Obstetrics - Pregnancy
We provide care for normal and high-risk pregnancies. We feel strongly that you and your family be an integral part of the decision making process during your pregnancy, labor and the birth of your child. We will always provide you with the necessary information and help guide you through all the important decisions to insure you have a healthy and happy pregnancy. Our main goal is to help you have a healthy baby while also providing a good experience.
We have onsite ultrasound services. You will generally get 3 ultrasounds during your pregnancy. On you first visit we will do a confirmation ultrasound where we make sure that your baby has a heart beat and confirm your due date. The second ultrasound is a screening for Down’s syndrome called the Nuchal Skin Fold/Nuchal Translucency or First Trimester Screen. The third ultrasound (the one you have been waiting for) is the anatomy scan where we look at all the baby’s organs and parts to make sure everything looks normal (including the sex). Occasionally other ultrasounds will be indicated but this would be determined by necessity. Visit our Ultrasound Page
Diabetes: There are two kinds of diabetes in pregnancy. The first is “pre gestational” meaning that you already have diabetes prior to becoming pregnant. In this case you will likely be very familiar with taking care of your blood sugars. There are some differences however when you are pregnant, so you will have a referral to a high risk MD and a dietician who will review these differences and help you keep good control of your blood sugar. You will still see us in the office and be delivered by us. The other type is “Gestational Diabetes” which is diabetes that develops in pregnancy. We screen every pregnancy for this between 26-30 weeks. If you have an abnormal screen then you will have another test, which is a “diagnostic test”, and if that test is abnormal then you have gestational diabetes. At that point you will have a dietary evaluation and a consultation with a high-risk doctor. Most women can control their blood sugar with their diet. If blood sugar is not well controlled with diet, then we will start a pill or as a last resort insulin injections.
High Blood Pressure: High blood pressure (hypertension) is one of the more common complications we deal with during pregnancy. Women who have elevated blood pressure prior to the 20th week generally have what is called Chronic Hypertension and occasionally require treatment with oral medication. Women who develop hypertension after the 20th week of gestation have what is called pregnancy-induced hypertension. If you develop this we will want to watch you closely to make sure you do not develop Preeclampsia. This is achieved with frequent visits for blood pressure checks and checking the urine for protein as well as blood work. Occasionally if you do develop Preeclampsia it could mean that your baby will need to be delivered. Hypertension related to pregnancy generally resolves after delivery.
Advanced Maternal Age: Anyone who delivers a baby after the age of 35 is considered advance maternal age and is increased risk for certain complications of pregnancy. Patients who are older when they become pregnant are at a greater risk for certain birth defects such as Down’s syndrome. They also are more likely to have other medical problems that complicate pregnancy such as hypertension, diabetes, thyroid disease etc.
Thyroid disease: There are two types of thyroid disease, Hyperthyroidism (too much thyroid hormone) and Hypothyroid (too little thyroid hormone). Hyperthyroidism is relatively rare in pregnancy and can be treated with medications. Hypothyroidism is much more common and is treated with replacement thyroid hormone. If you have hypothyroidism we will check your thyroid level at least every 2-3 months to be sure that you have enough.
Multiples:With the advent of assisted reproduction the incidence of twins, triplets and higher order multiples are increasing. Multiple pregnancies considered high risk because they are at increased risk for certain complications such as pre term labor/delivery, preeclampsia and diabetes. We monitor twin pregnancies very closely with ultrasound and consultation with the perinatologist if necessary.
Blood Clotting Disorders
There are many diseases that cause your blood to clot more easily than it normally should. Many are genetic, some are acquired. There are blood tests to check for them that we can do in the office. Drs. Moore and Jewell have had many successful pregnancies of patients with these conditions. As more and more of these diseases are discovered, the panel of labs gets more involved. In fact, two of the disorders we check for have been discovered in the past ten years and there are probably more to be discovered. These diseases have not been well studied in pregnancy. Most of the research is in the cardiovascular realm, but we think these diseases can cause miscarriage or even stillbirth. The theory is that clotting happens in the placenta or uterus blocking the blood supply to the developing baby. There are many safe treatments for them and Dr. Aguilar is well versed in treating these various disorders.
If you would like to schedule an appointment or have questions regarding any of the services or procedures listed above, feel free to contact us at (210) 492-2300. Our staff will answer your questions and address any concerns you may have.
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