We provide comprehensive obstetric care for normal and high risk pregnancies. As parents ourselves, we understand that pregnancy is an exciting but sometimes scary time. We do our best to put you at ease and encourage the entire family to participate in the experience.

1ST TRIMESTER
 
1st Visit- at your first visit you will have a detailed intake with the nurse and you will meet your doctor. You will receive an ultrasound on our 30 inch flat screen monitor and receive a keepsake picture of your baby. A pap smear and routine blood work will be performed.

Tests for Chromosomal Abnormality

These are optional tests available to help detect chromosome abnormalities such as Down syndrome. It is a personal decision whether to have these tests performed. Some reasons would be maternal age greater than 35 years old, a prior infant with abnormalities, or personal preference. If you are interested in these tests, we can have one or more scheduled:

CVS (Chorionic villus sampling)- This is an invasive test that can be done around 10-12 weeks. During a CVS, a small sample of cells is taken from the placenta.

Nuchal Translucency/ Ultra Screen- This is a minimally invasive test performed between 9-13 weeks from the last menstrual period. A transvaginal ultrasound is used to measure the neck fold (or nuchal translucency) of the baby. A blood test is also performed that tests for Beta HCG and PAPP-A proteins. These combined tests can detect 90% of babies with Downs Syndrome and 97% of babies with Trisomy 18.

Quad Screen- This is a maternal test offered from 16-20 weeks. Where blood is drawn to check the levels of 4 proteins (alpha-fetoprotein, HCG, estriol, inhibin A). This helps screen for Down’s syndrome, Spina Bifida and Trisomy 18. However there is a small risk of false positive (the test is abnormal but the baby is normal) and false negative results (the test is normal but the baby is abnormal).

Amniocentesis- This is an invasive test that can be performed at 15-18 weeks. It will reveal the baby’s exact chromosomes. In this procedure, a sample of amniotic fluid is withdrawn from the mother’s abdomen using a needle. These cells are then cultured in the lab for about 2 weeks.

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ACTIVITIES GENERALLY CONSIDERED SAFE DURING PREGNANCY

• Color your hair
• Paint with an open window
• Exercise- Ask for guidelines
• Lifting up to 20lbs
• Sexual intercourse
• Flying until 36 weeks of pregnancy
• Traveling more than 2 hours away until 36 weeks of pregnancy
• TB test
• Flu shot (after 13 weeks of pregnancy)
• Manicure/Pedicure

Nutrition:

• Attempt to eat a well balanced diet. Do not over eat sweets or carbs such as white rice, pasta, or breads. Small frequent meals with balanced protein, fat, and carbohydrates will keep blood sugar levels stable.
• Lemon drops and ginger can also help with nausea
• Do not eat swordfish, shark, mackerel, or tilefish
• 2 servings of fish such as salmon, catfish, and shrimp are acceptable and actually recommended
• Stay away from processed lunch meats and hot dogs unless heated

Nausea and Vomiting in Pregnancy
Nausea and occasional vomiting is upsetting but is very common from 6-12 weeks. If you cannot keep food or water down for 24 hours or more, call the office. Small frequent meals and fluids may help as well as avoiding unpleasant odors.

Ginger in many forms can relieve nausea. It can be in the form of ginger root capsules (desiccated ginger…same stuff used for cooking), tea made from freshly grated ginger, ginger ale (with real, rather than artificial ginger), ginger cookies, or a product called Ginger Works which is ginger in some sort of thick, sweet syrup.

Wrist acupressure bands for motion sickness help some. These can be purchased in most drug stores.

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*Please refer to this list before calling the doctor’s office. Only call Doctor ON-CALL if it is a TRUE EMERGENCY. **Our Physicians only have privileges at Oakbend Medical Center, Methodist Hospital Sugar Land, St Luke's Sugar Land and Memorial Hermann Sugar Land Hospital. All other facilities will not contact your physician.

SYMPTOM	MEDICATION (FOLLOW DIRECTIONS ON BOX.)
Headache, Fever, Pain	Tylenol or Tylenol ES ONLY. *No Aspirin, Motrin, or Aleve.
Stuffy Nose, Headaches	Actifed, Benadryl, Saline Nasal Drops, Tylenol, Claritin, Pseudoephedrine.
Cough	Triaminic, Robitussin DM
Sore Throat	Chloraseptic, Cepacol
NOTE:	If you experience a sustained fever greater than 100.5 with any of the above symptoms, please call the office.
Heartburn, Gas	Mylanta, Tums, Maulax, Pepcid AC, Zantac
Constipation	Metamucil, Colace, Surfak, Citracel
Diarrhea	Immodium Clear liquids for 24 hours Call PCP for appointment. If diarrhea lasts 48 hours
Nausea, Vomiting	Vitamin B6, Emmetrol, Clear liquids for 24 hours. Call for appointment if it lasts 24 hours.
Painful Urination	Please call office

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