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What to Expect at Your First OB Visit

Your first trip to Denali OB-GYN usually includes a health history with a nurse or medical assistant, a complete physical exam and a Pap smear with your provider. Lab work and a pelvic ultrasound are also done at this time. Initial lab work includes your blood type, immunity to diseases such as hepatitis and rubella, and urine culture.
The pelvic ultrasound will establish viability, estimated date of delivery, placement of the placenta and to rule out a tubal pregnancy. Your first visit will typically be the longest, so plan on being in our office for one to two hours.
At each visit we will ask you for a urine sample. The sample is checked for excess protein and glucose which can indicate pregnancy complications. We will check your weight and blood pressure, measure your abdomen for fetal growth and listen to your baby’s heartbeat. We will schedule appointments approximately every four weeks at the beginning. Toward the end of your pregnancy we will see you more often and weekly for the last month of your pregnancy.
We offer and encourage further testing at various times during your pregnancy. One of the tests we offer is the Early Screen. This consists of a blood test as well as an ultrasound that is performed between 11-13 weeks gestation. This test estimates the chance of your baby having Down ’s syndrome, Trisomy 13 or Trisomy 18. You will be given information at your first visit that will help you make an informed decision about this optional test.
At approximately 20 weeks gestation, you will be offered a detailed ultrasound. This ultrasound evaluates the growth of your baby, checks for fetal anomalies, as well as the gender of your baby.
Between 24-28 weeks gestation, you will be screening for gestational diabetes. During this appointment you will be given a glucola drink and have your blood drawn one hour late. Also, at this time we will be checking for anemia. The glucola test is a screening test and does not make a diagnosis of gestational diabetes, but recommends further testing only for those who might be at an increased risk
The providers in our office share “call” time. Optimally you can see your provider at most visits and your delivery. However, you may be seen by all six of our OB-GYNs over the course of your pregnancy. We will do our best to accommodate all of your personal needs.
You will also meet with our Patient Account Representative to go over what your insurance has indicated they may or may not cover.
The Patient Account Representative, medical assistant and provider are all part of your care team, so feel free to ask them any questions you may have at any time during your pregnancy.

Appointments

Whether it’s your first or one of multiple pregnancies, we make sure your pregnancy is a positive experience. You are welcome to select one physician as your primary provider for your prenatal care, or you may be assigned a physician and optimally your provider will be there for delivery; however the providers in our office share “call” time which means you may be delivered by the physician on call.
Most women visit the doctor 12 times during their pregnancy.

  • Schedule your first appointment eight weeks from the start of your last period
  • Visit every 4 weeks until 28 weeks
  • Visit every 2 weeks from 28 –36 weeks
  • Visit every week after 36 weeks until delivery

The visit between 24 and 28 weeks includes a screen for gestational diabetes. Postpartum visits are scheduled with the primary physician at 6 weeks for vaginal births and at 2 weeks and 6 weeks for cesarean births.
All deliveries are at either Providence Alaska Medical Center or Alaska Regional Hospital.

Laboratory tests

At your initial visit, lab work includes:

  • Complete blood count (anemia screen)
  • Blood type and antibody screen
  • Rubella – German Measles – Titer
  • Varicella – Chicken Pox – Titer
  • Urinalysis
  • Urine culture (Asymptomatic urinary tract infections are common in pregnancy and have been associated with pre-term labor and/or the development of pyelonephritis or kidney infection)
  • Pap smear (if due)
  • Sexually Transmitted Diseases such as Syphilis (RPR), Gonorrhea, Chlamydia – All required by law
  • Hepatitis B – recommended by the American Academy of Pediatricians
  • HIV (AIDS) – recommended by the American College of Obstetricians and Gynecologists and the CDC

Additional tests during pregnancy:

  • Ultrasound at first trimester to confirm due date
  • 18 – 20 weeks for anatomy screen ultrasound evaluates baby growth, fetal anomalies and sex of baby
  •  24 – 28 weeks:
    •  One hour Glucola to screen for gestational diabetes
    • Complete blood count
    • Antibody screen and Rhogam (if Rh negative)
  • 36 weeks:
    • Beta Strep vaginal and rectal culture (Approximately 10–30 percent of the population are carriers of this bacteria which has been associated with serious infections in the newborn. Mothers who test positive at any time will be treated in labor with intravenous antibiotics.)
  • Optional testing:
    • 11–13.6 weeks Nuchal Screening – includes ultrasound and lab draw for Stepwise Part 1 checking for Down’s Syndrome and Trisomy 18
    • 14–22.9 weeks Nuchal Screening – includes ultrasound and lab draw for Stepwise Part 2 for Neural tube defects, Down’s Syndrome, and Trisomy 18
    • Screening for carrier status of recessive genetic diseases