Obstetrics

Plano OB Gyn Associates J. Kyle Mathews, MD

Welcome to the Virtual Office for Plano OB Gyn Associates.  Founded by J. Kyle Mathews, MD, Plano OB Gyn Associates is dedicated to providing state of the art care for women.  Our staff offers timely, compassionate and personalized care. We strive to provide you with answers and options, as quickly as possible, and to assist you in understanding the personal solutions best suited to meeting your individual needs. Through this site you access to the latest medical information on Women’s Health and the ability to establish a personal medical home in order to receive guidance regarding you healthcare concerns.

Obstetrics

 

Dr. Mathews is a Board Certified Obstetrician having trained at University of Texas Southwestern, Parkland Hospital.  This prestigious training program is the source for the Textbook, Williams Obstetrics, considered by most obstetricians as the premier text in obstetrics today.

Patients are provided the most up to date information, education, and technological advances to assist them in their care.  Active patient participation is encouraged.   Hospital care is provided at Presbyterian Hospital of Plano, voted “Best Hospital to have your baby” by women in the surrounding communities, and Baylor Medical Center of Frisco.

Complete obstetrical care is offered including, in office ultrasounds, high risk, and multiple gestation pregnancies.   Plano OB/Gyn Associates is dedicated to providing personal care.  Call coverage is shared with one other Board Certified Obstetrician on weekends and when the Doctor is on vacation.  Having this type of arrangement makes it much more likely that “your doctor” will be the one to delivery your baby and provide your care.

Plano OB Gyn Associates is a dedicated women’s facility and is uniquely situated to address the needs and concerns of women.  With a compassionate, experienced and dedicated staff, and comfortable surroundings, your care may be discussed in a private setting with confidence.

Preconception Counseling, J. Kyle MD, Plano OB Gyn Associates

Becoming a parent is a major commitment filled with many challenges, and rewards.  Pregnancy can be an exciting, fulfilling, delightful time.  It can also be a time of uncertainty and change.  Many aspects of pregnancy are part of the natural process over which you have no control.  However, you can control many important factors in determining your health and the health of your baby.  The best way to get the most out of your pregnancy is to obtain the most accurate information and be well informed for the many important decisions you are soon to face.  Being well informed will help prevent anxiety and worry and make your pregnancy more pleasant and secure.

MAKING SOME PLANS

By making some plans and adjustments prior to becoming pregnant, you can significantly impact the success of your pregnancy and the health of your baby.    The advancements in modern obstetrical care have provided you with the opportunity to significantly impact the outcomes of your pregnancy.  We have reached a level in prenatal care where the optimal time to assess, manage, and treat many pregnancy conditions and complications are before pregnancy occurs.  Preconception counseling of patients prior to becoming pregnant is an important opportunity to identify, educate, and treat many conditions that may complicate pregnancy.  At this time, questions about the individual’s expectations with regard to pregnancy can be discussed, family histories can be explored, and past medical histories obtained.  The opportunity to discuss diet, exercise, and the use of medications can be helpful in improving overall health. Immunization to Rubella (Measles) can be given to non-immune individuals and appropriate genetic screening can be offered for individuals at risk for certain diseases such a Tay Sachs disease and others.  Specific medical conditions can be discussed, optimally managed, and the possible effects on pregnancy explored.  Conditions such as hypothyroidism, diabetes, asthma, and hypertension can be fully evaluated and treated before pregnancy.  Potential occupational environmental exposures can be identified and discussed.  The risk of certain birth defects can be reduced.  Folic acid supplementation prior to becoming pregnant has been shown to reduce the incidence of spine and brain defects.  Prior complications with pregnancy can be discussed and the risk of reoccurrence can be accessed.  By investing time prior to becoming pregnant, you can improve the overall outcome of your pregnancy.

DECISIONS, DECISIONS

Choosing who will care for you during your pregnancy and delivery may be one of your first decisions.  Ideally, you will have already chosen a doctor prior to becoming pregnant and had a chance to discuss preconception issues.  If not, you may want to schedule a get acquainted visit with your potential new physician so that you have an opportunity to learn about the practice and the doctor, and to meet the staff.  Make sure the physician is qualified by asking question about his or her credentials.  Referrals from friends and co-workers are an excellent source, but their specific needs may differ from yours.   Be sure to evaluate your needs and concerns prior to your visit and discuss them with your doctor.

Prenatal Care, J. Kyle Mathews, MD, Plano OB Gyn Associate

There have been tremendous strides in medicine to improve the health and well being of every newborn.  Modern medicine has reduced the dangers and discomforts of pregnancy through years of research and technological advances.  Although most pregnancies proceed normally, every pregnancy poses some degree of risk.  Assessing the risk on an ongoing basis is a central part of prenatal care. While no two pregnancies are alike, prenatal care will help you prepare for the changes to come.

Regular visits to your doctor are central to your care.  Your first visit will be longer and more involved than other visits.  It will include a medical history, laboratory tests, and physical examination.  Many physicians prefer to see you for your first obstetrical visit between 8 and 12 weeks from the first day of your last menstrual period.  The average length of pregnancy is 280 days, or 40 weeks from the first day of the last menstrual period.  A normal full term pregnancy can last anywhere between 37 and 42 weeks gestation.  The estimated date of delivery (EDD), or estimated date of confinement (ECC) as it  is sometimes called can be estimated by taking the date your last menstrual period began, adding 7 days, and then counting back 3 months. Your doctor will use an obstetrical wheel to calculate your exact date during your first visit.  Often an early ultrasound will be scheduled to confirm your pregnancy and the estimated date of delivery.  Ultrasound scans done in the first 13 weeks of pregnancy are excellent at diagnosing the baby’s age, possible twins, and ruling out potential miscarriages. In addition a special ultrasound can be preformed, Nuchal Translucency scan, combined with blood hormone levels to help evaluate the fetus for possible chromosomal abnormalities.

After your first prenatal visit, the following visits are usually monthly till 28 to 30 weeks.  These visits are shorter and generally used to see how you are doing and how the baby is growing.  During these visits, your weight and blood pressure are checked, and a urine sample is taken for analysis. Testing offered during this time will vary but in general consist of two blood tests and possibly an ultrasound.  The first test is an alpha- fetoprotein (AFP) test.  This test is used to help identify fetuses that may have abnormalities of the brain and spinal cord.  The two most common abnormalities are anencephaly and spinal bifida commonly referred to as neural tube defects.  Anencephaly occurs when the brain and the head do not develop normally.  Spinal bifida occurs when the lower part of the spinal cord is open and the spinal cord and nerves are exposed.  This test, the AFP, is often combined with two other blood tests and called a triple test.  The AFP combined with three blood hormones can estimate the risk of the baby having Down syndrome.  In the United States, the majority of babies are born healthy.  Birth defects occur in 2 to 3 percent of babies born each year.  Neural tube defects occurs in 1 to 2 babies per 1000 births and Down syndrome is seen in 1 in 800 babies born.  The second blood test is a glucose tolerance test to help rule out diabetes that may develop in pregnancy.  This test is usually done between 24 and 28 weeks gestation.  In some pregnancies, a second trimester (14 to 26 weeks) ultrasound may be done to assess the babies anatomy and growth.  Women over the age of 35, and those with medical conditions such as diabetes, high blood pressure, or thyroid disease will usually have this high level scan done.

Visits from 28-30 weeks to 36 weeks are generally every two weeks.  A vaginal culture is often done between 34 and 36 weeks gestation for group B Streptococcus.  Group B Streptococcus (GBS) is a type of bacteria that can be found in up to 40% of pregnant women.  A woman can pass GBS to her baby during delivery.  Most babies who get GBS from their mothers do not have any problems.  Some babies can get sick and have major health problems or even die.  If group B Streptococcus is recovered by culture, it is often treated at the time of labor to try and prevent infection of the baby.

Visits from 36 weeks to delivery are usually weekly.  During this time a cervical exam is often preformed.  The events to occur in labor and delivery should be discussed and labor warnings are given.

 

LABOR AND DELIVERY

 

Awaiting the birth of a child is an exciting and anxious time.  Most women give birth between 37-42 weeks of pregnancy.  However, there is no way to know exactly when you will go into labor.  You should ask your doctor when you should call if you think you are in labor.  Ask how you should reach him or her and if you should go directly to the hospital or call the doctor first.  Questions about the use of monitors, IV’s, episiotomy’s, and pain relief options are best discussed prior to the onset of labor.  Indications for cesarean section should be discussed and any questions answered.  Hospital policies regarding the number of family members allowed to attend delivery may be considered and any special request should be discussed with your doctor.  As is every pregnancy different, every labor is also different.  Your past experience or the experiences of a family member or friend may not be the same as your pending one.  Your concerns and fears should be discussed with your doctor.

“By participating in your care prior to becoming pregnant, during your pregnancy, and during delivery, you can insure your pregnancy will be exciting, fulfilling, and healthy.”  J. Kyle Mathews, MD, Plano OB Gyn Associates

Discomforts and Body Changes of Pregnancy:

1. Abdominal Discomfort: Caused by stretching of the round ligaments.

Treatment: Relax, heating pad and hot baths, Belly Bra.

 

2. Backache: Caused by muscle strain from weight gain, shape and balance.

Treatment: Good posture, firm mattress, comfortable shoes, good body mechanics (squat instead of bending over), pelvic rock for lower back, heating pad and hot baths, Belly Bra.

 

3. Breast: Increased size and tenderness; increased size due to milk glands enlarging and increase in fatty tissue; increased blood supply.

Treatment: Supportive bra, preferably cotton-may need to wear to bed.

 

4. Colostrum: Yellowish fluid produced by breast. It is baby’s first food. May begin about 5^th month or later of pregnancy.

Treatment: Pads to absorb leaking fluid. Do not use plastic.

 

5. Colds: Caused by virus. Antibiotics not helpful.

Treatment: Benadryl, Actifed, Tavist, Dimetapp and Tylenol if fever. Tylenol Sinus also OK. Increase fluids and rest. Claritin for nasal drainage associated with allergies. Robitussin DM for cough. DO NOT USES Afrin.

 

6. Constipation: Slower passage of food due to hormone changes and pressure from uterus on colon. Iron in vitamins sometimes cause constipation.

Treatment: The most common cause is lack of adequate fluids.  Hydrate Hydrate Hydrate! High bulk diet-grains and raw vegetables. Lots of liquids, fruits and juices. Go to the bathroom when you feel the urge-Do Not Wait. If you need a laxative, MiraLax works best.  Others, Metamucil or Milk of Magnesia may be used.

 

7. Contractions: Stretching of round ligaments that hold up the uterus. Pressure from the baby’s head. Tightening of the uterine muscles.

Treatment: Increased hydration. Empty your Bladder. Increase rest. Warm bath. Back rubs.

 

8. Diarrhea: Due to hypermotility of bowel.

Treatment: Increase your fluid intake. Gatorade is good as are all clear liquids. Kaopectate, Pepto-Bismol, or Imodium AD as directed on the package.

 

9. Feeling Faint: Caused by low blood pressure or low blood sugar.

Treatment: Avoid standing for long periods and move frequently to stimulate circulation. Frequent rest periods especially towards the end of pregnancy. Eat healthful foods in small amounts at frequent intervals. Hydrate.

 

10. Fatigue: Hormone effect is strong. Using extra energy to care for and carry growing baby.

Treatment: Try to get adequate sleep and rest. Exercise to stimulate circulation. Prenatal vitamins, extra Iron.

 

12. Headache: Anxiety, tension, fatigue, nasal congestion. Vision problems may be related to increased fluid volume and are usually temporary.

Treatment: Relaxation and rest. Hot, moist towel over eyes and forehead for sinus type headaches. Tylenol, two, 2-3 times daily. Pregnancy is not the time for new contacts or glasses to be fitted. Wait until after pregnancy.

 

13. Heartburn: Increased stomach acid. Reflux of stomach content into esophagus.

Treatment: Bland diet-avoid fried foods. Frequent small meals. Riopan or Mylanta-use one tablespoon 30 minutes after each meal and at bedtime. Gaviscon Chewables, Prilosec, Zantac, or Pepcid AC may be used.

 

14. Hemorrhoids: Due to constipation or pressure from growing uterus. Increased circulation volume causes veins in the rectum to dilate.

Treatment: Avoid constipation. Do not sit long lengths of time while having a bowel movement. Sitz baths: sit in 6 inches of warm water 2-3 times daily for 15 minutes. Preparation H, Anusol HC, or Proctofoam may be used.

 

15. Leg Cramping: Calcium absorption is decreased during pregnancy. Uterine pressure slows circulation to the lower extremities.

Treatment: Keep up calcium intake-milk products. To relieve cramping in the calf, push away with your heel and point your toes toward your shoulder. Take a calcium supplement and increase your potassium. Eat a banana twice a day for potassium.

 

16. Insomnia: Sleeplessness.

Treatment: Benadryl, 50mg, may be helpful.

 

17. Nausea: Caused by high hormone levels. Increased stomach acid as the stomach empties more slowly. Also, caused by not getting enough Vitamin B6.

Treatment: Frequent small meals-eat slowly. Bland diet with protein snack before bed. Crackers before getting out of bed in the morning. Take Vitamin B6 25-50mg every day.

 

18. Nosebleeds: Increased circulatory volume. Vessels become overloaded and rise close to the surface.

Treatment: Saline Nasal Sprays, NOT Afrin. Eat foods with Vitamin C. Use cold compresses and lie down during a nosebleed. Increase humidity in the house. Apply a small amount of Vaseline to nostrils at bedtime.

 

19. Shortness of Breath: Uterus puts pressure on your diaphragm as it grows.

Treatment: Stand tall. Use deep breathing/slow breathing techniques. Sleep with your pillows propped up to make breathing easier. Lay on left side.

 

20. Sinus Troubles: Allergies

Treatment: Tavist D, Benadryl, Claritin, or other antihistamines. Saline nasal drops.

 

21. Skin Color: Discoloration or Pigmentation changes are brought on by hormone increases. Usually on the face, nipples, and line from navel downward.

Treatment: Hormones will decrease after pregnancy and color will also decrease.

 

22. Stretch Marks: Occur on abdomen, breasts and thighs. Normal skin elasticity is not sufficient. May not disappear completely but fade with time.

Treatment: No real cure available but may keep skin soft and moist with cocoa butter or creams and oils. Eat proper diet of protein.

 

23. Stool: May be black or dark due to presence of iron in the stool.

Treatment: If this started after beginning iron and vitamin tablets there is no problem. If this was present before the therapy was started then discuss with the Doctor.

 

24. Swelling-Extremities: Increased fluid in pregnancy. Uterine pressure to blood vessels which help return fluid from legs. Lengthy intervals standing or sitting slowing circulation. Tight clothing.

Treatment: Frequent rest periods with legs elevated. Do not sit with legs crossed. Drink plenty of clear fluids. Limit use of table salt. Wear loose fitting clothing. Bed rest.

 

25. Vaginal Discharge: Increased vaginal secretions due to hormone levels and increased blood supply. Ph balance changes.

Treatment: No treatment required unless discharge becomes excessive or has an odor.

 

26. Vaginal Itching: Possible Yeast Infection.

Treatment: Do Not Douche. Wear cotton underwear. Gyne-Lotrimin or Monistat may be used.

Medications That May Be Used In Pregnancy:

• Tylenol (for fever, pain)
• Tylenol Sinus, Benadryl Sinus/Allergy, Actifed, Benadryl, Actifed, Tavist, Dimetapp, Claritin
• Drixoral (for congestion)
• Robitussin DM (for congestion, cough)
• MiraLax, Metamucil, Milk of Magnesia (for constipation)
• Kaopectate, Imodium AD (for diarrhea)
• Riopan, Mylanta, Tums (for heartburn)
• Preparation H, Anusol HC, Proctofoam (for hemorrhoids)
• Calcium (for leg cramps)
• Pepcid AC, Zantac, Prilosec,  (for heartburn)
• Vitamin B6: 25-50mg daily (for nausea)
• Vitamin C, Saline Nasal Spray (for nosebleeds)
• Saline Nasal Spray (for sinus congestion, nosebleeds) NOT Afrin
• Benadryl (for insomnia)

Diet in Pregnancy:

Good nutrition is important in pregnancy.  However, most Americans diets are adequate in nutritional value with many being more than adequate.  You should try to eat healthy in pregnancy and take this as an opportunity to clean your diet up if need be.  An important fact of pregnancy is that you only need an additional 300 calories a day for pregnancy.  It is not carte blanche.  You are eating for one, not two.  The following are recommendations:

• Limit caffeine to no more than 300 mg per day. An 8-ounce cup of coffee has about 150 mg of caffeine on average while black tea has typically about 80 mg. A 12-ounce glass of caffeinated soda contains anywhere from 30-60 mg of caffeine. Remember, chocolate contains caffeine — the amount of caffeine in a chocolate bar is equal to 1/4 cup of coffee.
• Approved sweeteners include aspartame (Equal or NutraSweet), acesulfame-K (Sunett), and sucralose (Splenda). These sweeteners are considered safe in moderation.
• Saltwater fish should be limited to two or three times a week.  Do not eat shark, swordfish, king mackerel, or tilefish (also called white snapper), because they contain high levels of mercury. Freshwater fish is fine.
• Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheese. These cheeses are often unpasteurized and may cause Listeria infection. There’s no need to avoid hard cheese, processed cheese, cream cheese, cottage cheese, or yogurt.
• Avoid raw meats and fish, especially shellfish like oysters and clams.

Exercise In Pregnancy:

If you have been following a regular exercise program prior to your pregnancy, you should be able to maintain that program to some degree throughout your pregnancy. Exercise does not increase your risk for miscarriage.  You should avoid heavy weights and exercises in which you could use your balance. If you are starting an exercise program, start slow.  Keep yourself well hydrated and do not exercise to the point of breathlessness or exhaustion. Exercises that require you to lying flat on your back should be avoided if uncomfortable or after the second trimester (26 weeks).  As a general guideline, it is suggested that you keep your heart rate under 140 bpm during cardiovascular exercise.

Vaginal Bleeding or Spotting in Pregnancy:

Four out of 10 women will experience some spotting during the first trimester (13 weeks) of pregnancy.  I do not require my patient to notify me if this occurs before 13 weeks gestation, or if the spotting is associated with intercourse.  Bleeding more like a period or occurring after 13 weeks should be reported to the doctor.   

Labor Warnings AT TERM (The following information is for my patients AT Term, 37week gestation and beyond, and without complications. Please follow any special instructions given to you by your doctor.)

You should notify your doctor if you bag of water breaks, you have heavy vaginal bleeding, or you have 12 strong contractions in one hour. Spotting, losing your mucous plug, or irregular contractions do not require you to contact the doctor.

Hospitals for Obstetrics

Your choice of hospital for delivery of your baby can make a significant difference in your overall experience and satisfaction, not to mention play a vital roll in the care of you and your infant.  Dr. Mathews Delivers at two hospitals, Texas Health Presbyterian Hospital of Plano and Baylor Medical Center of Frisco.  Both facilities offer excellent care.  Presbyterian Plano has a Level III nursery.  Baylor Frisco has a Level II nursery.

 

Texas Health Presbyterian Hospital of Plano

http://www.texashealth.org/body.cfm?id=1573

 

Baylor Medical Center of Frisco

http://www.baylorhealth.com/PhysiciansLocations/Frisco/SpecialtiesServices/WomensServices/Pages/Default.aspx

This site offers you access to the latest medical information on Women’s Health.

Kegel Click Here

Morning Sickness Click Here

Post Partum Click Here

Postpartum Depression Click Here

Sexuality in Pregnancy Click Here

Glossary of Terms

Amniocentesis.  Laboratory analysis of amniotic fluid. A small amount of amniotic fluid is removed from the sac surrounding the baby, inside the mother’s uterus, to determine if any genetic abnormalities exist. The test, typically performed during the second trimester, is extremely reliable and can also be used to determine the baby’s sex.

Antepartum.  Before labor or delivery.

Anti-D Gamma Globulin.  Immunoglobulin for prevention of Rh-sensitization.

Apgar Score.  Physical assessment of a newborn baby; usually conducted at one minute and five minutes after birth to determine the level of health of the newborn.

Basal body temperature (BBT).  A woman’s body temperature at rest; used for detection of ovulation.

Blood count.  A test used to detect anemia and infection.

Bloody Show, Passing of the cervical mucus, Mucus Plug, caused by softening and dilating of the cervix.

Breakthrough bleeding. Endometrial bleeding during the use of oral contraceptives.

Cervical ectropion or eversion.  Migration of cells from the lining of the endocervical canal (endocervix) to the outer portion of the cervix (ectocervix). Sometimes inaccurately called erosion or abrasion, which implies damage. Cervical ectropion is a normal condition and is common in young women and women taking birth control pills.

Cesarean Section.  A surgical procedure, during which the fetus is delivered through an incision in the lower abdomen and the uterine wall.

Colposcopy.  Examination of the vagina and cervix by using an instrument that provides low magnification.

Effacement, The process by which the cercix prepared for delivery by shortening the length of the cervix.  At 100% the cervix no longer has any significant length on examination.

Embryo.  A developing baby during the first trimester.

Epidural.  Type of anesthesia administered through the back during labor. Not the same as a “spinal.”

Estimated Date of Confinement (EDC).  Also known as the due date. Calculated as 40 weeks—about nine months—from the first day of the last menstrual period (LMP). Keep in mind, though, that any delivery within 38 to 41 weeks is considered normal. The term comes from the fact that pregnant women were once confined during the last trimester of pregnancy.

Fecal Occult Blood Test.  Test in which a stool sample is checked for blood that could indicate colon or rectal cancer.

Fetus.  A developing baby after the first trimester.

Gestation.  Pregnancy.

Gestational Age, Calculated from the first day of the woman’s last menstrual period.  The assumption is that she will ovulate 14 days after the start of her cycle.  Fetal age, Fertilization age, Conceptional age or Developemental age is 2 weeks less.  A quick method for calculating the Gestational age is to add 7 days to your Last Menstrual Period. The subtract 3 months.  Then add 1 year to the current year.

Laparoscopy.  Direct visualization of the peritoneal cavity, ovaries, and the outer surfaces of the fallopian tubes and uterus by using a laparoscope. A laparoscope is a slender instrument—essentially a miniature telescope—with a fiber optic system that can illuminate the inside of the abdomen.

LMP.  First day of a woman’s last menstrual period before pregnancy; important to know when calculating the estimated date of confinement (the “due date”).

Mucus, Cervical.  Secretion of the cervical mucous glands; the quality and quantity of these secretions are influenced by estrogen and progesterone. Estrogen makes secretions abundant and clear, with spinnbarkeit and afernpattern on drying. Progesterone makes secretions scant, opaque and cellular, without a fern pattern on microscopic examination.

Mucus Plug, Just as the nose secretes mucous to protect itself for impurities, so does the cervix in pregnancy.  Throughout Pregnancy, a mucus plug blocks the opening of the cervix to prevent bacteria from entering the uterus.

Multiparous or Multip, A woman who has given birth two or more times.

Nullipara, A woman who has never completed a pregnancy beyond 20 weeks.

Osteoporosis.  Atrophy of bone caused by demineralization.

Pap Test.  A test in which cells are taken from the cervix and examined in a lab for abnormalities that could signal cancer.

Parity or Para, The number of times a woman has given birth.

Preeclampsia.  A dangerous condition unique to pregnancy, characterized by elevated blood pressure, protein in the urine and severe swelling (edema). Preeclampsia can occur anytime after 20 weeks of pregnancy and up to six weeks after birth. Approximately seven percent of pregnant women in the U.S. develop the condition. Eclampsia, which can be fatal, occurs when the above symptoms are followed by seizures. About one in 20 preeclampsia cases develops into eclampsia.

Primipara or Primip, A woman in her first pregnancy.

Post partum.  After delivery, or childbirth.

RhoGAM.  Rh immunoglobulin (RhIg), also known as RhoGAM, is a special blood product that can prevent an Rh-negative mother’s antibodies from reacting to Rh-positive cells. Women diagnosed as Rh-negative receive an initial RhIg dose at about the 28th week of pregnancy and a second dose within 72 hours after delivery.

Risk factors.  Individual attributes (such as age, gender and family history) and habits (such as sexual activity, smoking and drug abuse) that are more common among people who contract a particular disease than in people who do not contract the disease.

Rubella (German Measles).  An acute exanthematous viral disease that may cause fetal malformation if contracted during the first trimester of pregnancy.

Salpingectomy.  Surgical removal of a fallopian tube.

Salpingo-oophorectomy.  Surgical removal of a fallopian tube and ovary.

Sexually Transmissible Disease.  A disease that spreads by sexual contact, including chlamydia infection, gonorrhea, genital warts, herpes, syphilis, and infection with human immunodeficiency virus (HIV, the cause of acquired immunodeficiency syndrome [AIDS]).

Station, The position of the presenting part of the infant, usually the head, as related to the mothers pelvis. May be measured from -5 to +5 or -3 to +3 with the positive numbers meaning the baby if further down in the pelvis and vagina.  At +5 or +3 the baby’s head is visible.

Trimester.  A time period of three calendar months. Gestation is divided into three trimesters each consisting of 13 weeks.

Tubal ligation.  Permanent sterilization by surgically cutting and tying the fallopian tubes. Commonly referred to as having one’s “tubes tied.” Can be performed at the same time as a cesarean section, which eliminates the need for a second surgery, or ten weeks or more after a vaginal delivery. In the latter case, a non incisional approach may be used called Essure.  (Link to Essure info in Gynecology section.)

Varicella.  Virus that causes chicken pox.

Vulva.  The lips of the external female genital area.

 

Links to Obstetrical Information

ACOG American Congress of Obstetrics and Gynecology
http://www.acog.org/publications/patient_education/patientpage.cfm

Patient Education Pamphlets
http://www.acog.org/publications/patient_education/

Web MD
http://www.webmd.com/

Mayo Clinic
http://www.mayoclinic.com/health/pregnancy-week-by-week/MY00331

Note: Please be careful regarding advice over the Internet. There is more misinformation than information. The above links at least have some science behind the recommendations.J. Kyle Mathews, MD, Plano OB Gyn Associates