Presentation Women’s Care Florida

Women’s Care Florida
Drs. Breit, Dukes, Lincourt, Jones, Moore, Whitcomb, Atlanova
Kate Hughes ARNP
Please view and listen to the presentation prior to your visit. This
information will better prepare you for your upcoming
appointment with us.
Please turn your speakers on.
Consider getting a pen and paper to write down
any questions you may have regarding the
There are multiple links for further information
within the presentation- you do not have to view
all of these.
You may pause the presentation at anytime.
From left to right: Dr. Bruce Breit, Dr. Mellissa Moore, Dr. Yelena Atlanova, Shannon Ratke ARNP,
Kate Hughes ARNP, Dr. Anne Marie Jones, Dr. Wendy Whitcomb, Dr. Ester Lincourt, Dr. Steven Dukes
Winter Park
This is our main location.
All ultrasounds are completed at this
All locations have full lab services
Waterford Lakes
during your routine pregnancy
Weeks 8-28
1 visit per month
Weeks 28-36
2 visits per month
Weeks 36 to Birth
1 visit per week
Detailed health history
Identification of medical problems
Discuss any medications being taken
Complete physical exam including
pelvic exam
Lab tests
Check weight and blood pressure
Calculate due date
Discuss genetic screening as
Address questions or concerns
• Checking your weight and blood
• Measuring your abdomen to check your
baby’s growth (middle and late
• Listening for the baby’s heartbeat (after
the 12th week of pregnancy)
• Tests and screenings based on your age,
health history, ethnic background, or
the results of other tests.
• Answering any questions that you have
concerning your pregnancy
a timeline
20 weeks
Ultrasound for
fetal anatomy
and gender
28 weeks
35 weeks
Blood glucose
test to ensure
diabetes has not
Group B Strep
36 weeks
We will begin pelvic
checks to assess your
cervix and position of
baby, these will
continue weekly until
you deliver
*Group B Strep Swab
Winter Park Memorial Hospital
Their “boutique” baby place has many amenities and services available
to suit your family.
Please visit their website at
We also ask that you
preregister at the hospital
online or drop off the form
that will be provided to you
at your visit.
preparing for your little one
Classes are available at Winter
Park Memorial Hospital. You can
sign up online and view available
classes at
– For first time parents we
recommend the Gift of
Motherhood Series.
– There are also classes
available for siblings,
grandparents, and infant first
aid is available.
preparing for your little one
• We offer screening for chromosomal
abnormalities and open neural tube
defects in the practice.
• You have the option to decline or
complete genetic screening.
• Is genetic screening right for you?
– How important is the assurance of a
normal screening test?
– If the results of a screening test are
positive will you choose a more
invasive diagnostic test that carries a
possibility of losing the baby?
– Would a firm diagnosis affect how you
handle the pregnancy or prepare for
the baby?
– If you opt out of further testing, how
will you handle the uncertainty about
your baby's health?
preparing for your little one
• Most, but not all affected fetuses will
be detected
– Incorporates both first-and secondtrimester screening
– First trimester screening involves: Fetal
nuchal translucency (NT)
• Ultrasound to measure the thickness
of the neck and markers in your blood
• This is non invasive and carries little to
no risk
• The blood test and ultrasound are combined to generate a risk for
- If the risk is high, the patient falls into a "screen-positive" category,
is immediately informed and offered further testing (see diagnostic
testing below).
- If the initial test is negative the patient goes on to the second
trimester testing
preparing for your little one
• Second trimester screening-involves a
blood test called the MSAFP
• MSAFP measures markers in
your blood as a screening for
spinal (or open neural tube)
abnormalities and some other
fetal and placental anomalies.
• We recommend all patients
have this screening because it
effects management of your
– Even if you decline First
trimester screening
preparing for your little one
You have the option to choose diagnostic
tests only or as a follow up if screening is
- First trimester : CVS (Chorionic villus
- Second trimester : Amniocentesis
• These tests carry some risks including
infection and miscarriage.
• You may be sent to a specialist to
have these tests performed.
preparing for your little one
In general a healthy diet full of fresh vegetables, fruits, and meats
with whole grain is preferred.
– Here is a link for further reading on nutrition and pregnancy.
During pregnancy an extra 300 calories per day is all that is
– The common phrase “eating for two” is not an accurate
statement and should be avoided to
prevent excessive weight gain.
preparing for your little one
Raw/uncooked food
Soft, unpasteurized cheeses
Excessive caffeine
Unwashed vegetables
High mercury fish
A comprehensive list of safe versus
unsafe fish
nancyhealth/fish mercury.htm
For a more detailed explanation of foods
to avoid
We do not recommend that you smoke cigarettes during pregnancy.
If you do currently smoke, some useful resources to help you quit
are recommended below:
• 1-800-Quit-Assist
There is no known amount of alcohol that is safe to consume during
Illicit drugs are not recommended
For more information and a useful video on the topic please visit
Please refer to the handout of safe
medications during pregnancy given
to you.
It is also available on our website at
If there is any question please call
our office and speak to us before
taking any medication, OTC
supplement, or herbal preparation.
for the health of your baby
We recommend you use a
prenatal vitamin with DHA.
These can be purchased at your
local drugstore and used during
your pregnancy.
If you would prefer a prescription
please discuss this during your
Pre-pregnancy weight
Recommended weight gain
Underweight (BMI less than 18.5) 28 to 40 pounds
Normal weight (BMI 18.5 to 24.9) 25 to 35 pounds
Overweight (BMI 25 to 29.9)
15 to 25 pounds
Obese (BMI 30 or more)
10 to 15 pounds
BMI calculator Link:
For healthy pregnant women exercise is recommended during pregnancy.
Research shows that regular
Increases overall energy
prevents high blood pressure
prevents gestational diabetes
decreases post-partum depression
decrease the “aches and pains” of
pregnancy, including low back pain
• helps to prepare the body for labor
For healthy pregnant women exercise is recommended during pregnancy.
We recommend 30 minutes or more of moderate
exercise a day on most, if not all, days of the week. In the
absence of either medical or obstetric complications.
As a rule if you can carry on a conversation while you're
exercising you are going at the right level. If you can't
speak normally, you're likely pushing yourself too hard..
Do not lay flat on your
back for exercise after 4
months gestation
For healthy pregnant women exercise is recommended during pregnancy.
If you were not working out prior to pregnancy it is okay to start
walking daily.
• The mayo clinic has further information on this topic
If you were working out prior to pregnancy in general you can continue
your workout routine.
• Walking, running, swimming, elliptical, stationary bicycle,
prenatal yoga, prenatal palates are all examples of safe activities
during pregnancy.
• In general you should avoid contact sports, sports that place you
at a high risk for falling, and heavy weight lifting during
during pregnancy
There are multiple resources available to you to
help you track the development of your baby
during the pregnancy.
Mayo clinic has information that tracks the
pregnancy by weeks at
There are many other available resources. We
caution you, however, to avoid blogs and the
information contained within them for
making health care decisions.
Round ligament stretching pain
Heartburn/Acid reflux
Back pain
Evening leg cramps
Sleep positioning
All of these are addressed in further detail
• Many vaccines are safe during pregnancy
and promote health of mother and baby.
• Vaccines given during pregnancy in our
– Tdap- safe after 20 weeks and provides
whooping cough protection for your infant
• Family members with close contact to child can
also receive this vaccine in the office.
– Influenza- recommended during flu season
• Vaccines after pregnancy
– Rubella and Chickenpox may be given after
birth if you are not immune
Is a small parasite that should be avoided during pregnancy
• Do not change cat litter boxes or clean bird cage while
– If you are cleaning them gloves and mask are
• Wash all fruits and vegetables well before eating
• Avoid digging in gardens without gloves
• Cook all meat through and wash hands well after handling
raw meat
For more information on pets in pregnancy
during pregnancy
Sexual activity is considered
safe during routine
• Sex cannot harm your baby or
cause a miscarriage
If you have bleeding, pain, or
discomfort during intercourse
please stop what you are doing
and do not resume intercourse
until discussed in the office.
• For more information
during pregnancy
Air travel and car travel is safe during pregnancy until 34 weeks.
– After that time air travel should be avoided and car travel should be
limited to trips 1 hour from home.
– For longer trips please discuss with physician prior to traveling.
Be sure when traveling to fasten the lap belt under your abdomen and
across the tops of your thighs to avoid pressure on baby.
Walk around every 2 hours for at least 5 minutes to promote circulation
Cruises should be completed prior to 24 weeks gestation per cruise line
For more travel information:
These ultrasounds are optional
and for enjoyment.
• They are not part of your
routine prenatal care.
These are available at our facility
optimal between 28 and 32 weeks.
This can be a nice way to “meet
your baby” prior to delivery
Domestic violence is more
common during pregnancy.
If you are in an unsafe
living situation please
discuss this with us.
Further resources
1-800-799-SAFE (7233)
during pregnancy
Pain management in labor
Choosing a pediatrician
Breast or bottle feeding
Cord Blood Storage
Contraception after delivery
Remember most babies are born healthy!
Enjoy your pregnancy
You have a great team here to work for you!
Women’s Care Florida
Presentation information created
by Kate Hughes ARNP-BC