CT Pregnancy Services
Congratulations on your new pregnancy! CT Coastal OB/GYN is excited for you and, as your partner, we look forward to working with you to make this journey as seamless and stress-free as possible. At your first or second obstetrical visit, we will give you a pregnancy education packet. Much of this information can also be found on our website. Please call our office if you have any questions or concerns not addressed below. Thank you for choosing our practice.
Scheduling Your Prenatal Visits
Every milestone from conception to delivery should be celebrated. To maintain a healthy pregnancy, it’s important to visit our office for regular pregnancy check-ups. The typical pregnancy check-up schedule is as follows:
- Weeks 4 to 28: 1 prenatal check-up a month.
- Weeks 28 to 36: 1 prenatal check-up every 2 weeks.
- Weeks 36 to 40: 1 prenatal check-up every week.
We recommend following this schedule for check-ups; however, it can change depending on the health of you and your baby. Prenatal care is vital for you and your baby’s health and these check-ups can increase the likelihood of a successful birth.
Your first prenatal visit should be scheduled immediately after you’ve learned you’re pregnant. During this visit, your medical history will be documented and a general health check-up will be administered. Your doctor will provide early pregnancy tips, diet, and lifestyle advice to follow to ensure a healthy pregnancy. They will also answer any questions or concerns that you may have.
Types of Prenatal Testing
The first step is to confirm you are pregnant, which entails an initial visit that should be scheduled six weeks after your last menstrual period (or two weeks after a missed period) and may include an ultrasound. After the confirmation visit, an initial pregnancy visit is scheduled. This visit takes longer than usual because it includes a thorough review of your history and blood tests, a full physical exam, and discussing a wide variety of topics to ensure that your pregnancy is a healthy experience.
Subsequent prenatal visits are generally every four weeks until you are 28 weeks pregnant, every two weeks from 28-36 weeks, and then weekly until 41 weeks, which is one week after your due date. These visits will involve checking your weight, urine for protein and sugar, blood pressure, monitoring the growth of your baby, listening to the heartbeat, reviewing your diet, and discussing any questions or concerns you have.
Prenatal visits may be more frequent if needed, based on your specific pregnancy course and needs.
Initial Blood Tests
The initial prenatal labs include a blood count, a blood type and RH status, a test for unusual red blood cell antibodies, a test for hemoglobin disorders, a test to see if you are immune to rubella (German measles), and tests for syphilis, HIV and hepatitis B.
Ultrasounds
We generally perform two medically-indicated ultrasounds in our office:
- First trimester: This helps confirm your due date or evaluate bleeding.
- Second trimester: Occurring around 20 weeks, this ultrasound is used to assess the anatomy and growth of your baby. The sex of the baby can often be determined at this time, if desired.
Additional ultrasounds are done if medically necessary to monitor the health or growth of your baby. Occasionally, we refer patients to the Yale Maternal-Fetal Medicine group for an ultrasound.
If you have any specific concerns about your baby’s growth or development, please discuss this with us and we will schedule more tests if necessary.
Glucose Tests
Between 26 and 28 weeks, we will check your blood count, offer an HIV test, check again for syphilis (as required by Connecticut state law), and perform a glucose screening test for gestational diabetes. Because of a hormone put out by the placenta, some women cannot metabolize glucose as well during pregnancy. If the mother’s blood sugar is too high throughout the end of her pregnancy, the baby can grow too big, and can have problems maintaining its blood sugar following birth. Babies with very low blood sugar can have problems with seizures, maintaining their temperatures, and adapting to life outside the uterus. Many women with gestational diabetes are able to maintain a normal blood sugar range with diet modifications, and the baby generally does very well.
Gestational diabetes screening is done utilizing a 1-hour glucose challenge test. Fasting is not required for this test. At the lab you will be given a sweet sugar solution to drink; one hour later a sample of blood is drawn to check your glucose level. If the glucose level is normal after one hour, no further testing is done. If the glucose level is high, we will ask you to undergo a fasting 3-hour glucose tolerance test (GTT). If two of the values (one, two and three hours after drinking the glucose solution) OR the fasting glucose on the three-hour test are elevated, we will consider that you have gestational diabetes.
Group B Strep Tests
We test all pregnant women at 36 weeks for Group B streptococcus (GBS) using a vaginal swab. It is a widespread bacteria. It resides in the gastrointestinal tract of up to 40% of men and women. In women, it can grow in the urinary tract or vagina as well. People who have these bacteria are said to be “colonized” and are called “carriers.” There is no way to get rid of GBS permanently. It tends to come and go, and rarely causes symptoms in adults.
Why is this important during pregnancy? Because 15-40% of women are colonized with GBS during their pregnancies. There are no symptoms, and colonization may come and go. GBS is not treated during pregnancy unless it is present in high amounts in the urinary tract.
In rare circumstances, GBS can cause a serious illness in the newborn if the mother is colonized. Almost all GBS illnesses in newborns can be prevented with universal screening. That means that each pregnant woman is tested for GBS at the end of pregnancy. If the culture is positive, the mother is given IV antibiotics in labor. Approximately 99% of babies exposed to GBS do not become infected.
More information is available at these websites:
Optional Testing for Pregnant Women
Some diseases are genetically passed from mother to baby. Blood from a pregnant woman can be tested to find out the risk of specific genes being passed to the baby. Even if you are healthy and have no family history of these diseases, you may have a single gene or be a “carrier” of a disease.
Your genes never change. Therefore, these tests do not need to be repeated in future pregnancies. Testing is typically done early in pregnancy but may be done at any time.
The most common genetic disease tests are offered to everyone. Additional tests may be offered based on your family history or ethnic background. Knowing if your baby has a chance of inheriting a disease may change the way you plan for your baby or how you manage your pregnancy. The midwife or doctor will review these testing options at a prenatal visit in the first trimester.
Optional Testing for the Baby
There are two groups of problems that can be screened for without any risk to your pregnancy or baby:
- Down Syndrome or chromosomal problems: The risk for chromosomal problems can be determined using tests of a pregnant woman’s blood and may include an ultrasound of the baby’s neck. Having this information may change the way your plan for your baby or how you manage your pregnancy. The midwife or doctor will review the type of testing that is most appropriate for you at a prenatal visit in the first trimester.
- Spina Bifida or neural tube defects: A test of the pregnant woman’s blood can be done to determine the risk for problems with the development of the spine, spinal cord, or brain. We recommend this testing to everyone; it can be done in the early part of the second trimester (15-21 weeks).
Warning Signs: When to Call CT Coastal
If you are experiencing any of the following symptoms, please give us a call.
- Bleeding
- Persistent pain that comes and goes at regular intervals
- A fever over 100.4 F
- Painful urination
- Vomiting that lasts more than 24 hours
- Severe headaches that aren’t relieved by Tylenol (acetaminophen)
- Blurry vision or flashing lights in front of your eyes
- Leaking fluid from the vagina
- Contractions that do not stop right away when you get off your feet and drink water (contractions are completely normal unless you are more than 36 weeks).
- Decreased fetal movement
Pregnancy FAQs
FAQ’s:
How can I tell if I’m pregnant?
- Classic signs and symptoms of pregnancy include a missed period, tender or swollen breasts, frequent urination, nausea with or without vomiting, and fatigue. You can also take a pregnancy test if you have a feeling you may be pregnant.
When should I take a pregnancy test?
- For a more accurate result, wait until you’ve missed a period to take a pregnancy test. If you don’t know when your next period is due, take the test at least 21 days after you last had unprotected sex.
If I find out I’m pregnant, when should I see a doctor?
- We recommend making an appointment for your first prenatal visit within eight weeks of your last menstrual period.
What prenatal vitamins should I take?
- Beyond checking for folic acid and iron, look for a prenatal vitamin that contains calcium and iron. Prenatal vitamins help promote the development of the baby.
What is a birth plan?
- A birth plan is a written document of what you would like to happen when you are giving birth. This outline of your preferences during your labor and delivery can include who you want with you during labor, if you want pain medication, and anything else that will make you comfortable at that time.
To learn more, please visit our pregnancy links page.