Obstetrics

Other tests may be necessary depending on your particular situation. These tests are as follows:

• Three-hour Glucose Tolerance Test (GTT)

  The Three-hour Glucose Test is given only if your One-hour Glucose Tolerance Test result is abnormal. If this test indicates that you have gestational diabetes, you will need treatment (usually a special diet) and closer observation for the rest of your pregnancy.

• Two-hour Post-Prandial Blood Sugar (2 HR PP)

  This test will be given at each visit if you have gestational diabetes. The test measures your blood sugar to be sure it is within normal range, which helps to determine your treatment plan.

• Toxoplasmosis Titer

  If you have cats, you could have an infection that is spread by cats and has been related to congenital abnormalities in the fetus. This test checks for the presence of antibodies.

  If you have cats, you are susceptible to toxoplasmosis. Please do not change the litter box. Let another family member do this job for you. Also keep cats out of your face. Use good hygiene after petting any cat. Wear gloves if you work outside in your yard and you have stray cats or neighborhood cats. Testing is available for this infection.

• Rhogam and Antibody Screen

  If you have Rh negative blood, you will be tested for antibodies to Rh positive blood. These can harm the baby if it has Rh positive blood. You will be given Rhogam at 28 weeks and after the baby is born if the baby is Rh positive. This will suppress your immune system to prevent antibodies from being made that may harm the fetus in this and future pregnancies.

• Sonogram (Limited)

  Ultrasound is used to determine the size of the fetus in relation to the calculated due date. It is medically indicated if the uterus is measuring larger or smaller than normal. It will also check the baby’s heartbeat, movement, and position. It can determine if there is more than one fetus and rule out some abnormalities.

• Biophysical Profile

  This test uses ultrasound to evaluate the status of the fetus by measuring several factors including: spine and body movement, limb movement, amniotic fluid movement, fetal weight, breathing and the position of the placenta.

• Non-stress Test (NST)

  Non-stress test assess fetal heat rate in response to activity and spontaneous contractions graded as reactive and non-reactive. If the NST is non-reactive, it may be followed by a physical profile or a contraction stress test that will assess the baby’s response to indicated contractions. If you are diabetic, these are done weekly late in the pregnancy. They are also done if you are past due or notice a decrease in normal fetal movement.

• Biophysical Profile with NST

• Amniocentesis

  This procedure is recommended if you are 35 or older due to the increased incidence of congenital abnormalities after this age. It may also be indicated if there is a family history of chromosomal abnormalities. This fee is for the office procedure only. You will receive a separate bill from the outside reference laboratory for the actual chromosome analysis.

• Syphilis Test

  As part of prenatal care, all pregnant women undergo a series of blood tests. One of these tests is for syphilis. State law requires testing at your initial visit and at 28 weeks. Having this test will enable your physician to give you and your baby better healthcare. Our office is required by law to report all positive tests to the Guilford County Department of Public Health. This test will become part of your medical record and the result will be kept completely confidential. Only healthcare providers directly involved in your care will know your result. You will be asked to sign a consent form during your next office visit.

• HIV Antibody Test

  This test will not tell you:

  1. If you have AIDS
  2. If you will develop AIDS
  3. If you are immune to AIDS
  4. If you are healthy

  
  A negative test result indicates that the antibody has not been found in your blood. If you test negative, there are two possible explanations:

  1. You have not been infected with the virus; or
  2. You have been infected by the virus but have not yet produced antibodies

  
  A positive test results indicates that you have probably been infected with the AIDs virus and your body has produced antibodies. Researchers have shows that most people with AIDS antibodies have active virus in their bodies. You should therefore assume you are infectious and capable of passing the virus on to others. A positive result does not mean:

  1. That you have AIDS
  2. That you will get AIDS
  3. That you are immune to AIDS

  Without treatment, 50% of HIV infected people will develop an AIDS-related illness within 10 years. In some people, AIDS-related illnesses may develop within a few years.

  
  Source: CDC- Voluntary HIV Counseling and Testing: Facts, Issues, and Answers.

  
  Note about Confidentiality – People taking the test should be aware that there may be some risk associated with letting others know about the test results. Test results have been used to discriminate against persons in employment and insurance. However, you should know that it is illegal in North Carolina for persons to be discriminated against in public housing, public services, public accommodations or public transportation because of HIV infection. Someone who is infected with HIV protected under the Americans with Disabilities Act. Those who need to know that someone has tested positive include that person’s health care providers (doctors and  dentists), sex partners, and anyone with whom that person has shared needles or syringes.

  Our office is required by law to report any positive HIV antibody test to the Guilford County Department of Public Health. http://epi.publichealth.nc.gov/cd/lhds/manuals/std/nclaws/Reference_Guide_to_Selected_PracticeRequirements.pdf

• Cystic Fibrosis Carrier Test

  Carrier testing for Cystic Fibrosis is available. Please speak with your provider if you have questions or concerns about the disease. You should discuss testing with your doctor if Cystic Fibrosis runs in your family or the father of the baby’s family. For more information about Cystic Fibrosis visit www.cff.org

• Familial Dysautonomia Test

  If you are of Ashkenazi Jewish origin (Eastern European), or you have a family history of Familial Dysautonomia, or if your partner is a carrier of this disease; please inform the provider you see at your Prenatal Dare Plan visit. Testing is available for this disease. For additional information about Familial Dysautonomia visit www.familialdysautonomia.org

• Other Prenatal Testing

• Why should I have prenatal testing?

  According to the American College of Obstetricians and Gynecologists (ACOG), almost all children in the United States are born healthy. Only 2 or 3 out of 100 newborns have major birth defects. For a majority of babies the cause is unknown. However, there are certain birth defects that can be tested for prenatally—before a baby is born. These include Down syndrome, trisomy 18, trisomy 13, and open neural tube defects.

  The risk of having a baby with chromosome abnormality, such as Down syndrome, increases with the mother’s age. However, ACOG recommends prenatal testing be offered to all pregnant women, regardless of age.

• We offer InformaSeq Prenatal Test and First Trimester Screen | Fß and Nuchal Translucency Screening

• InformaSeq Prenatal Test

  This is an early and accurate test for assessing the risk of Downs syndrome and other chromosome conditions. This test also offers an optional analysis for fetal sex and chromosome (X,Y) conditions.

• First Trimester Screen FB

  This is a simple blood test used to screen for chromosome abnormalities including Downs syndrome. It is performed when a fetus is between 9 weeks and 13 weeks, 6 days of age. Your blood is analyzed for 3 markers normally found in all pregnant women.

  The blood test is followed by an ultrasound (Nuchal Translucency Screening) given when the fetus is between 11 weeks, 1 day and 13 weeks, 6 days of age. The ultrasound confirms your baby’s age and measures the amount of fluid behind the baby’s neck.

• Additional Notes:

  Sonograms will vary in price.
  Some insurance carriers consider these as non-covered services in which case, you are responsible for the payment. Please familiarize yourself with your insurance benefits.

• Global Fee for Prenatal Care and Delivery

  A global fee is charged for obstetrical care and will vary in cost depending on the type of delivery you have.

• Insured Patients

  You are responsible for the portion of your obstetric care not covered by your insurance. This is to be paid prior to delivery. The insurance department will arrange a monthly payment plan for your non-covered percentage of the delivery fee. Global charges for prenatal care and delivery will be filed following delivery.

• Uninsured Patients

  Uninsured patients must pay for their delivery in full at their initial prenatal visit. Payment in full is required for all labs, ultrasounds and procedures at the time of service.

  Please provide us with Complete Insurance Information

  • Insurance company name, address for claims, and phone number to verify benefits
  • Policyholder’s name, date of birth, social security number and employer
  • Group and/or policy number
  • Pre-certification requirements

  You are responsible for notifying your insurance company of your expected hospital admission. Your benefits may be reduced if pre-certification is required but not obtained.

• Frequency of Prenatal Visits

  • Every 4 weeks for the first 28 weeks of pregnancy
  • Every 2 weeks from the 28th week through the 36th week
  • Once a week from the 36th week until delivery

  Visits may be more frequent in some pregnancies. Your provider will perform a pelvic exam at your first visit, at your 28 week visit, then weekly beginning at 36 weeks. The purpose of the pelvic exam is to check the cervix for thinning and dilation, and to check the baby’s position and presentation.

  Contact our insurance department at 336-379-9742 with any questions regarding our charges or your account. Contact patient accounting at Women's Hospital for hospital charges.

• Global Fee for Prenatal Care and Delivery

  A global fee is charged for obstetrical care and will vary in cost depending on the type of delivery you have.

• Insured Patients

  You are responsible for the portion of your obstetric care not covered by your insurance. This is to be paid prior to delivery. The insurance department will arrange a monthly payment plan for your non-covered percentage of the delivery fee. Global charges for prenatal care and delivery will be filed following delivery. Payment for additional tests and procedures is expected at the time of service and will be filed at that time. If you have a deductible, you will be required to pay the entire amount at your first visit.

• Uninsured Patients

  Uninsured patients must pay for their delivery in full at their initial prenatal visit. Payment in full is required for all labs, ultrasounds, and procedures at the time of service.

  Please provide us with Complete Insurance Information:

  • Insurance company name, address for claims, and phone number to verify benefits
  • Policyholder’s name, date of birth, social security number and employer
  • Group and/or policy number
  • Pre-certification requirements

  You are responsible for notifying your insurance company of your expected hospital admission. Your benefits may be reduced if pre-certification is required but not obtained.

• Frequency of Prenatal Visits

  • Every 4 weeks for the first 28 weeks of pregnancy
  • Every 2 weeks from the 28th week through the 36th week
  • Once a week from the 36th week until delivery

  Visits may be more frequent in some pregnancies. Your provider will perform a pelvic exam at your first visit, at your 28 week visit, then weekly beginning at 36 weeks. The purpose of the pelvic exam is to check the cervix for thinning and dilation, and to check the baby’s position and presentation.

  Contact our insurance department at 336-379-9742 with any questions regarding our charges or your account. Contact patient accounting at Women's Hospital for hospital charges.

In the event of an after-hours or weekend emergency, you may reach the on call provider by calling our office at 336-273-2835. You will be connected to our answering service for further assistance. In the event of an OB emergency, please report to the Women's and Children's Center at Moses Cone Hospital or call 911.

Medications Safe to Use During Pregnancy (.pdf) Keep this list with you during your pregnancy. Make a copy and put it on your refrigerator, bookmark this page for quick look-up on your computer, and take a picture of it with your cell phone to always have it handy.

For the latest information regarding the Zika virus, click the link to the CDC below.

https://www.google.com/search?q=cdc+zika&ie=utf-8&oe=utf-8

You can also see the Fox 8 News interview with Dr Taavon on the Zika virus by clicking here.

GREENSBORO, N.C. – Florida Department of Health officials confirmed Friday that four people infected with the Zika virus in the Miami-area got it from mosquitoes in the United States.

Until now, every reported case of Zika in the U.S. was travel related, including 21 in North Carolina, according to the Centers for Disease Control and Prevention.

“It makes me kind of scared to go outside. I mean I know it’s not in North Carolina, but I don’t want to be one of the first cases in North Carolina,” says Winston Salem mom-to-be Emily Brittain.

Brittain is pregnant with twins and due in October. She says she has been following the Zika virus in the news ever since she and her husband Wes were invited to a wedding in the Caribbean islands of Turks and Caicos earlier this summer.

“I don’t want to put myself or my children at risk and I would rather be safe than sorry,” Brittain said.

Dr. Rick Taavon, physician at Wendover OBGYN in Greensboro, says this kind of concern by expecting parents is something he sees often.

“Very common concern especially this time of year with people in the summer doing more travel, Caribbean, Cancun, those are all very popular areas and of course Florida as well,” Taavon said.

Taavon says pregnant women or women who may want to get pregnant should not go to areas with Zika—that now includes the Miami-area in Florida.

“There's a lot of unknowns we don't know how often women who get infected or people who are exposed to mosquitoes will infect their babies,” Taavon explained.

Taavon says experts still don’t know exactly how long the virus will stay in a man or woman’s system or when it could impact an unborn baby.

Taavon’s advice is stay away from areas that are impacted by the virus. He also says it’s a good idea to take precautions at home like wearing bug spray, long sleeves and pants and emptying out any standing water around your home where mosquitoes breed.

Read Dr Taavon's article on the Zika Virus.

Daily Activities

(www.americanpregnancy.org/isitsafe)

• Practice good hygiene - wash hands often.
• Avoid very hot showers, tub baths, hot tubs. Ok for tub baths or hot tubs as long as the temperature is 100 degrees F or less.
• Hair treatments are allowed after 12 weeks in pregnancy (perms, relaxers, and hair color).

Activity and Exercise

(exercise sheet - pregnancy and postpartum ACOG)

• Exercise 30 minutes per day - You may try:  brisk walking, swimming, walking on treadmill, riding stationary bike.
• Do not over-exert yourself to the point of fatigue.
• Do not lift more than 20 pounds in pregnancy - ask for assistance if you need to move heavier objects.
• Avoid activities that could cause personal harm: such as riding motorcycles, bungee jumping,  water rafting, etc.

Nutrition and Vitamins

(www.choosemyplate.gov)

• Take a prenatal vitamin or multi-vitamin daily with folic acid 400-1000mcg daily.
• Take your vitamin with food to decrease nausea.
• Take a DHA supplement daily - many prescription prenatal vitamins include a DHA supplement.
• Eat small, frequent meals that focus on nutritional balance.
• Maintain adequate calcium intake with dairy products, nuts, and green leafy vegetables.
• Drink 8-10 glasses / water bottles daily (8oz serving size).
• Limit caffeine intake to 1-2 servings per day - this includes coffee, tea, chocolate, and soft drinks.
• Notify your provider if you have cravings for non-food substances like dirt, corn starch, plants, paper, freezer frost or ice.

Meats, Deli products, and Cheese

(www.americanpregnancy.org/pregnancycomplications/listeria.html)

• Avoid any raw or rare meats in pregnancy - cook meats thoroughly to medium.
• Wash hands after handling any raw meats and clean countertops after any meat exposure.
• Consume only pasteurized dairy products.
• Limit deli meats and hot dog consumption and warm meat thoroughly prior to consumption.

Artificial sweeteners

(www.americanpregnancy.org/pregnancyhealth/artificalsweetener.html)

• Avoid Saccharin (pink packet called Sweet'N Low).
• Limit Aspartame / NutraSweet to 1-2 servings per day (Diet Coke, diet foods, and blue packet called NutraSweet).
• Ok to use Sugar based products (yellow packet called Splenda, green packet called Truvia, or Stevia).
• Agave (Agave nectar) is NOT recommended in pregnancy.

Fish

(http://www.fda.gov/food/foodborneillnesscontaminants/metals/ucm393070.htm)

• Avoid raw or rare seafood of any type - no sushi or raw oysters or tuna steak.
• Avoid deep water, large fish in pregnancy due to Mercury contamination (shark, swordfish, king mackerel, tilefish).
• Ok to consume 2-3 servings per week of canned light tuna (ok for one serving of albacore tuna per week), salmon, flounder, tilapia, catfish, pollock, crab, trout, scallops.
• Check local advisories for any locally caught fish prior to consumption.

Pets and Animals

(www.marchofdimes.com/pregnancy/complications_toxoplasmosis.html)

• If you have indoor cats, ask someone else to change the litter box.
• Maintain good hygiene by washing hands after contact with pets.
• Wear gloves in the garden or when digging in dirt.
• Contact us if you are bitten by an animal.

Tanning and Sunscreen

(www.americanpregnancy.org/pregnancyhealth/tanningmethods.html)

• Wear sunscreen while in the sun - use 30 SPF or higher to protest skin.
• Ok for self-tanning sprays and lotions AFTER 12 weeks (avoid use in first trimester).
• Avoid tanning bed use while pregnant.

Contact our office

If you need to reach a nurse or provider - please call our main number 336-273-2835 at any time of day or night.

Call us IF you experience:

• any bright red bleeding
• onset of pain
• regular contractions
• leaking of water from vagina
• a fever over 101 degrees F
• a decrease in baby activity or baby is not moving
• vomiting with dehydration - unable to tolerate anything by mouth for more than 4 hours

Check out www.text4baby.org website for pregnancy information sent right to your cell phone.

We especially need:

• any abnormal pap history with any resulting treatment to the cervix,
• any abnormal gyn history,
• all lab and ultrasound reports,
• History and Physicals,
• Operative Notes,
• Discharge Summaries.

Please have the above records faxed to your MD here as soon as possible.

Please have the entire remaining medical record sent by mail. Records should be faxed and mailed to the attention of the MD you will be seeing here:

Wendover OB/GYN & Infertility

1908 Lendew Street

Greensboro, NC 27408

Phone: (336) 273-2835

Fax: (336) 274-4594

Please call us if you need help or if you are unable to obtain your records.

Coronavirus and Breastfeeding

Coronavirus FAQs from the CDC    

The physicians and midwives at Wendover OB-GYN & Infertility follow the recommendations from The American College of Obstetrics and Gynecology (ACOG), the Center for Disease Control (CDC), and the Advisory Committee on Immunization Practices (ACIP) that all pregnant women should receive the flu vaccine at any time during their pregnancy. The following link provides important information for immunizations and pregnancy: Immunizations for women during pregnancy.

The ultimate decision whether to have genetic screening tests is yours to make. The American College of Obstetricians and Gynecologists is a great resource for information.