Your Pregnancy Guide

Thank you for selecting our group. This guide was developed to educate you about our practice and your pregnancy.

Our obstetricians are Drs. Mark Fuoss, Bryan LaBuda, Frank DiCenzo, Christina Cirucci, and Kristine Santerini, all certified by the American Board of Obstetrics and Gynecology. Appointments rotate among members of the obstetric team, allowing you the opportunity to meet everyone involved with your pregnancy care. Deliveries are performed at Heritage Valley Sewickley. Two offices are available for obstetric visits: Edgeworth Medical Commons, 301 Ohio River Boulevard, Suite 301, Sewickley; and Edgetowne Commons, 1009 Beaver Grade Road, Suite 200, Moon Township. For your convenience, early-morning and late-afternoon appointments are available.

When calling the office, please identify yourself as an OBSTETRIC PATIENT to facilitate location of your medical records.

 

Phone Calls
All non-emergency calls should be made to (412) 741-6530 between 8:00 a.m. and 4:00 p.m. If you think you may be in labor at any other time, or have a medical emergency, call (412) 741-6539. If you have a phone number that does not accept calls from blocked numbers, it is very important that you remove this restriction by dialing *86; otherwise, the doctor may not be able to return your phone call.

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Appointments
Routine appointments are scheduled as follows:

ABOUT 8-11 WEEKS FROM YOUR LAST MENSTRUAL PERIOD
You will meet with a member of our staff to gather important personal and family history. Prenatal laboratory work will be ordered at this time. Please be sure to go to the lab designated by your insurance company before your next appointment.

ABOUT 12 WEEKS FROM YOUR LAST MENSTRUAL PERIOD
You will have your first visit with the doctor, which includes a review of your medical history and laboratory results. An internal pelvic examination is performed to measure your uterine size.

UP TO 28 WEEKS
Appointments are scheduled about every 4 weeks.

28-36 WEEKS
Appointments are scheduled every 2 to 3 weeks.

36 WEEKS UNTIL DELIVERY
Appointments are scheduled every week, and a pelvic exam may be performed.

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Laboratory Tests
Initial prenatal testing includes complete blood count, urinalysis, rubella testing, blood type, and testing for sexually transmitted diseases.

Additional testing during pregnancy includes:

18-20 weeks: An ultrasound to evaluate the pregnancy
24-28 weeks: A glucose stress test to screen for gestational diabetes and RPR testing to screen for syphilis. In addition, if your blood type is Rh-negative, a RhoGAM® injection will be administered.
Around 36 weeks: Group B strep culture

Optional Testing

In addition to the routine laboratory tests, optional testing is available to screen for various genetic abnormalities. If you desire this testing, you must contact your insurance company to obtain authorization before scheduling.

First Trimester Screen: An ultrasound and blood work are obtained between 11-13 weeks of pregnancy to screen for Down syndrome. This screening test is performed at The Western Pennsylvania Hospital and Magee-Womens Hospital in Pittsburgh.

Quad Screen: This test screens for spina bifida and Down syndrome, with blood work obtained between 16-20 weeks of pregnancy.

Cystic Fibrosis Carrier Screening: You may have this blood work obtained at any time throughout your pregnancy.

Advanced Maternal Age: Women 35 years of age and older are considered to be of advanced maternal age. The risk of bearing a child with certain chromosomal birth defects increases as a woman ages. Please contact our office if you would like a referral to a genetic counselor who will discuss diagnostic tests such as amniocentesis and chorionic villus sampling (CVS).

 

Things to Avoid
To ensure a safe pregnancy and the health of your baby, please avoid the following:

  • Saunas and hot tubs
  • Alcohol and nicotine (smoking)
  • All prescription and non-prescription drugs, unless recommended or prescribed by a doctor who knows that you are pregnant

 

Medications During Pregnancy

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Common Questions

Employment and Disability: You may continue working throughout your entire pregnancy, providing your job poses no more hazards than those encountered in daily living and your pregnancy is uncomplicated. Barring any unforeseen complications, disability is offered from 38 weeks of pregnancy until 6 weeks postpartum for a vaginal delivery and until 8 weeks postpartum for a Cesarean section. In the event of complications during pregnancy and/or delivery, disability will be evaluated on an individual basis. It is your responsibility to provide our office with the appropriate Family and Medical Leave Act (FMLA) forms for completion.

Exercise: Moderate exercise is permissible during the first 20 weeks of pregnancy. After this, check with a member of the OB team regarding exercise recommendations.

Travel: Common sense should be used. In most cases, you may travel domestically without restrictions up to 36 weeks of pregnancy. We strongly recommend that you stay close to home during the last four weeks of pregnancy. If traveling by car, stop every hour and walk around for a few minutes to increase circulation. If flying, walk up and down the aisle every hour for a few minutes. Most airlines do not allow air travel after 36 weeks of pregnancy.

Hair Treatments: Avoid hair dyes or permanent waves during the first three months of pregnancy. Avoid contact of these solutions with the scalp. Highlights may result in less exposure.

Anesthesia: Epidural and intrathecal analgesia is available for pain control during labor. A consultation at 36 weeks of pregnancy will need to be scheduled with the anesthesia department at Heritage Valley Sewickley. Please advise a member of the obstetrics team if you are interested.

Spotting in Pregnancy: Spotting may occur after intercourse, vaginal exam, or bowel movement. If you have any other bleeding, call the office.

Discharge: Increased vaginal discharge is common in pregnancy. If you have excessive discharge or discharge with odor, itching, or burning, please contact the office to schedule an appointment. The mucus plug will discharge as thick or regular mucus from 36 weeks until delivery. Please contact the office if you have watery discharge.

Length of Stay After Delivery: Many insurance programs provide a 48-hour hospital stay after vaginal delivery and a 72-hour stay after a Cesarean section. Review your insurance company’s policy on hospital stays prior to delivery. You may go home earlier if you are doing well.

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Cord Blood Banking
Our practice is happy to obtain blood from the umbilical cord for cord blood banking at the time of delivery, as long as prior arrangements have been made. Please notify our billing office as soon as you have made this decision, and we will make sure this information is included in your medical file and forwarded to Heritage Valley Sewickley. Because this process involves additional time and paperwork, our fee for obtaining the cord blood sample is $200. This fee is not covered by insurance companies and should be paid by the eighth month of pregnancy.

 

Fees
All routine prenatal visits, your delivery (vaginal or Cesarean section), and one postpartum visit are billed globally to your insurance company.

Our global charge does not include laboratory charges, ultrasound, prenatal vitamins, or circumcision fees. In addition, if a Cesarean section is performed, the cost of the surgical assistant is not included. The charge for circumcision is approximately $300; please note that many insurance companies no longer cover this procedure.

Any complications of pregnancy such as premature labor, need for high-risk monitoring, or other conditions will be billed separately. We will certify your pregnancy with your insurance company at the beginning of your obstetrics care. However, if your insurance coverage changes during the course of the pregnancy, you are responsible for informing us of the change. After verifying benefits, if your insurance company states that you will be responsible for a portion of the charges, we will send you a letter to set up a payment plan.

If you do not have insurance coverage, a direct payment plan will be set up for you. All charges must be paid in full by the eighth month of pregnancy. We also recommend that you contact the credit office at Heritage Valley Sewickley to make payment arrangements for your hospitalization.

 

Classes
Expectant parent classes are available through Heritage Valley Sewickley. For more information, please contact the hospital at (412) 749-4270 or click here. For Lamaze classes, please contact Terry Chesky at (412) 264-4515.

 

We hope you find this guide informative. We appreciate having you as a patient and look forward to sharing this pregnancy with you!

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