One Hour Glucola Instructions | Three Hour Glucola Instructions | Cystic Fibrosis Testing | Maternal Serum Alpha-fetoprotein (MSAFP) | Warning Signs to Notify Office or On Call Nurse | Visits to Your Doctor During Pregnancy | Safe Over-the-Counter Medications During Pregnancy

One Hour Glucola Instructions

A blood sugar screening is recommended at 24-28 weeks gestation. This test will determine the possibility of gestational diabetes.

You should be fasting (nothing to eat or drink) after midnight the night before you appointment. You should allow 1 hour for this appointment. PLEASE DO NOT LEAVE OUR OFFICE until the nurse instructs you the test is completed.

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Three Hour Glucola Instructions

This test is more conclusive to rule out gestational diabetes.

You should be fasting (nothing to eat or drink) after midnight the night before you appointment. You should allow 3 hours for this appointment. PLEASE DO NOT LEAVE OUR OFFICE until the nurse instructs you the test is completed. You cannot eat or drink anything until the test is completed.

You will be notified of your results within 48 hours if abnormal.

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Cystic Fibrosis Testing

What is Cystic Fibrosis?

Cystic fibrosis is a life-long illness that is usually diagnosed in the first few years of life. The disorder causes problems with digestion and breathing. Cystic fibrosis does not affect intelligence or appearance.

What is the Purpose of Cystic Fibrosis Carrier Testing?

The purpose of CF carrier testing is to see if a couple is at increased risk for giving birth to a child who will have CF. Cystic fibrosis carrier testing is a laboratory test done on a sample of blood or saliva. If testing shows that a couple is at high risk, additional testing can be done on the developing baby to see whether or not it will have CF. However, most women’s test results are normal.

Cystic fibrosis cannot be treated before birth. The purpose of having this information about your developing baby is so you can prepare yourself to care for a child with special health care needs.

If My Test Result Is Normal, Could I Still Be a Carrier?

Yes. There are some mutations in the CF gene that the current test cannot find. For this reason, you could be told your test result is normal and you could still be a carrier. Like most medical tests, this one has limitations because not all CF mutations are known. However, these unknown CF mutations are rare. The likelihood that you are a carrier even though you had a normal result is very small.

If the Test Shows I Am a Carrier, What Should I Do?

If the test shows that you are a carrier, the next step is to test the baby’s father. Both parents must be carriers for the baby to have CF.

If the father has a normal test result, the chance that your baby will have CF is very, very small. This remaining risk is because the test is not 100 percent accurate, as mentioned in the previous section.

However, since this is a very rare occurrence, if you are a carrier but the father has a normal result, no further testing would be recommended.

What if Both My Partner and I Are Cystic Fibrosis Carriers?

If two people who are both carriers have a child, that child may have CF. When two carriers have a child together, there is a 1-in-4 (25 percent) chance with each pregnancy that the child will have CF. This is true even if they already have other children with – or without- CF.

If CF testing shows both parents are carriers, you might then see a provider for genetic counseling. This person could give you more information and help you decide if you want to test the baby for CF.

How Do I Decide Whether or Not to Have Carrier Testing?

After learning about CF carrier testing, some people decide to have testing, and others decide against it. The cost of testing is covered by some insurance and not by others. You may want to check with your insurance company before deciding if you want testing.

Listed as follows are some reasons other people have given for having or not having CF testing.

Possible reasons to be tested:

• If CF seems like a very serious disorder to you
  
• If the chance of being a CF carrier seems high to you; this may be especially likely if a member of your family or your partner’s family has CF or is a known carrier
  
• Because test results are usually reassuring
  
• Because the cost of testing is covered by your insurance company
  

Possible reasons not to be tested:

• If CF does not seem like a very serious disorder to you
  
• If the chance of being a CF carrier seems low to you; this may be especially likely if you are Asian American or African American
  
• Because the test is not perfect and will not identify all carriers
  
• Because the cost of testing is not covered by your insurance company
  

FOR MORE INFORMATION, CONSULT YOUR PHYSICIAN.

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Maternal Serum Alpha-fetoprotein (MSAFP)

The MSAFP is a blood test done on the mother’s blood at 15-20 weeks, best done at 16 weeks.

It will be positive in 80-85% of mothers whose fetuses have spina bifida. It is also positive in a large number of fetuses who have an abdominal wall defect. About 90% or greater of "screen positives" turn out to be false positives because of the way the test is set up – it is only a screening test.

IMPORTANT – Remember that the test only gives a RISK, not a diagnosis.

What is it?

A maternal blood test that looks for three substances normally present in the bloodstream of pregnant women:

• Maternal serum alpha-fetoprotein (MSAFP) – a protein that is normally produced by the fetus
  
• Human chorionic gonadotropin (HCG) – a hormone produced in the placenta.
  
• Estriol – an estrogen produced by both the fetus and the placenta.
  

What does it test for?

High levels of AFP may indicate that the fetus has a neural tube defect, most commonly spina bifida or anencephaly. Low levels of AFP may indicate Down syndrome.

Abnormal levels of HCG and estriol may indicate chromosome abnormalities.

How is it performed?

Blood is drawn from the mother and then tested in the laboratory.

How long does the procedure take?

The blood draw will take 5 to 10 minutes.

When is it performed?

The most accurate results are achieved when the test is performed between 15 and 20 weeks of gestation.

How long does it take to get results?

It may take several days to get the test results back from the laboratory.

What are the risks?

There are no risks.

Are there any potential side effects?

No.

FOR MORE INFORMATION, CONSULT YOUR PHYSICIAN.

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Warning Signs to Notify Office or On Call Nurse

1. Four or more contractions an hour not relieved by drinking 2 glasses of fluids
   
2. Severe abdominal pain
   
3. Swelling of the hands, feet and face with or without a headache, unrelieved by rest, elevation and Tylenol
   
4. Persistent nausea and vomiting (continues past 24 hours)
   
5. Decrease in fetal movement, less than 8 movements an hour after drinking at least 8oz sweet drink, resting on left side in a quiet room, monitoring movements
   
6. Headache and blurred vision unrelieved with fluids, Tylenol and rest after 2 hours
   
7. Burning or painful urination
   
8. Fever greater than 101, 2 hours after taking Tylenol
   
9. Gush or trickle of water from vagina
   
10. Vaginal bleeding can be normal after intercourse or exam, if heavy or with pain notify nurse or go to the Emergency Room

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Visits to Your Doctor During Pregnancy

We are pleased you have selected Northwest Arkansas OB/GYN Associates for your health care needs. Our goal is for you to receive excellent OB care and a rewarding experience.

Your first visit is spent with our trained staff. We will obtain your medical history information, perform lab work, as well as, provide you with the opportunity to receive information and answer questions about your pregnancy. At that time you will schedule an initial visit with your physician to discuss you history and perform an exam.

Below we have outlined our routine schedule of maintenance visits so that you will be aware of our policies.

• 2nd visit – (approximately 12 weeks) – Meet with the physician for exam, 1st fetal heart tones and discuss role of MSAFP.
  
• 16 Weeks – Draw MSAFP if desired
  
• 20 Weeks – Ultrasound, register for childbirth classes
  
• 24 Weeks – Discuss signs and symptoms of pre-term labor
  
• 28 Weeks – Blood glucose testing, Antibody screening and Rhogam if required
  
• 30 Weeks – General labor and delivery
  
• 32 Weeks – Discuss breastfeeding
  
• 34 Weeks – Routine visit
  
• 36 Weeks – Group B Strep Test
  
• 36 through 40 Weeks – weekly cervical exams
  

These services will be provided by your physician or by our nurses. Should you have any questions please feel free to ask.

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Safe Over-the-Counter Medications During Pregnancy

The following over the counter medications may be taken safely during pregnancy. Please remember that non-drug treatment should be first attempted, then if there is no relief, you may use the following guidelines. Example- if you have a headache, the non-drug treatment is to lie down in a quiet darkened room and rest. If no relief after trying this, then try Tylenol or Anacin 3.

What you can take for:

COLD or SINUS

• Tylenol 1-2 every 4 hours
• Aspirin Free Dristan
• Chlor-Trimeton
• Drixoral (after 16 weeks)
• Sudafed

*Inhalers for Asthma are OK except Cromolyn

COUGH

• Robitussin (Plain or DM)
• Benylin Expectorant
• Cough Drops – Halls or Cepastat
• Chloraceptic Lozenges

HEARTBURN

• Riopan Plus or any low sodium antacid
• Maalox – if constipated. Do NOT take Tums with Prenatal Vitamins, calcium prevents absorption of iron.
• Mylanta

NAUSEA

• Vitamin B-6, 100mg 3 times a day
• Emetrol

VOMITING

• Bowel rest, clear liquids 12 to 24 hrs. Then advance to bland foods i.e. bread, soup, rice etc as tolerated. Consult physician for medication.

HEADACHES

• Tylenol 2 every 4 hours
• Anacin 3

SORE THROAT

• Chloraceptic
• Cepacol Lozenges
• Sucrets

CONSTIPATION

• Surfak Stool Softener
• Senokot
• Doxidan
• Metamucil

DIARRHEA

• Bowel rest, clear liquids 12 to 24 hrs. then advance to bland foods i.e. bread, soup, rice etc as tolerated

HEMORRHOIDS

• Tucks
• Annusol Suppositories
• Preparation H
• Tronolane
• Ice packs

YEAST INFECTION

• Monistat

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