Your baby’s heartbeat can be heard starting at about week 8, but is best heard at your 12 week prenatal visit.
You can expect to begin to feel the baby move at about 20 to 22 weeks of pregnancy. You may not feel daily regular movements until 28 weeks of pregnancy.
It is common to have spotting or bleeding in these situations. The spotting should resolve in about 24 hours. Cal your doctor if you experience heavy bleeding (like a period) or prolonged bleeding (longer than 48 hours).
You need to be healthy for the baby to be healthy. Use of inhalers such as Ventolin, Asmacort, Proventil, or Flonase will help to keep the breathing passages open.
Obstetricians have standardized timing a pregnancy to 40 weeks so that it is easier to communicate and determine due dates as well as well as testing. The first day of your last menstrual period is used to calculate your due date. 20 weeks is exactly half way through your pregnancy or about 4 1/2 months along.
You should continue to care for your teeth in the normal manner. If X-rays are necessary, your dentist will shield the baby. Filling cavities or taking antibiotics, if prescribed by your dentist, is safe and desirable as pregnancy can increase dental disease.
Mild swelling of the ankles and legs is related to the normal and necessary increase in body fluids during pregnancy. To ease the discomfort, elevate your legs or lie down when you can, wear comfortable shoes, and avoid elastic-top socks or stockings.
Tylenol is considered safe to take for a headache, fever or any general discomfort. Follow the recommended dosage on the bottle. Call the office if your headache continues beyond 24 hours.
Sudafed or Actifed is considered safe to take for decongestant. Robitussin is considered safe to take for a cough. Tylenol is safe to take for a fever, aches, and pains. Sore throat lozenges are safe to take for a sore throat.
It is highly recommended by the CDC if you are pregnant or having your baby during the flu season that you get the flu shot.
On your first blood draw for lab testing, you are checked for your immunity. Please call the office if you have been exposed.
Please call your physician if you have been exposed. It is likely that you have had the disease as a child and are, therefor, immune. If you are not sure, a blood test can be done to determine if you are immune.
Please discuss with your doctor if you plan to travel during the third trimester. You should never fly in an airplane after your 35th week of pregnancy. When traveling, it is important to drink plenty of water and to get up and walk about the cabin of the plane every hour.
You may sleep on your back until the third trimester as long as you are comfortable. At that time, if your uterus compresses your major blood vessels, you may become nauseated or dizzy. Placing a pillow under one hip should prevent these symptoms.
Increase oral fluids, dietary fiber (fresh fruits and vegetables), and exercise (walking). You may try Citrucel, Metamucil, Colace or Fibercon. Coffee can also have a laxative effect and alleviate constipation. In an emergency, Dulcolax suppositories or Fleet’s enema may be used.
Early in pregnancy, it is normal to feel cramping as the uterus grows and discomfort as the ligaments stretch. During the second trimester, it is normal to feel pains in the pelvis as the uterus grows, your skin stretches, and the baby moves around. During the third trimester, it is common to have a backache and sciatica. Sciatica causes shooting pains down the back of the leg and buttocks.
There is no information that any of these procedures will hurt your baby. Please weigh any benefits against any unknown potential risks.
Taking prenatal vitamins with folk acid or folic acid alone during the first trimester may decrease the incidence of neural tube defects like spina bifida. There is no data that states that after the first trimester prenatal vitamins are essential.
A warm bath is safe, but the water temperature should not exceed 100 degrees.
Yes. There are several antibiotics that are safe in pregnancy. Consult your OB provider if you are concerned about a medicine you have been prescribed by another physician. The only antibiotic that you should absolutely not take in pregnancy is tetracycline.
No, but if you have any difficulty breathing, you should return to a lower elevation.
There is no evidence that sex causes miscarriage or premature labor in low-risk pregnancies. You may be sexually active until labor starts unless your physician instructs you otherwise. If your pregnancy is complicated, discuss this with your doctor.
Yes, hormones cause the ligaments and the cartilage in the joint to soften and move during pregnancy.
Yes, it is common to have palpitations. Notify your physicians if you have fainting spells.
Monistat or Miconazole 7 day cream is preferred.
Use Anusol HC cream or Tucks medicated pads to relieve hemorrhoidal discomfort. Increase the fluids and fiber in your diet to decrease constipation.
The recommended daily allowance during pregnancy is 1500 mg daily. Calcium supplements with Vitamin D are preferred.
Avoid long periods of standing or sitting. When sitting, elevate your legs above the level of your hips. Try wearing support pantyhose throughout the day. Exercise, such as walking 20 to 30 minutes daily, is also helpful.
Yes. In an uncomplicated pregnancy, we recommend exercise as it makes labor easier and decreases the incidence of pre-term labor as well as cesarean section. If an exercise causes cramping, shortness of breath, or pain, then decrease the intensity or stop exercising and discuss with your doctor
Heart rate does not determine whether the baby is a girl or boy.
Usually around 18-20 weeks during your anatomical ultrasound.
This really depends on your reason for the ultrasound. Please consult our staff.
If the dates are off by greater than 2 weeks, then the due date may be changed. If an ultrasound was performed earlier, your dates will not change.
The schedule for what doctors may be on call is never set in stone. This is always subject to change.
After deciding to proceed with cord blood collection, the parents need to contact a collection company to obtain a collection kit. The kit is brought to the hospital by the patient and given to the labor nurse or obstetric tech for the delivery table. If a cesarean section is necessary, the kit must be placed on the sterile table.
You should check with your carrier. Usually collection and storage are not a covered benefit. Your insurance may reimburse your physician for the professional charges encountered with the collection.
Many companies are now providing this service. A list can be obtained at parentsguidecordblood.com. More information can be found at viacord.com or cordbloodregistry.com. When choosing, look for a firm that has a good transplant history and that freezes the sample in their own facilities.
The menstrual cycle is not the same for every woman. On average, menstrual flow occurs every 28-32 days and lasts about 4 days. Even if there are some variations of timing and duration, your period can still be considered normal.
Please see this Guide to Perimenopause from WebMD or to see what our doctors have written on this topic, see Dr. Salerno’s article Vaginal Dryness or Dr. Crawford’s article The Weighty Issue.
Hormone replacement therapy is not for everybody. Your ovaries will continue to age, with or without hormone therapy. However, some women experience severe hot flushes and lack of sleep because of the natural aging process.
The effect of hysterectomy on sexual function is a controversial subject. It was thought in the past that women who had a complete hysterectomy (removing the uterus and cervix) experience more sexual dysfunction than women who don’t.
There is no screening test that will tell you if you have ovarian cancer or not. Doctors use CA 125 to help in diagnosis and in monitoring the treatment of women with ovarian cancer. It helps in evaluating the likelihood that a suspicious ovarian cyst is cancer or not. Only when the cyst or ovary is removed and examined, you can be sure it is cancer or not
PCOS refers to a condition which hormones (androgens/estrogen) are overproduced by the ovaries. In this condition, ovulation occurs sporadically. The excess and not well organized hormones can cause a lack of a menstrual cycle, excess hair growth, obesity, acne, and insulin resistance. As a result, women with PCOS are at a high risk of developing diabetes.
Your discharge is normal. Every woman is different; some have more discharge than others. You will notice that your discharge changes in appearance about 2 weeks after your cycle. As long as your discharge doesn’t smell, is not irritating or itchy, you do not need to do anything about it.
It is not necessary to douche at all. Douching can lead to changes in the environment of the vagina which can lead to infections such as Bacterial Vaginosis (BV) and yeast infections. The vagina is a self-cleaning organ. Also, if you already have an infection in the vagina, douching can spread this infection into your uterus and pelvic cavity.
There are a variety of reasons why you may be irritated. It is best to consult your physician in these cases. For more information of symptoms and options, please refer to this Fact Sheet from the Illinois Department of Dr. Salerno’s article of Vaginal Dryness.
Dr. Salerno wrote about the Addition Benefits of Birth Control
Frequently asked questions answered by the Mayo Clinic about birth control.
Cervical Shield is an alternative to condoms and spermicide that can be obtained with a prescription.
Emergency Contraception is the use of large doses of estrogen to prevent implantation. It is an important option for women and should be considered when condoms break or get misplaced, when sexual assault occurs, or when diaphragms or cervical caps dislodge.
Side effects vary from person to person. Some women experience little, if any side effects, while others have significant side effects. Keep in mind that there are many hormonal combinations of the pill and if you did not tolerate one there might be a better one for you.
The most common reason women become pregnant on the Pill is improper usage. Pregnancies usually occur because initiation of the next cycle (the next pack of pills) is delayed or forgotten allowing for ovulation to take place. If you do become pregnant while taking the pill, immediately stop taking them.
Women using the Pill decrease their risk of uterine cancer by 50%, ovarian cancer by 40%, and benign breast disease by approximately 40%.
This is an area of controversy and there is no definitive answer for this question. There have been studies that show no increase risk of breast cancer in birth control pill users and there have been studies that demonstrate the converse. From a review of all of these studies the conclusion that can be drawn is that birth control pills do not initiate breast cancer in women.
The pill can be used for many years safely. Long term non-contraception benefits of the Pill include regulated menstrual cycle with less blood flow, reduced risk of iron deficiency anemia, and less painful periods.
Infertility is not increased by use of the Pill. Women who have taken the pill have no higher rate of spontaneous miscarriages, and do not have higher rates of bearing children with abnormalities. For more information on how to plan for a pregnancy, please see Dr. Deeley’s Preconceptual Planning article.
A UTI, or urinary tract infection, is an infection anywhere in the urinary tract. UTI’s are caused by bacteria, and they have many different causes.
Genital HPV infection is a sexually transmitted disease (STD) that is caused by human papillomavirus (HPV). Human papillomavirys is the name of a group of viruses that includes more than 100 different strains or types. More than 30 of these viruses are sexually transmitted, and they can infect the genital area of men and women including the skin of the penis, vulva (area outside the vagina), or anus, and the linings of the vagina, cervix, or rectum.
A LEEP (Loop Electrosurgical Excision Procedure) is used to cut away cervical tissue for examination or removal.
For more information on LEEP, read this article.
A colposcopy is a special way of looking at your cervix by using a lighted, low-powered microscope. At the start of the process, a speculum is placed in the vagina to visualize the cervix. The microscope is used to make the cervix appear larger and allows your healthcare provider to find and then take a sample of biopsy of any abnormal areas.
Endometriosis is a common disorder that affects women of reproductive age. It occurs when normal endometrial tissue (the lining of the uterus) grows outside the uterus. This misplaced tissue may implant itself and grow anywhere within the abdominal cavity. The disease is highly unpredictable. Some women may have just a few isolated implants that never spread or grow, while in others the disease may spread throughout the pelvis.
Progressively increasing menstrual cramping may be a symptom of endometriosis. These are caused by contractions of uterine muscle initiated by prostaglandins released from the endometrial tissue. A puzzling feature of endometriosis is that the degree of pain it causes is not related to the extent of the disease. Some women with extensive disease feel no pain at all.
The oral glucose test (OGTT) measures the body’s ability to use a type of sugar, called glucose, that is the body’s main source of energy. An OGTT can be used to diagnose prediabetes and diabetes.
A OGTT is commonly done to check for diabetes that occurs with pregnancy (gestational diabetes). Patients with Gestational Diabetes will also need to take a glucose tolerance test during their post partum period.
Pregnant women who have had gestational diabetes in a previous pregnancy, women with a strong history of diabetes, those who have given birth to a baby who weighed more than 9lbs, and women who are younger than age 25 and are overweight before getting pregnant.
1 hour test – No specific diet is required, just eat as you normally would.
3 hour test – Eat a balanced diet for at least 3 days prior to the test including an extra carbohydrate added to each meal. Carbohydrates include: fruits, breads, cereals, rice, crackers, and starchy vegetables.
The initial glucose tolerance test takes 1 hour. If the patient does not pass the 1 hour test a second glucose tolerance test is scheduled which takes 3 hours.
For the one hour test you will drink a sweet liquid containing a measured amount of glucose. It is best to drink the liquid quickly; you are given 5 minutes to drink the liquid.
Since activity can interfere with test results, you will be asked to remain in the office and sit quietly during the entire test. You cannot eat or drink during the test, this includes gum and candy.
Yes you will be required to take a glucose tolerance test the same as pregnant patients.
The testing is the same as the 1 hour test for pregnant patients.
It depends on what the lab work is and why you are having lab work done. Our staff will inform you if you need to make certain considerations for lab work.
Here are several possible abnormal pap-results:
LSIL is a low-grade abnormality. Your doctor sees changes in your cells, but isn’t cancer. Your doctor will likely call for a colposcopy exam, which will take place in the doctor’s office. Depending on the results of the colposcopy, you may need a LEEP or Cone Biopsy.
Bone Densitometry is a radiological procedure done to detect low bone mass. It is the gold standard for diagnosing osteoporosis or low bone density. The bone densitometry or DXA scan allows for a diagnosis of osteoporosis or osteopenia in patients prior to a fracture.
The patient is asked to lay face up on a padded x-ray table for approximately 10-20 minutes.
The patient should be comfortably dressed, with clothing that does not have metallic ornamentation. We do not ask that any clothing be removed, but you will be asked to remove any metal objects and jewelry that is around your waist.
A scanner arm moves over the patient’s body but does not touch the patient or cause any pain. A low dose of radiation is then used to measure the bone density in the lower spine, hip and possibly the arm. This is known as a T-score. A Z-score is also obtained.
A T-score is when the bone mass or density is then calculated and compared to the peak bone mass of a controlled population at age 30. A normal T-score is -1 and above. A low bone mass is between -1 and -2.5.
Bone density tests are begun at age 50 or within the first two to three years after becoming menopausal.
Sometimes a patient is asked to have a scan at a much earlier age due to medications they are taking or because of family history. Certain medications such as Depo Provera, Femara, Arimidex anti-convulsant medications, steroids, or antacids can cause bone loss.
A patient should not have a DXA if they have had any x-ray dye in their system within the last 48 hours.
Pregnant women should not have a DXA scan.
We ask that a patient stop taking calcium at least 2 days before the DXA is performed.
All Women has been certified and licensed by the State of Kentucky to perform and evaluate the DXA scans. The technicians and physicians have to be re-licensed every two years to maintain our license.
Your pharmacist can assist you in refilling a prescription.
During your visit, you will be asked to complete various forms. The information you provide assists us during your consultation to assess your medical condition as well as indicate your billing arrangements.
If you have any problems during office hours, you can speak with our OB or GYN nurse. After hours, one of our physicians is always on-call for any emergency.
If you are unable to keep an appointment, please contact our office at least 24 hours prior to your scheduled appointment. If you fail to do so, a charge will be applied to your account.
We see patients by appointment only. To make an appointment please call (502) 895-6559 during office hours.
You will given specific information about the procedure and necessary preparations at the time when the appointment is made.
It depends on why you are being seen at the time of appointment. Please contact us if this is the case.
Please contact our reception, we will provide you with Release of Information form. Once the Release of Information form is submitted back to us we will release your records and information.
We accept a variety of insurance plans, please check with us on registration. We are please to assist you with filing the appropriate forms. If you had recent changes to your insurance coverage please notify us.
We accept cash, personal checks, Visa and MasterCard. Our financial manager will assist you if you have specific questions about fees or other financial policies.
We require the following before we can provide you care and treatment: (1) Updated demographic and current insurance information (2) Co-payment or payment for non-covered services (3) Referral if required by your insurance plan
Once you have seen the doctor and charges for your encounter have been posted, your insurance company will be billed. Following receipt of the explanation of benefits and payment, disallows, write-offs and discounts have been taken, or if there is a denial of the claim, you will be sent a statement for any balance due.
A service charge of $20-$50- may be made on the following: