Obstetrical Patient Visits
NEW OBSTETRIC PATIENT VISIT:
- Baseline History, Physical Exam, and Lab tests
- Cultures CT/NG, Pap smear if indicated, Urine
- CBC, Blood group and Rh type, antibody screen,
- HIV, RPR, HBsAg, Hb electrophoresis,
- TSH, Vitamin D, Rubella titer, Varicella titer
- Risk assessment and discussion.
- Introduction to Website
- Counseling Genetic Tests:
- NIPT, Carrier Screening: Universal, or Simple.
- Info For Every Week of Pregnancy
FIRST ULTRASOUND OF PREGNANCY:
- Transvaginal Ultrasound
- Dating the Pregnancy, Confirm Life, Rule out twins
- Images sent to the patient’s phone.
- Review for urgent problems
- Schedule New OB visit in 7-10 days
12 WEEK VISIT:
- Offer EVMS Genetic Consult Option
- Multiple Marker Screening
- Non-Invasive Prenatal Screening
- Carrier Screening (Simple)
- Carrier Screening (Universal)
- Offer Cystic Fibrosis, Tay Sach, Fragile X, SMA tests
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
16-17 WEEK VISIT:
- Multiple Marker (Quad Screen) if no NIPT
- AFP testing (if NIPT done)
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Provide Ultrasound Consent Info
20 WEEK ULTRASOUND:
- Look at baby’s anatomy (Morphology Scan)
- Determine Fetal Sex (if unknown)
- Tuesday-Thursday Evenings
21-22 WEEK VISIT:
- Review Ultrasound
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
26-28 WEEK VISIT:
- Pediatrician List
- Birthing Plan
- Birthing (and other) Classes
- When Labor Begins
- Recommend Pertussis (Tdap) Vaccine
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Screen for Gestational Diabetes
- Recheck H&H, RPR, HIV,
- Recheck Blood type and antibody screen
- If Rh (-) receive Rhogam
30-32 WEEK VISIT:
- Pre-register at Sentara Leigh Hospital
- Visit Sentara Leigh Hospital
- Remind Cross Coverage Arrangement
- Circumcision Information
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
35 WEEK VISIT:
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Group B Strep Vaginal Culture
- Recovery From Pregnancy Info
- Birth Control after Baby is born
37 WEEK VISIT:
- Start internal examinations
- Cervical dilation / Fetal Position
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
38 WEEK VISIT:
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Cervical dilation / Fetal Position
39 WEEK VISIT:
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Cervical ripeness / Fetal Position
40 WEEK VISIT:
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Cervical dilation / Fetal Position
41 WEEKS AND BEYOND
- Any Problems or Questions?
- Vital Signs, Weight, Urine check.
- Uterine Size, Fetal Heart Beat
- Cervical ripeness / Fetal Position
- Non-Stress Testing, Biophysical Profile
- 2x/week visits hereafter