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Prenatal Fetal


Prenatal Fetal

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Premier OB/GYN of South Florida
     Jorge Pando, MD. OB/GYN
       Palmetto Medical Plaza
      7100 W 20 Ave. Suite #701
          Hialeah, Fl. 33016
                                Obstetrical Calendar
Initial Visit
     Determine due date
     Discuss prenatal vitamins
     Order labs, ultrasound, offer information about genetic testing options
About 12 Weeks
     Check weight, BP, and urine
     Discuss prenatal laboratory testing
     Listen to fetal heart beat
About 16 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     Order Alpha Fetal Protein test (AFP) if desired
     Order 20 week Sonogram
About 20 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     Sign up for Childbirth Education Classes
About 24 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     Give Lab sheet for 28 weeks glucose test and CBC
About 28 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     CBC and one-hour glucose test (fasting is not necessary)
     A Rhogam shot is given to patients who have Rh-negative blood type
     Complete hospital pre-registration form and select a pediatrician
About 30 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     Discuss glucose test results
About 32-36 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     Check for the baby's position
     Group B strep culture of the vagina
     Order 36 Week Sonogram
About 36 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
     A cervical examination may be done
     Non Stress Test, if indicated
About 40 Weeks
     Check weight, BP, and urine
     Listen to fetal heart beat and check uterine size
      Non Stress test
      Cervical examination
      Discuss plan for delivery

                             Nutrition in Pregnancy
Managing Nausea and Vomiting in Pregnancy

      Keep crackers, Melba toast, or dry cereal within reach of your bed. Eat some
       before getting up
      Eat frequent small meals.
      Avoid allowing your stomach to become empty as this can increase nausea.
      Try to take adequate fluids, even small sips, if you can't handle solids. Try clear
       juices, flat sugar-sweetened soft drinks, Gatorade, lemonade, ginger ale, tea like
       ginger tea, and peppermint tea.
      Avoid drinking coffee and caffeinated teas.
      Avoid drinking citrus fruit juices and large amounts of water.
      Drink liquids mainly between meals.
      Try to avoid cooking odors that make you feel ill.
      Avoid or limit your intake of high-fat and spicy foods.
      If you have a bad taste in your mouth, hard candy may help.


    Pre-pregnancy             Total Weight       Rate of Gain for 2nd & 3rd
    Weight                    Gain               Trimesters
    Normal Weight             25-35 pounds       1 pound per week
    Underweight               28-40 pounds       More than 1 pound per week
    Overweight                15-25 pounds       More than 2/3 pound per week
    Twins                     30-35 pounds       1-1/2 pound per week

Note: These recommendations are used as a guideline only. Each woman and
pregnancy is unique and individualized. Nutritional counseling and assessment should
be a part of prenatal care and proper adequate nutrition is encouraged for optimal
health for the mother and her baby.

Food Group & Recommended Serving                                                    Servings:

Dairy Foods
                                                                                    (4 Servings)
Rich in calcium, protein, vitamins & minerals
Sources: Milk, yogurt, cheese, salmon, dark leafy greens, cottage cheese

Protein Foods

Rich in protein, iron and B vitamins                                                (6 Servings)
Sources: Beef, pork, lamb, chicken, fish, eggs, cheese, cottage cheese, tofu,
peanut butter, dried beans or peas, nuts, seeds.
Vitamin A Rich Fruits & Vegetables

Rich in vitamin A and fiber
                                                                                    (1 Serving)
Sources: Carrots, spinach, dark leaf greens, sweet potatoes, winter squash, chili
peppers, red peppers, tomatoes, cantaloupe, mango, papaya, apricots, vegetable
juice cocktail.
Vitamin C Rich Fruits & Vegetables

Sources: Oranges, grapefruit, tangerines, lemons, cantaloupe, kiwi fruit,
                                                                                    (1 Serving)
strawberries, mango, papaya, broccoli, Brussels sprouts, cabbages, cauliflower,
chili peppers, red & green peppers, tomatoes

Other Fruits & Vegetables

Rich in other vitamins, minerals and fiber                                       (3-7 Servings)
Sources: Apples, bananas, grapes, peaches, pears, pineapple, plums, watermelon,
green beans, beets, corn, cucumbers, lettuce, peas, potatoes, radishes, zucchini
Bread & Cereals
                                                                                    (6-11 Servings)
Rich in B vitamins, iron & fiber
Sources: Breads, tortilla, crackers, hot & cold cereals, rice, noodles, macaroni

                                                                                    As needed to meet caloric
                                                                                    needs. Use in moderation.
                                                                                    Fats occur normally in many
Provide vitamin A & essential fatty acids
                                                                                    foods such as meat, poultry,
Sources: Butter, margarine, oils, bacon, salad dressings, olives, avocados
                                                                                    & dairy products.
                                                                         Drink at least 8 glasses of
                                                                         liquids each day. Avoid
Fluids                                                                   drinks high in sugar and
                                                                         caffeine. Do not drink any
                                                                         alcoholic beverages.

                              Links to Other Information

     For information on child safety and the proper use of car seats, log on to the American
     Academy of Pediatrics at www.aap.org/family/carseatguide.htm

     Prenatal classes at Palmetto General Hospital Maternity Care Center:
                                  Approved Prenatal Medications
      Listed are medications you can take safely for the minor discomfort of pregnancy. In general, it is best to
      avoid any medications during the first twelve (12) weeks of pregnancy. If you are taking a prescription, we
      should be notified as soon as possible at 305-698-5300.

PAIN MEDICATION                                  HEARTBURN, INDIGESTION, GAS
Tylenol (acetaminophen) for minor aches and      Tums
pains, headaches.                                Rolaids
Codeine (by prescription only)                   Gas-X
                                                 Mylanta (safe to use for first 12 weeks)
DO NOT USE:                                      Tagamet
Aspirin                                          Zantac Acid
Advil                                            DO NOT USE:
Aleve                                            Pepto-Bismol (contains aspirin)
COUGH/COLDS                                      DECONGESTANTS
Robitussin (cough)                               Sudafed (pseudoephedrine)
Robitussin DM (non productive cough)             Robitussin CF
Tylenol Cold                                     Ocean Mist nasal spray (saline solution)
Tylenol Sinus
ANTIHISTAMINES                                   NAUSEA
Zyrtec                                           Small frequent meals
Claritin                                         Ginger Ale
Benadryl                                         Sweet fruit syrup from canned fruits, i.e. pears/peaches
Dimetapp                                         Zofran

INSOMNIA (unable to sleep)                       YEAST INFECTIONS
Benadryl                                         Monistat
HEMORRHOIDS                                      TOOTHACHE
Preparation H (safe throughout entire            Orajel
pregnancy)                                       May see dentist, have cavity filling with Novacaine, have dental x-ray with
                                                 lead shield.
DIARRHEA                                         SWEETENERS:
Imodium (1 dose - if it persists please notify   Nutrisweet
office)                                          DO NOT USE:
Follow the BRAT diet (banana, rice,              Sweet and Low
applesauce, toast)
LICE TREAMENTS                           CONSTIPATION
Rid (only)                               Colace
DO NOT USE:                              Milk of Magnesia

                                How to Recognize Labor
    There are certain signs of labor. You may have all of them or only one of them. They
    may occur in any order.

    This is a pinkish or light red vaginal discharge, often mixed with mucous. This may come
    a few days or hours before labor begins. Call us right away if the bleeding is very bright
    red or enough to saturate your pants.

    RUPTURED MEMBRANES: (Breaking of the bag of water)
    This may be a gush or just a trickle of fluid. It may be difficult to distinguish from urine
    or normal vaginal discharge. If you have any doubt about whether or not your membranes
    have ruptured, we want to hear from you. Amniotic fluid has a characteristic clean aroma,
    almost like very, very dilute bleach. Please note the color of the fluid- clear, greenish, or
    bloody. Even if you are not having other signs of labor at the time your membranes
    rupture, it is very important to get in touch with us or go to the emergency room.

    The tightening of the urine muscle causes a sensation which may be perceived as severe
    menstrual cramps or may be as indistinguishable as gas pains. Contractions may begin in
    the back and move around to the front. You may feel your abdomen tightening at the
    same time. The tightening should reach a peak of intensity and then ease. Walking,
    changing position, taking a shower, etc. will not cause true labor to stop but may relieve
    false labor or Brackston Hicks contractions. Try timing the contractions noting when
    each one starts.

          Severe swelling in your face, hand or feet; weight gain of 2-3 pounds in one day.
          Blurring of vision or spots before your eyes
          Severe or constant headaches
          Sever, continuous vomiting
          Fever and chills
          Burning and pain when you urinate
          Sharp, constant abdominal pain

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