Valley Obstetrics & Gynecology PS

Obstetrics

Congratulations on your pregnancy! We all look forward to taking care of you and your baby. We would like to share an overview of the general appointment and tests done/offered during your pregnancy. Upon each visit you will be seeing either a Medical Doctor or a Nurse Practitioner that work as a team.

1st appointment: You can expect the following at your first visit:

A review – of your Past Medical History, Family History, and Surgical History. Also, we'll discuss how our office works, including the office policies and procedures.

A physical exam – including a Pap smear, and a culture for chlamydia and gonorrhea. This is done on everyone as a screening test and it is recommended by the American College of Obstetricians.

Lab work – initial recommendations include CBC, blood type, Rh factor and antibody screen. Optional lab work includes HIV and Cystic Fibrosis tests.

Book – Planning Your Pregnancy and Birth – this is a wonderful resource book that we encourage you to read and refer to throughout your pregnancy.

Office Handout – this handout has been developed by our office as a quick resource guide as to what is okay/safe medications to use and other commonly asked questions. Please refer to it as needed.

Prenatal Vitamins – we encourage taking a prenatal vitamin, especially taking Folic Acid 0.4 mg as this helps decrease the chances of neural tube defects.

At each subsequent visit after check in, please proceed to the restroom and leave a urine sample. We need this each time for completeness of care.

2nd appointment and each subsequent appointment:

Review Lab work
Answer any questions that you might have
Depending upon stage in pregnancy, listen for fetal heart tones
Measuring fundal height, position of baby, dilation as indicated (usually in the last month of pregnancy)
Blood pressure, weight each visit
Urine check

From your initial visit to the 28th week of pregnancy, you will be seen every 4 weeks. From the 28th week to the 36th week, you will be seen every 2 weeks. The 36th week to delivery, you will be seen every week. (Subject to change if provider finds more frequent visits necessary). Each visit is approximately 10 minutes.

15th – 20th week Testing Options:

Alpha-Fetoprotein Test – Alpha-fetoprotein is a substance made by the fetus. A small amount of AFP crosses the placenta and enters the blood. A high level of AFP can signal a risk of neural tube defects and certain other defects.

Quad Screen or Multiple Marker Screening Test – This test measures the levels of estriol and human chrionic gonadadotropin, as well as AFP in your blood. It can also measure the risk of Neurotube Defects, Trisomy 21 and Trisomy 18. If either of these tests place you in the high risk range, further testing will be discussed and arranged. This might include genetic counseling, ultrasound or aminocentesis.

18th – 20th week:

Ultrasound for anatomical survey. This is usually done in our office using the latest Ultrasound equipment. Our machine has 4D capabilities. If you bring a CD or VHS tape, a portion will be recorded. Pictures will also be provided. If your baby cooperates and you wish to know the sex of your child this information will be given to you.

Here at Valley Obstetrics & Gynecology we use ultrasound in order to help diagnosis many different conditions both in gynecology and obstetrics. We use a 4D ultrasound machine that produces the clearest pictures available. Since we have the machine right here in our office it is more convenient for our patients. There is no second registration process at an imaging center that you have to drive to. Ultrasounds at our office are performed by either a certified sonographer or a physician

24th – 28th week:

Lab Testing – CBC, Glucose Testing (for diabetes) and antibody screen applicable to your blood type.

35th – 36th week:

Beta Strep Culture - This is a vaginal/rectal culture. If tested positive we will treat with antibiotics in labor to help prevent sepsis or pneumonia in infants.

Classes: We recommend Lamaze classes to everyone. It is offered at Community Health Education Resource or CHER (handout in your packet). Also, there are a lot of other wonderful classes including Breast Feeding, Fathers Only, Sibling Class, etc. that you may be interested in.

Hospital: We deliver exclusively at Valley Medical Center. Tours are available in Labor and Delivery as well as pre-registration. Consider calling for an appointment at (509) 473-5475.

Our Mission: At Valley OB-GYN our mission is to provide the highest standard current medical care, as well as personalized care to meet your unique needs.

We look forward to taking care of you during your pregnancy!

Sincerely,

Robert Hartman, M.D.

Lori Joy, M.D.

Craig Smentek, M.D.

Jeffery Williams, M.D.

Karen A. Kuehn, MSN, ARNP

Douglas L Brown, D.O.