First Trimester Screening

Instructions/Activity:
Pelvic rest for 6 weeks. (No douching, tampons, or sexual intercourse.)
No vigorous exercise for 6 weeks.
If you have had a C-section, no heavy lifting greater than 10 lbs. For 6 weeks.
No driving for 1-2 weeks (if you have had a C-section) or while take Percocet.
If you have had a 4th degree tear, nothing in the rectum (suppositories, etc.) for 6 weeks.
Also, please use a stool softener for 2-3 weeks after your delivery, such as Colace (which is sold over the counter)
For C-section patients, keep your incision clean and dry. Let the water/soap run down on the incision in the shower. Do not apply soap on a towel and directly scrub your incision. Do not apply any creams/lotions/Neosporin to your incision. Your steri-strips may fall off on their own, otherwise we will inspect and/ or remove them at your 1-2 week appointment. 

Your next appointment should be:
~ In six weeks for a vaginal delivery, unless otherwise specified at the time of discharge.

~In 1-2 weeks, if you had a C-section, for an incision check. You will then have another appointment 4 weeks later for your 6 week post partum exam.

Call the office if you have...

Signs of mastitis including: reddened, hard, and exquisitely tender areas to the breast accompanied by a fever greater than 100.4.
Excessive vaginal bleeding greater than 1 soaked pad per hour. (You will have vaginal bleeding for 4-6 weeks after delivery. This may slightly increase 2-3 weeks after delivery, but will then taper off.)
An exquisitely tender abdomen accompanied by a fever greater than 100.4.
Any signs or symptoms of post partum depression.
For C- section patients
~ Any opening of your incision
~Any drainage from your incision that is excessive, or any pus coming from the incision.

Medications:
Percocet, 1-2 tablets every 4-6 hours as needed for pain.
Ibuprofen 600 mg every 6 hours as needed for pain.
For constipation: Colace, Milk of Magnesia
Continue your prenatal vitamins as long as you are breast feeding or for 30 days after delivery.
For hemorrhoids, use Tucks pads, Preparation H, Proctofoam as needed.
For cracked/sore nipples you may use Lanolin cream. 





Episiotomy and Laceration Care

“Sitz Baths” (simply sitting in a tub of warm water 15 minutes, 2-3 times per day) can help to relieve discomfort resulting from lacerations. Additionally, Tucks pads. Witch Hazel and Lanacaine, may be applied to the external vaginal area as needed. You may also use oral pain medications as described above. Stitches will dissolve in 1-6 weeks. You will be more comfortable if you are not constipated; please follow directions above to prevent/treat constipation.


Hemorrhoids

Sitz baths, as described above, can help alleviate hemorrhoid pain as well. You can aso use topical agents such as Tucks pads, Witch Hazel pads, or Preparation HC. Actively prevent constipation.

Reasons to Call Your Physician
Fever greater than 101
Cesarean incision that is red, draining or increasingly painful
Signs of a breast infection: red and painful area on your breast, especially if associated with fevers greater than 101 and/or flu-like symptoms
Foul- smelling vaginal discharge
excessive vaginal bleeding (see above section on vaginal bleeding)
Swollen, red, painful area on your leg
Chest pain
Persistenly painful urination or inability to urinate
Worsening vaginbal or rectal pain
Persistent headache not relieved with pain medication, changes in vision, and severe right sided painThe more you understand your body and how it functions, the better equipped you'll be at taking care of yourself to achieve optimal health. We've included the Patient Education section on our website to provide you with valuable, practical wellness information which you can incorporate into your lifestyle to improve the quality of your life. We hope you will turn to these pages whenever you have a question about health related issues and urge you to contact our practice at any time to make an appointment with one of our doctors. 

What is a First Trimester Screening?

A first trimester screening, performed roughly between 11-13 weeks of pregnancy, is used to detect chromosomal abnormalities such as Down's Syndrome, Edwards' Syndrome and Patau's Syndrome. It involves two parts, a blood test and an ultrasound screening referred to as a ‘Nuchal Scan’ or ‘Nuchal Translucency Screening.’ The screening helps your OB/GYN determine the fetus’ risk of these abnormalities.

How is a Nuchal Scan Performed?

A nuchal scan is done by ultrasound. The ultrasound technician will measure the amount of fluid in the back of the baby's neck. While all babies have some fluid in the back of their necks, the presence of excess fluid in the back of a baby's neck can be a symptom of an abnormality.

When Is a Nuchal Scan Performed?

Nuchal scans are generally performed between 11 and 14 weeks gestation. Tests completed before or after this range are not as accurate.

How Accurate are Nuchal Scans?

Nuchal scans are screening tests - not diagnostic tests. This means that they can be used to assess the risk or likelihood that your baby has an abnormality, but they cannot be used to diagnose a condition. If your nuchal scan does detect an abnormality, you will then have the option to pursue further diagnostic testing.

First trimester combined screenings typically detect Down Syndrome 85 percent of the time. However, they also give a false positive 5 percent of the time, meaning that they indicate an abnormality that doesn't exist.

What Should I Do If My Nuchal Scan Comes Back Positive?

If your nuchal scan indicates that there might be an abnormality, the first thing you need to do is try to relax. Just because the scan says something could be wrong with your baby's chromosomes does not necessarily mean that something is.

At this point, you will likely have the option to pursue diagnostic testing such as chorionic villus sampling or amniocentesis for a better understanding of what is going on. These tests do come with increased risks, however, so you will want to talk to your doctor to find out which course of action is best for you.

What Risks are Associated with Nuchal Scans?

Nuchal scans themselves present no known risks. However, receiving a false positive can lead to undue anxiety, more testing and even terminating a pregnancy needlessly.

Nuchal scans are routine and relatively risk-free, so if your doctor recommends one, do not be alarmed. He or she is likely just checking to be sure.