Obstetrics at Renaissance OB/Gyn

 We typically schedule your first obstetrical visit around 8-9 weeks gestation however if you are unsure of your last menstrual period or would like to meet our staff to ask questions and voice concerns, we would encourage a suppression of menstruation visit, where expectations for the pregnancy are outlined and questions can be answered.  We will also discuss risks associated to any medical conditions that you may have as well as risk of miscarriage and ectopic pregnancy.

After that, your first obstetrical appointment is typically an hour long, which includes a full health history interview and complete physical exam including a pap and STD screening.  We welcome your partner to attend as well especially since we go through their health history as well.  You will also be given a lab slip to have blood testing done and we ask that this be completed prior to your next visit with us, so that we may discuss these lab results in person.  Auscultation of the fetal heart beat can be obtained around 11-12 weeks gestation.

Prenatal visits are usually every four weeks until week 28, every two weeks until week 35 and then weekly until delivery.  Certainly if any concerns arise during your pregnancy then more frequent appointments may be necessary. 

A full anatomy Obstetrical Ultrasound is typically done around week 19-20 weeks gestation to obtain a detailed report of your baby's growth and anatomy.  You may need an ultrasound at an earlier time during your pregnancy should you be unsure of dating, have irregular cycles, cramping, bleeding or any other issues of concern. This appointment is usually an hour long and afterward, you'll meet with either MaryLou Phillips, CNM or Dr. Garcia to discuss results.

At your inital obstetrical appointment you will be given a lab slip for blood work to be drawn either at Quest Diagnostic Labs on Euclid Avenue in Cortland or at the Cortland Regional Medical Center.  The first set of labs, include but is not limited to: CBC, Hepatits B Antigen, RPR, Blood Type, Antibody Screen, Lead, Varicella, Rubella and HIV testing.  Cystic Fibrosis testing is offered and is an optional test.  Other tests may be added depending on your health or history in past pregnancies per provider recommendation.

At week 16-22, the Maternal Serum Alpha Fetal Protein test will be offered.  This is our optional screening test for Down Syndrome, Trisomy 18 and Neural Tube Defects.  Screening means that this doesn't diagnose if your baby has any of those conditions, rather lets us know that you're pregnancy needs to be offered a high level ultrasound and potentially an amniocentesis at the Perinatal Center in Syracuse.  For Down Syndrome, this test is approximately 85% accurate and for Neural Tube Defects it's approximiately 60% accurate which is why a genetic amniocentesis is recomended as that has over 99% accuracy for diagnosis.

As you enter the 3rd trimester, week 27-29 brings the last serum test - a One Hour Glucose Test, CBC and (if warranted) Blood Type and Antibody Screen.  The One Hour Glucose Test is our screening test for Gestational Diabetes.  This is a non fasting test, where you show up to the lab, drink a sugary liquid substance, stay for an hour and the lab will test your blood.  If this result is greater then 140, it is recommended that you do the Three Hour Glucose Tolerance Test.  The 3hr GTT is our diagnostic test for gestational dibetes.  A CBC is a test ordered to check your iron stores as most pregnant women become anemic as they enter the 3rd trimester.  If so, your provider will start you on an Iron supplement until delivery.  If you are Rh negative, then blood type and antibody screen will be ordered as well to be sure that you are still a candidate for Rhogam which will be given at the next appointment.

Deliveries

Here at Renaissance OB/Gyn Dr. Garcia and MaryLou Phillips, CNM both take call and do deliveries.  The provider on call the day you arrive in labor or with an obstetrical concern will be the one to take care of you.  Currently, we deliver at Cortland Regional Medical Center.  In the event that you would need a C-Section, Dr. Garcia is the operating surgeon and MaryLou Phillips, CNM is the First Assist, so you may have both of them.  Keeping that in mind, there are some times when your office visit may need to be rescheduled or delayed as babies decide to come when they want to.  We apologize in advance but know that in a few shorts weeks it may be you and your baby that need our attention at that time.

Cystic Fibrosis is an inherited disease that causes thich mucus to build up in the lungs and digestive tract.  It's a recessive disordered which means that both parents would have to be carriers in order to produce a child with cystic fibrosis.  If both parents are carriers then that chance can be up to 25%.  This specific test is to see if mom is a carrier.  If positive, then the father of the baby is encouraged to get testing as well.  There is a small chance that even if both parents are not carriers that the could spontaneously create a child with cystic fibrosis although this is not common.

Ectopic Pregnancy - An ectopic pregnancy is when the embryo implants anywhere except the uterine lining as expected. This can occur on the cervix, ovary, in the abdomen, or in a fallopian tube. It occurs in less than 1% of pregnancies and is obstetrical emergency! Signs and symptoms usually include bleeding, spotting, and severe abdominal pain - can feel sharp, stabbing, tearing in nature. If you have any of these symptoms its important to call your health care provider immediately.

Miscarriage - Any woman newly pregnant has a 20% chance of miscarriage in the first trimester. That means 1 in 5 women will miscarry in the first 13 weeks. It is very important that you contact your health care provider  if you experience any cramping, bleeding, or spotting.