Thank you for selecting our group. This brochure was developed to educate you about our practice and your pregnancy.
PLEASE READ THIS AS SOON AS POSSIBLE
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. Dr. Kerri McIntyre is board eligible. 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, MoonTownship. 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.
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.
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. 28-36WEEKS Appointments are scheduled every 2-3 weeks.
36 WEEKS UNTIL DELIVERY
Appointments are scheduled every week, and a pelvic exam may be performed.
CALL OUR OFFICE IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING:
- Bloody discharge from the vagina
- Persistent severe headaches
- Severe nausea and vomiting
- Chills and fever over 100.4°F orally
- Abdominal cramping and bleeding
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. Recommend T-Dap for whooping cough and tetanus.
- Around 36 weeks: Group B strep culture
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: This blood work may be 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).
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.
Medications during Pregnancy
Throughout your pregnancy, you can expect to have breast tenderness, possible nausea, frequent urination, and emotional changes. Below is a list of some common problems you may experience and their remedies.
Nausea and vomiting: Ginger tablets (50 mg) three times a day, Emetrol ®,Bonine®, Vitamin B6 10-25 mg 3-4 times per day, Unisom (Doxylamine) 12.5 mg 3-4 times per day, nausea wrist bands. Eat six small meals per day rather than three large meals. Decrease fiber and fat and increase carbohydrates in your diet. Do not recline until at least two hours after eating.
Indigestion and heartburn: Riopan®, Maalox®, Mylanta®, TUMS®, Gaviscon®, Pepcid®AC,Zantac 75®, or Zantac 150® may be used. Eat smaller meals. Do not recline until at least two hours after eating.
Calcium supplements: Os-Cal ®, Caltrate®
Yeast infections: MONISTAT®,Gyne-Lotrimin® Constipation: MiraLAX®, Colace®, Surfak®, Metamucil ®. Try eating 100% bran cereal and other high-fiber foods. Increase fluids to 8 glasses of water per day.
Sleep problems: Benadryl ® orTYLENOL® PM may be taken only after the first trimester (after 12 weeks). Aches, pains, low-grade fever: Regular or Extra StrengthTYLENOL® (acetaminophen)
Cold symptoms: OCEAN® Nasal Spray, chlorpheniramine,and Cold-EEZE® may be taken during the first trimester (12 weeks) of pregnancy and beyond. SUDAFED® Decongestant or SUDAFED® PE Decongestant, Claritin®,and ZYRTEC® may be taken during the second trimester and beyond. Plain Robitussin®(guaifenesin) may be taken for cough.
Other safe medications during pregnancy:
Penicillin,Zithromax®, cephalosporins, erythromycin, Macrodantin®
- Steroid creams, oral steroids
- Proventil ® (albuterol)
- Caladryl ® Lotion, Benadryl ® Cream
- Local anesthetics WITHOUT EPINEPHRINE
Although these medications are considered safe in pregnancy, always discuss with your doctor any medications you are taking
- Varicose veins: Quality support pantyhose or maternity hose can help.
- Hemorrhoids: TryAnusol ®, Preparation H®, orTUCKS® Medicated Pads.
- Pelvic pressure: A maternity support belt may help.
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 LeaveAct (FMLA) forms for completion.
Exercise: Moderate exercise is permissible during the first 20 weeks of pregnancy. After this time, check with a member of the obstetric team regarding exercise.
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 obstetric 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.
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. If a Cesarean section is performed, the cost of the surgical assistant is also 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 obstetric 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.
Expectant Parent Classes are available through Heritage Valley Sewickley. For more information, please contact the hospital at (412) 749-4270. For Lamaze classes, please contact Terry Chesky at (412) 264-4515.
We hope you find this brochure informative. We appreciate having you as a patient and look forward to sharing this pregnancy with you!
We hope you find this guide informative. We appreciate having you as a patient and look forward to sharing this pregnancy with you!