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
POSTDATES VISITS:
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