Fequently Asked Questions

Definitely yes. Your obstetrician can review your past family, medical and reproductive history and make recommendations to assure you are as healthy as possible prior to conceiving. Starting folic acid may help reduce certain types of neurological birth defects. In addition, making sure all vaccinations and blood work are current can all help achieve a healthy pregnancy.

For most healthy women, the benefits of the pill outweigh the risks. The benefits include easy light, predictable, painless periods. The pill improves acne. The pill can reduce your risk of developing ovarian and uterine cancer later in life. It reduces the incidence of fibrocystic breast disease, fibroid tumors of the uterus, and ovarian cysts. The risk of blood clots is minimal at 5/10,000 and there does not appear to be any increase risk of breast cancer. In healthy non-smokers you can take the pill through menopause up to age 55.

The CDC recommends all pregnant women receive the flu vaccine if they are pregnant during flu season which usually runs from October through March. In addition, the Tdap vaccine is recommended with each pregnancy for protection against whooping cough. If you are traveling out of the country or work in a field which exposes you to hepatitis, then you should receive the Hepatitis B and Hepatitis A vaccines which are safe in pregnancy.

The average weight gain in pregnancy is 30 lbs. which equates to ½ lb. per week in the first 20 weeks and then 1 lb. per week in the second 20 weeks. If you are underweight then the weight gain is expected to be 28 to 40 lbs. If you are overweight the weight gain is 15 to 28 lbs. For twins the expected weight gain is 35 to 45 lbs.

A saline sonohysterogram is an office procedure where under the guidance of an ultrasound, saline is instilled into the uterus using a catheter. This distends the uterine cavity and allows the physician to see inside the uterus for polyps, fibroids, or tumors which otherwise may not be visible using traditional ultrasound alone.

If pills are not taken daily you do run the risk of an unwanted pregnancy. There is a birth control patch that is changed weekly and a vaginal ring that is changed at monthly intervals. Longer term options include a shot that is given every three months, an implantable rod that is effective for three years, or intrauterine devices that last for either five or ten years. If you have completed your childbearing, permanent surgical options are available. Talk to your doctor about the risks and benefits of birth control and what choice might be right for you.

Most women do not get pregnant on their first attempt. A percentage of women will get pregnant each month and by 12 months approximately 90% of those women trying will succeed. Women who are wanting to conceive should keep a menstrual calendar. If after one year you are unsuccessful see your doctor. If your periods aren’t regular however, see your doctor sooner. Your physician will discuss with you what studies need to be done to find out why you are unable to conceive. Also, if you are 35 years or older discuss with your doctor prior to 12 months.

A pap smear is a screening test for cervical cancer. During a pelvic exam cells from your cervix are obtained using a soft brush. Young women should get a pap smear at age 21 years of age. However it is important that once you are sexually active you see your doctor even though no pap smear is performed as screening for sexually transmitted diseases is recommended. Also, if you are not already on birth control you will need to consider your options and discuss this with your gynecologist.

Not only is dental care safe during pregnancy, it is recommended. Poor oral hygiene and periodontal disease can cause problems with an otherwise normal pregnancy, including infections and even preterm labor. Local anesthesia, antibiotics, and even pain medications can be used. Don’t forget to discuss with your obstetrician and your dentist any allergies to medications that you might have. If needed, x-rays can be performed as long as the abdomen is shielded.

When you start routine pregnancy care your doctor will ask you questions about your history. You may have issues that will prompt your obstetrician to tell you to refrain from intercourse. As your pregnancy progresses, situations might arise where your doctor tells you not to have sex. However, for most women sex during the entire pregnancy is absolutely fine and causes no problems. If you have any spotting, bleeding, or pain then avoid sex and be sure to notify your doctor.

An itchy vaginal discharge for most women usually means a yeast infection. Over the counter creams can be used to relieve your symptoms. If your discharge continues then you need to be seen by your doctor to determine if other causes exist. Sometimes your doctor can diagnose the problem just by examining you, but often cultures need to be performed to determine the appropriate treatment. If your discharge has other qualities such as an odor, color other than white or clear, or you are having pain then you should visit your doctor prior to trying over the counter remedies.

HPV (Human Papilloma Virus) is a group of viruses that cause, among other things, genital warts and cervical cancer. HPV is transmitted via intimate contact. Certain types of HPV can cause change in the cells of the cervix and if left undetected, may lead to cervical cancer. Regular gynecologic exams and PAPs aid to detect HPV and its effects. Your doctor may choose to test for HPV at the same time as doing a PAP. While HPV is common (8 out of 10 women will be infected with HPV), it is usually transient.

Gardasil is a vaccine that helps protect against infection with HPV. HPV (Human Papilloma Virus) is the cause of genital warts and cervical cancer. Gardasil is FDA approved and recommended for girls and women ages 9-45 years old. It is safe and very effective in preventing infection with the most common types of HPV that cause genital warts and the most common types of HPV that cause cervical cancer. It is most effective when given prior to the onset of sexual activity, and is a series of two to three injections given over 6 months.

A hysterectomy is the removal of the uterus. Sometimes the ovaries are removed at the same time as well. Traditionally, hysterectomies have been performed by a large incision on the abdomen and require a several day stay in the hospital and a 2-3 week recovery at home. Today, many hysterectomies can be performed laparoscopically, using instruments through a number of small incisions on the abdomen. This requires only a brief stay in the hospital, and many return to work within 1-2 weeks. Your doctor can determine if this surgical approach is appropriate for you.

Herpes is a virus that is transmitted through intimate contact. It is responsible for sores on the lips and mouth (usually type 1) and also for sores on genitals (usually type 2). The outbreaks of sores are typically recurrent, and can occur up to many times a year. Although there is no cure for herpes, the number of outbreaks can be greatly reduced through medication. Herpes can be transmitted to others even when no sore is present. Taking medication daily can also dramatically reduce the risk of transmitting herpes to an uninfected partner.

There are many misconceptions about common activities and their safety during pregnancy. Unless your pregnancy is complicated by certain high-risk conditions (such as preterm labor or abnormalities of the placenta), travel is appropriate for pregnant women until the last month (36th week) of pregnancy. It is always a good idea to take your doctor’s contact information with you when you travel, in case a problem arises far away from home, and records may be needed. During any prolonged trip in a car or plane, you should periodically take short walks to help prevent a blood clot from forming in your legs.

Group B Strep (GBS) is a bacteria that is common in the vagina of women and can be passed to a baby during delivery. Most babies exposed to GBS do not have any problems, but a few may become sick. To help prevent transmission during delivery, all pregnant women are tested the month before they are due to see if they are a carrier of GBS. Since your friend is a carrier of GBS, she will receive antibiotics during labor to help prevent transmission to the baby. Your friend is not alone; up to 30% of women test positive for GBS.

After excluding serious medical causes such as cancer, there are many options ranging from medication to surgery. Often medical treatments such as birth control pills or progesterone can be effective. Minimally invasive surgery including endometrial ablation can also be a good solution. This procedure destroys the inner lining of the uterus and can result in a significant decrease or elimination of bleeding. Of course, not every option is appropriate for every patient. Ultimately, a hysterectomy may be needed, but new surgical approaches using minimally invasive techniques may be appropriate and can dramatically reduce post-operative pain and shorten recovery time.

New start instructions:

HPV Positive-Your pap smear is positive for the Human Papilloma Virus, or HPV. This is a virus transmitted through intimate skin to skin contact. Certain strains of this virus can increase your risk of developing cervical cancer. Knowing you have been exposed to HPV helps us monitor you more closely to ensure we identify if cells are changing and, if needed, remove them to prevent cancer from developing.