Upload
april-dawson
View
213
Download
0
Embed Size (px)
Citation preview
Prenatal care at North York Prenatal care at North York General HospitalGeneral Hospital
11th edition July 2013
North York General Hospital North York General Hospital Obstetrical care.Obstetrical care.
Average 6000 deliveries per annum 30% C section (19% Primary 11% Repeat 9%
Forceps) Birthing suites with Jacuzzi Good Anesthetic department 24 hours service SPOE Monitoring system First days program 24 hour discharge Advanced Level I1c (30 weeks) Nursery at NYGH
First Prenatal visitFirst Prenatal visit
HistoryExaminationTestsDiscussionPlanning a healthy pregnancy
Prenatal DiagnosisPrenatal Diagnosis
Prenatal Screening ( non invasive)12 week NT, with Blood test ( same day)16 week blood tests only18-20 weeks Anatomical Ultrasound
– NIPT “Harmony” Testing
Prenatal Testing( Invasive )CVS testingAmniocentesis
Prenatal Testing IPS and FTSPrenatal Testing IPS and FTS IPS = FTS + MSS
– 12 weeks FTS(First Trimester Screen) = tests (NT ultrasound, blood tests, PAPP-A, HCG) – results 1 week later
– 16 weeks MSS(Maternal Serum Screen) = blood tests (HCG, MSAFP, ESTRIOL)
– 12 + 16 weeks IPS(Integrated Prenatal Screen) = FTS + MSS – results 1 week later
At 16 weeksAt 16 weeks
Registration at NYGHBlood tests are done NOW not at 18 weeks
(same day HIV etc) Prenatal classesMake sure that you have 18 week
ultrasound booked
Other Prenatal TestsOther Prenatal Tests
Special blood testsAmniocentesis ( picks up Chromosomal
problems) . This is a focused and specific test, that is obtained by needle to amniotic cavity .
Pregnancy loss on average about 0.5% (1:200)
Is NOT the ultimate test.
% Risk of Chromosomal % Risk of Chromosomal Problems in pregnanciesProblems in pregnancies
0
1
2
3
4
5
6
7
30-35 35-40 40-45 45-50
singleTwins
How to organize testsHow to organize tests
Take the New Prenatal form to the front desk to get dates.
When?Where?Always check with office if in doubtIf you cancel REBOOK
Prenatal Testing 2013Prenatal Testing 2013
Any Questions ?We can contact NYGH Genetics
departmentKeep in contact between 12 -18 weeksIf in doubt Please contact us
Other IssuesOther Issues
Diet and nutritionExerciseIf smoking TRY to QuitPrenatal classesBreast feedingNext appointment
Diet and NutritionDiet and Nutrition
Regular well balanced dietFlexible on weight gainIncrease calciumMay take vitaminsDo not OD on any one foodSpecial diets for vegetarians
ExerciseExercise
Keep to what you normally doLow impact exercisesDO not overdo it.In high risk pregnancies lots of restSpeak to me if there are concerns
SmokingSmoking
IS bad for you and babyCarbon monoxide poisoningNicotine effectsStunted babiesPoorer eyesightMore congenital abnormalities
Prenatal classesPrenatal classes
More for new moms and dadsHeld at hospital and other clinicsInfo can be gained from reading etcGood to meet other “new parents”
Breast FeedingBreast Feeding
Encouraged in all patientsCan do things both antenatal and
intrapartumAlways worth a try
Next appointmentsNext appointments
The officeThe Special TestsUltrasoundBlood testsGeneticsSpecial focused tests
Next appointmentsNext appointments
The prenatal testing if appropriateNext Ultrasound appt.Next visit to the office 4,2 or 1 weeksMake sure you know how to contact office
How to contact Dr. How to contact Dr. PairaudeauPairaudeau
The office is open Mon-Fri 9am to 5.30pmSome Weekends for emergency
– Saturday 8.20am to 9.45am– Sunday 8.15am to 9.15am– ALL other times at night or weekend to L and
D @NYGH Triage 2nd floor. No call necessary
In EmergencyIn Emergency
Please call Dr. Pairaudeau– click here for web site (check the FAQ section)– 416 417 9200– if unavailable then call labour and delivery 416
756 6275
Emergency ConsiderationsEmergency Considerations
DO NOT PANICTry to locate Dr. Pairaudeau or officeRemember office is open seven daysPlease do not use TELE HEALTHUse emergency only if appropriateAvoid walk-in clinic unless advisedUse family doctor as back-up
Emergency ConditionsEmergency Conditions
When you have bad pains or contractionsWaters breakBleeding more than a periodFever 38.5 C (fever over 39 C are serious,
needs attention)Bad problems that cannot waitWhat to expect
Labour and DeliveryLabour and Delivery
2nd Floor NYGH Leslie Street siteGo into room and call for the Nurse.The Nurse will see you and call me or the
duty doctor.Please make sure if you are less than 20
weeks and they send down to emerg .call me
Who delivers YouWho delivers You
We have an on call person 24hrs in HI like to do my own deliveriesAs long as I am available I will deliverWe have sign out system at midnightMaybe at conference95% attendance rate
Stay and discharge in HospitalStay and discharge in Hospital
If normal delivery 24 hours + -If complicated delivery till well enoughIf C\section 72 hours.Public Health Nurse ProgramMust be seen if serious problem by me