP: Screens for neural tube defects
• Cell Free DNA: Screens for Down Syndrome, Trisomy 18, Trisomy 13, or abnormality in the sex chromosomes (X and Y)
• Quad Screen: Screens for neural tube defects, down syndrome, and Trisomy 18
• Glucose Test: Screens for gestational diabetes
• Group B Strep: Screens for Group B Streptococcus, a bacteria often found in the urinary tract, digestive system, and reproductive tracts

Ultrasound: 

• Initial Ultrasound: Assess viability, assign a due date, and check placental location
• Nuchal Translucency: Measures the fold behind the baby's neck; used to screen for chromosomal anomalies such as down syndrome
• Anatomy: Assess organ development and detect birth defects
• 4D: Second look at growth and anatomy, sneak peak of your baby
• Growth: Determine estimated fetal weight and check position of the baby

Antenatal Testing: 

• Non-Stress Test (NST): Measures the fetus's heart rate in response to it's own movements
• BPP: An ultrasound that assess fetal well being by evaluating: Fetal heart rate, Amniotic fluid volume, Fetal movements, Fetal tone, and Breathing Movements

High-Risk Pregnancy

What is a high-risk pregnancy?

High-risk pregnancy is a pregnancy where the mother or the fetus have an increased risk of adverse outcomes compared to uncomplicated pregnancies. 

What happens if I have a high risk pregnancy?

If you have a high-risk pregnancy, your provider may refer you to a Maternal Fetal Medicine specialist for further evaluation.

Do I still see my regular OB provider if I am seeing Maternal Fetal Medicine?

Yes, you still have routine prenatal care appointments with your OB provider. Maternal Fetal Medicine providers works closely with your OB provider to determine the best plan of care to keep you and your baby safe and healthy throughout your pregnancy and delivery.

Some examples of pregnancy complications include:

• Gestational Diabetes
• Fetal Growth Restriction
• Pre-eclampsia
• Genetic Disorders
• Birth Defects
• Pre-existing Conditions: 

- Diabetes

- Hypertension

- Obesity

- Thyroid Disorders

• Age: 

- Advanced Maternal Age (35+)

- Young Maternal Age (<17)

• Multiple Gestations:

- Twins

- Triplets

• Previous Pregnancy Complications:

- History of Pre-Term Labor

- History of Pre-Eclampsia

-  Recurrent Pregnancy Loss

• Lifestyle Factors:

- Medication Exposure

- Smoking

- Alcohol

- Substance abuse

Pregnancy Care Timeline

*Your first visit is scheduled when you have missed your period and have had a positive pregnancy test; usually between 6-8 weeks after your last normal menstrual period.

*Your remaining appointments will be scheduled according to your needs, but typically every 4 weeks until 28 weeks, then every 2 weeks until 36 weeks, and then weekly until delivery.

Please note that this is a general pregnancy guideline for Ogeechee OBGYN.
Situations may arise throughout your pregnancy that may alter your plan of care. 

First Visit

• You will see one of the providers and discuss your medical history.
• An ultrasound will be done to establish that there is a normal uterine pregnancy, and to assist with assigning a due date.
• You will be given a prescription for prenatal vitamins.

Second Visit

• You will see our midwife, nurse practitioners, or physician assistant to answer questions related to your medical, family, and obstetric history.
• You will also have a complete physical with a pelvic exam and pap testing.
• Prenatal bloodwork will be done at this visit.*
• Any problems or concerns associated with pregnancy will be addressed as well.

*Cell-Free DNA Prenatal Screening is offered after 10 weeks gestation to screen for certain chromosomal disorders. This testing may or may not be covered by your insurance, so it is best to discuss your risk factors with your healthcare provider.

Weeks 14-16

• You will see one of our physicians at this visit.
• If you did not do the the Cell-Free DNA screening, you can schedule a gender ultrasound for this visit
• If desired, The "Quad Screen" can be done between 15-20 weeks.*

*This is an optional blood test that can determine if your baby is at higher risk for neural tube defects and chromosomal disorders that can cause mental retardation and other birth defects.

Weeks 20-22

• You will see our midwife, nurse practitioners, or physician assistant to discuss any problems or concerns with your pregnancy.
• An anatomy ultrasound is done to assess if the fetus has developed normally.

Week 24

• You will see our OB Nurse to discuss multiple topics such as breastfeeding and vaccines.
• You will also be given instructions for your glucose test at your next visit.
• If you plan on having a c-section, we will request a date to be scheduled at this visit.

Week 28

• You will see our midwife, nurse practitioners, or physician assistant to discuss any problems or concerns with your pregnancy.
• When you arrive for your appointment, you will be given the Glucola to drink.
• One hour after you have finished the Glucola drink, your blood will be drawn and sent to the lab for testing.*
• A 4D ultrasound will be done and you will be given copies of the ultrasound pictures printed from the machine free of charge. You can also purchase a flash drive from the front desk if you would like to have the images saved. This ultrasound also provides information regarding fetal growth and gives a second look at the anatomy.
• If you are Rh negative, you will get your first Rhogam injection
• You will get your Tdap vaccination
• Third trimester bloodwork is done to check blood counts and for CDC required follow up screening of HIV and syphilis.

*We also offer The Fresh Test

Week 32

• You will see our midwife, nurse practitioners, or physician assistant to discuss any problems or concerns with your pregnancy.
• A growth ultrasound will be done to check the size and position of your baby
• You will discuss your birth plan

Week 36+

• You will see our midwife or one of our physicians weekly for the remainder of your pregnancy.
• You will have your final growth ultrasound to determine the baby’s position and to determine the approximate weight of the baby.
• Group B Strep testing will be done
• Delivery planning

Post-Partum

• If you have a vaginal delivery, you will be scheduled for a 2 week post-partum phone call with our OB Nurse.
• If you had a c-section, you will be scheduled for a 1 week incision check.
• You will have a 4 week post-partum appointment with one of our providers.

FAQ

• How much weight will I gain during pregnancy?

Weight gain during pregnancy has an impact on more than just your appearance. Excessive weight gain during pregnancy, or being overweight before getting pregnant, increases the risk of birth defects, cesarean delivery, intrauterine growth restriction, larger infant birth weight, high blood pressure, gestational diabetes, preterm birth and stillbirth.

>If you are of normal weight, which is a Body Mass Index (BMI) between 18.5-24.9, your recommended weight gain is 25-35 pounds.

>If you are overweight, which is a BMI of 25-29.9, your recommended weight gain is 15-25 pounds.

>If you are obese, a BMI of 30 or higher, your recommended weight gain is only 11-20 pounds.

• How much can I exercise when I'm pregnant?

Exercise during pregnancy has many benefits and is encouraged if you are experiencing a normal, healthy pregnancy.

>Walking, swimming and low impact aerobics are generally recommended.

>Avoid exercising in hot temperatures, and make sure to drink plenty of water to avoid dehydration.

It’s best to discuss your exercise routine with your health care provider to make sure the activity is safe during the different stages of pregnancy.

• Can I continue to have sex while pregnant?

Sex is safe and does not harm the baby. It is normal to have more interest, less interest or mixed feelings about intercourse. There are some high-risk situations where your doctor may recommend avoiding sexual intercourse, but this is uncommon.
Do NOT have sex if you have vaginal bleeding or abdominal pain, blood or fluid leaking from the vagina, or have been advised not to by your doctor.

• Can I travel during pregnancy?

> Always wear a seat belt when traveling in a vehicle. The lap belt should be below your belly across your hips, and the shoulder belt should be across your chest, never under your arm or behind your back.

> Air travel is not recommended after 36 weeks. The best time to travel is during the second trimester between 14-28 weeks.

> Consult with vour healthcare provider before traveling out of the country. You may need to receive certain vaccinations or take additional precautions to avoid illness depending on the area.

• What vaccines are reccomended during pregnancy?

>All pregnant women should receive the Tap (Tetanus, Diptheria, acellular Pertussis) vaccine in the third trimester of every pregnancy.

>A Flu vaccine for the current year. Pregnant women suffer more severe consequences of influenza than non-pregnant women; some of which can affect the unborn baby. This can be given at any time during pregnancy.

>Vaccination against COVID-19 is also recommended for all pregnant women if the series was not completed prior to pregnancy. Depending on when the vaccine series was complete, you may be eligible for a booster during pregnancy.

• Do I see the same provider throughout my whole pregnancy?

No, throughout your pregnancy we try to make sure you have a chance to meet our all our providers.

• What foods should I avoid?

> All meat, poultry, eggs and seafood should be cooked well done.

> Avoid any raw or undercooked foods.

> Some types of fish are high in mercury; it’s best to avoid all tuna, swordfish, shark, king mackerel and tile fish.

>Avoid Unpasteurized milk and dairy products made with unpasteurized milk

> Avoid Deli meats/cold cuts (ham, turkey, bologna, salami, etc), hot dogs, pepperoni and frozen pre-cooked meats – unless they have been reheated to steaming hot

> Avoid Pate and meat spreads/salads, smoked seafood

• Where can I take prenatal and childbirth classes?

East Georgia Regional Medical Center offers prenatal and childbirth education classes, as well as breastfeeding and baby basics classes. 

• What if I want an additional ultrasound?

We now offer additional ultrasound packages!
Sweet Peek
>10-15 minute 3D/4D ultrasound session
>2 printed images
>Gender Determination (upon request, if >16 weeks)
Bundle of Joy
> 20-25 minute 4D ultrasound session 
> 4 printed images
> Digital gallery of all best images

• What if I don't want to take the regular glucose test?

We also offer The Fresh Test as an option for the glucose test. The fresh test is a 50-gram, 75-gram and 100-gram, glucose beverage for the screening of gestational diabetes mellitus. It is laboratory tested to ensure equivalency to traditional glucose beverages – it’s simply void of unnecessary additives!
The fresh test is intended to be used in the same manner as traditional glucose beverages and you’ll find instructions for use printed on every package.
The fresh test is manufactured to comply with the American Diabetes Association’s guidelines. Nearly 100% of women enjoy the taste of the fresh test greatly improving the patient experience!

• What medications can I take when I'm pregnant?

ALLERGY: Atarax (hydroxyzine), Benadryl (diphenhydramine), Chlor-Trimeton, Claritin (loratadine) Mucinex (guaifenesin)
CONSTIPATION: Citrucel (methylcellulose fiber), Metamucil (psyllium), Colace (docusate), Miralax
COUGH: Delsym, Robitussin (cough suppressants),
DIARRHEA: Imodium, Kaopectate
HEADACHE/FEVER/GENERAL ACHES & PAINS: Tylenol (regular strength); 2 tablets every 6 hours, not to exceed 8 tablets in a 24 hour period
HEARTBURN: Tums or Mylanta (calcium carbonate), Maalox (aluminum hydroxide), Pepcid or Zantac (famotidine), Prilosec (omeprazole)
HEMORRHOIDS: Anusol HC, Tucks Pads
SINUS CONGESTION: Sudafed, Neosynephrine, Vicks VapoRub (menthol cream)
SORE THROAT: Chloraseptic, Cepacol lozenges, Saltwater gargle
NAUSEA & VOMITTING: Ginger capsules or candies, Vitamin B6, Unisom (doxylamine)