|What is a Maternal-Fetal Medicine Specialist?
|A Maternal-Fetal Medicine Specialist is an obstetrician/gynecologist who has received 2-3 years of additional education and practical experience to gain special competence in various obstetrical, medical and surgical complications of pregnancy. By virtue of this training and technical proficiency, he/she provides care or consultation for both mother and fetus in a complicated pregnancy. In addition, he/she provides education and research concerning the most recent approaches to the diagnosis and treatment of obstetrical problems. He/she thus promotes awareness of the diagnostic and therapeutic techniques for optimal management of these complicated pregnancies.
It is recognized that many obstetricians are also qualified by training and experience to manage complicated pregnancies. Maternal-Fetal Medicine Specialists are complementary to obstetricians in providing consultations, comanagement or direct care for complicated patients both before (preconceptual counseling) and during pregnancy. The relationship between the obstetrician and the Maternal-Fetal Medicine Specialist will depend on the acuity of the condition and the local circumstances.
|Who needs a Maternal-Fetal Medicine Specialist?
| The discipline of Maternal-Fetal Medicine involves four major subgroups of patients:
|I am an OB; how can I refer patients to your practice?
|Thank you for trusting us with your high risk pregnancies. Please fill out our referral form and fax to: 706-722-7337, or e-mail to firstname.lastname@example.org
|When is the office open?
|Monday through Thursday, 8:00 AM-5:00 PM; Friday 8:00 AM-12 Noon.
We are closed on the following holidays:
|How do I make an appointment?
|In order to make an appointment, there are several steps you can follow:
|Are your new patient forms available online?
Yes, we have made our patient forms available online for your convenience. Feel free to print and fill these out before your appointment, or keep for your records. You will need Adobe Reader to view these files.
|Where is the office?
Our main office is located in the W.G. Watson Women's Center of University Hospital, 1348 Walton Way, Suite 4300 (on the 4th floor), Augusta, Georgia, 30901. To see it on a map, click here. You can also use this site to get driving directions to the office.
|Post Partum (After Delivery) Instructions
Please follow these instructions carefully upon discharge:
ACTIVITY: Restrict unnecessary activity for five days. Do not lift objects weighing more than 10-15 pounds. Climbing stairs should be kept to a minimum. Avoid full household duties and strenuous activity (lifting, stooping, and bending) for 2-3 weeks. Take morning and afternoon rest periods daily.
DIET: Eat balanced meals high in protein. Keep your bowel movements fairly soft. If necessary, use one or two Peri-Colace capsules at night before retiring with several glasses of liquid. If you are breast feeding, drink at least three additional glasses of liquid a day; preferably milk.
MEDICATION: Continue your prenatal vitamins/iron tablets as before delivery. If you are bottle feeding, start your birth control pills on the second Sunday after delivery. If you are breast feeding, we will discuss contraception at your post partum check-up visit. Take your other medication (if any) as prescribed.
BATHING: No tub bathing for at least 4-6 weeks. Take only showers or sponge baths. You may wash your hair at any time.
VAGINAL BLEEDING: Normally, postpartum bleeding will continue for 3-4 weeks. After a few days, it will turn into a brownish discharge, but at times you may have bright red blood again and occasionally blood clots. Should your postpartum bleeding become heavier than a normal menstrual period or should you continue to pass blood clots, contact the office.
MENSTRUATION: If you bottle feed, you will probably start menstruating in five to ten weeks. If you are breast feeding, you will probably not menstruate until at least three months after delivery.
SEXUAL INTERCOURSE: Intercourse, tampons, and douches must be avoided until after your post partum examination.
EPISIOTOMY CARE: Continue sitz baths and heat lamp treatments. Heat lamp treatments can be accomplished with a table lamp (shade on) with a 40-60 watt bulb. Use warm tap water for sitz bath. Check your temperature daily, and call if greater than 100. Also call if you notice bad odor or purulent vaginal discharge.
POST PARTUM CHECKUP: Call the office during your first week at home and make an appointment at six weeks.
BREAST FEEDING: Follow the breastfeeding nursing instructions. If you are not breastfeeding, follow the protocol provided by the hospital. If nursing, cleanse nipples with water and dry before and after nursing. Nursing bras should be worn for support. If not nursing, wear a bra 24 hours a day for at least 7 to 10 days. Supporting bra should be continued for pendulous breasts.
FOR CESAREAN SECTION: You may be going home with the staples still in place. Call the office in 1-2 days to have them removed. You also need to make an appointment to be seen in the office in 10-14 days for an incision check.
Please do not hesitate to call the office at (706) 722-4300 at any time if you should have any questions or problems.
|Frequently Asked Questions: Amniocentesis
|Amniocentesis is a procedure which allows a pregnancy to be tested for certain kinds of birth defects. Since you are going to have amniocentesis (or are thinking about having it), this may help answer some of your questions about the procedure and the tests that can be done.
|Frequently Asked Questions: Maternal Serum Screening
|What is a Cell Free Fetal DNA Testing?
|It is now possible to avoid an amniocentesis when the question of trisomy 13, 18, or 21 arises, thanks to cell free fetal DNA testing. Cell free fetal DNA is a test that measures the level of fetal chromosome 13, 18, and 21 DNA present in maternal blood. This test provides patients with valuable information without the risk of miscarriage associated with other tests.
|What is Expanded Carrier Screening?
|ACOG and ACMG now recommend that all patients be offered Cystic Fibrosis, Fragile X, and Spinal Muscular Atrophy carrier screening. For patients with an Ashkenazi Jewish background, there are additional tests that are recommended. These tests include Canavan, familial dysautomonia, Tay Sachs, Fanconi anemia type C, Niemman-Pick type A, Bloom, Mucolipidosis IV, and Gaucher disease. We now offer an expanded carrier screen for 107 diseases including all of those mentioned above. This testing is done for approximately the cost of the Cystic Fibrosis test alone.
|The Problem of Preterm Birth
Preterm birth is a significant problem affecting newborns today. Babies born prior to 37 weeks of pregnancy may have various problems due to incomplete growth and development. They may experience different problems of varying severity depending on the timing of their birth. Because the birth of a premature baby can affect you and your child for many years to come, we feel that it is important that you have the tools to identify preterm labor early. Early identification may help prolong your pregnancy.
Who is at Risk for Preterm Birth?
The following conditions may be associated with an increased likelihood of preterm birth.
What is Preterm?
The duration of pregnancy is calculated from the first day of your last menstrual period. Your due date is calculated as being 40 weeks from your last period, but every delivery occurring beyond the 37th week is considered full term. In order to understand what preterm is, it is necessary to divide the pregnancy into three stages. First stage, from the first day of the last menstrual period to the 19th week; second stage, from the 20th to the 36th week; and third stage, from the 37th to the 40th week of pregnancy.
If pregnancy ends prior to 20 weeks of gestation, it is considered a miscarriage or an abortion (spontaneous or therapeutic). If pregnancy ends after the 20th week, it is considered a delivery. If the delivery occurs during the period from 20 to 36 weeks, it is a preterm birth. If delivery occurs after 37 weeks of pregnancy, it is a term birth.
|What is Labor?
| Labor is the process by which the uterus (womb) contracts or tightens in a regular pattern and causes the cervix (the mouth of the womb) to open and prepare for delivery. Labor is diagnosed when both uterine contractions and cervical change occur. The changes in the cervix can be evaluated during a pelvic examination by your practitioner. The cervical changes that would occur during labor include:
|What is the Cause of Preterm Labor?
The cause of preterm labor is not completely understood. It is known that certain situations are associated with preterm labor and may increase your risk for early delivery. Very common factors would include carrying more than one baby (twins or triplets) or having had a preterm delivery in the past. Your practitioner may discuss these factors with you. At this time, preterm labor can't be prevented. We can only do the next best thing -- identify it early and treat it effectively to help the pregnancy continue.
Warning Signs of Preterm Labor
Early recognition of the signs of preterm labor may result in better management of your pregnancy. We feel that because you are the only person who stays "close" to your uterus 24 hours a day, you should be the one who can identify these signs early. You probably have a better sense of the changes occurring within your body than anyone else. The following are signs that occur during preterm labor. However, they can also be a very normal part of a healthy pregnancy. What you need to keep in mind as you go over these signs is what may represent a change from your normal pattern or experience.
Again, in the presence of any of the above signs, or if you feel something is different, lie down and monitor for uterine contractions.
What to do if you think you have Preterm Labor
| Sometimes, a problem can occur that needs attention right away. If you notice any of the signs below, CALL YOUR PHYSICIAN IMMEDIATELY.