Ranae Yockey, DO, FACOG 880 West Central Road Allison Corro, PA-C Busse Medical Building, Suite 6200 Madison Monk, PA-C Arlington Heights, IL 60005 Nicole Quigley, APN, CNM Phone: (847) 618-0730 Rosina Victor, APN, CNM Fax: (847) 618-0799 Megan Bishoff, APN, CNM Pregnancy Information Congratulations on your pregnancy! Before you know it, you will be giving birth. Here is some information on what you may experience during your pregnancy as well as baby’s development. You’ll be seeing your healthcare provider a lot for the duration of your pregnancy. In general, you can expect to go in every month until you are 28 weeks along. From weeks 28 to 36, your visits will likely increase to two appointments a month. Once you hit the 36-week mark, plan on a weekly check-up. (While typical, this schedule is not true for all pregnancies. If you are considered high risk, for example, you may be seeing your healthcare provider more often.) For any urgent questions or concerns outside of our normal business hours, please use our answering service number to contact our on-call provider. Answering Service: (855) 750-4897 Pregnancy Baby’s Size & What to Expect at your Common Symptoms Baby’s Development Week Weight appointment Morning Sickness Expect Growth Breast Changes from almost ¼ Frequent inch long (Grain of Heart begins to Urination Rice) to ½ or ¾ beat Food and Smell inch long All major organs Ultrasound to 8 Aversions (Similar to the Size - are formed determine cause for Mood Changes of a Raspberry) 6 The face, fingers, amenorrhea Back pain toes and eyes Abdominal appear Cramping (Pregnancy Confirmation) Excess Salivation Sometimes, No symptoms Less Nausea Discuss Medical and Expanding Uterus Family History The head is large, Bladder Relief Growth is about 2 Physical Exam since the brain Initial Pregnancy Blood Skin changes grows faster than ¼ inches long and tests: blood type and Increased the other organs. weighs RH factor, complete Discharge The Heart is approximately 0.50 blood count, Rubella Headaches Audible through an Oz titer, HIV, Hepatitis B, Dizziness syphilis, thyroid external Doppler. Bleeding and (Similar to the Size stimulating hormone, The umbilical cord Sensitive Gums of a Lime) Urine culture and 12 is formed. urinalysis (New OB) Bloating Fingers and toes Pap smear (if due) and Your breast size are formed. vaginal cultures for increases, and The placenta is yeast, bacteria, your nipples and growing and more gonorrhea and the area around chlamydia hormones are your nipples being produced. Urine test (areola) begin to darken. Nausea should The heartbeat is Blood pressure and start to subside. between 120 to weight check Energy Increase 160 beats per Urine test for Increased appetite minute. Glucose and protein Constipation Arms, hands, Fundal height Mood swings fingers, legs, feet, measurement (the Pulling pain low in toes, and ears are Growth is about fundal height is abdomen due to completely formed. 4.6 inches and taken of the the uterus growth baby's eyes can weighing 3.5 oz. abdomen to help Bleeding gums blink (Similar to the Size determine the Dizziness baby's fingers and of an Avocado) growth of the uterus Gas toes have and baby) 16 Headaches fingerprints Heart Tone check Heartburn About 1 cup of with Fetal Doppler Nosebleeds amniotic fluid Optional Genetic Baby Flutters surrounds the Test: 2nd Trimester Baby Bump baby. Screening/Maternal Food Cravings Serum AFP Glowing Skin Bigger Boobs Forgetfulness Dry Eyes Weight Gain Reproductive Anatomy Scan Belly Button system has Used to measure your Changes developed baby’s: Leg Cramps significantly Growth is little brain Swollen Feet Baby can hear more than 6.1 heart Vaginal you inches and kidneys Discharge Baby moving weighing 10 oz. stomach Shortness of move which is (Similar to the size bladder Breath called quickening of a Banana) diaphragm Indigestion genitals 20 face chest arms legs feet hands spine Urine test Aches and pains Baby’s weight is Growth is about 11 Urine test Braxton Hicks now coming from 3/4 inches long Discuss: contractions growing organs, (head to toe) and Fetal Movement Food cravings bones, muscle weighs 1 1/4 Monitoring Forgetfulness and accumulating pound, gaining Depression baby fat steadily at a rate Leg cramps Screening Nasal congestion of about 6 ounces Signs and Round ligament per week 24 pain (Similar to the Size Symptoms of of an Ear of Corn) Labor Sciatica (tingling Rapid brain Visits every two Growth is about 14 leg pain) growth, brain weeks 3/4 inches (head Sensitive skin tissue is Urine test to toe) and weighs Bloating & Gas developing the Preterm Labor around 2.5 lbs. Faintness & ridges and warning signs (Similar to the size Dizziness furrows Birthing Classes of a Head of Symphysis Pubis Your baby begins Kick Count Lettuce) Dysfunction to experience Blood Tests: 28 (SPD) REM (rapid eye Repeat CBC, HIV, Stuffy Nose movement) Syphilis Bleeding Gums sleep, which Glucose Tolerance Mask of means it’s very Test Pregnancy likely that baby is (Melasma) dreaming Changes in Fetal Lanugo, fine hair Routine Prenatal Visit Movement on baby’s skin, Answering your Braxton Hicks develops questions Contractions Skin begins to Blood pressure Fatigue thicken Expect Growth check Swollen feet and Lungs are from about 15 ¾ Discussion of ankles developing inches-17 ¾ symptoms Mood Swings Breathing inches, weighing Fundal height Carpel Tunnel movements about 3-5lbs measurement Bloating & Gas increase from (Similar to the size (now around 32 34 Constipation 30%-40% after centimeters, give of a Pineapple) - Stretch Marks 30 weeks or take a Itchy Skin Fingernails and centimeter or two) 30 Shortness of Toenails have Listening to the Breath grown in baby's heartbeat Colostrum ( Half of weight Swelling check yellowish fluid gained goes to Urine test leaking from your baby Weight check breasts) Eyelashes, Eyebrows, Hair have grown in Changes in Fetal Sleep-Wake Cycle Weight check Movement Development Blood pressure Pelvic Pain and Usually Head check Pressure Down Position Urine test Heartburn or (Engaged) Expected growth Vaginal Exam Indigestion Lungs nearly fully from about Group B Strep Bloating and Gas developed 18/19- over 21 Vaginal Swab Constipation Ability to Grasp inches weighing Swelling check about 6 lbs-9lbs Frequent Small Objects Fundal height Urination Coordination of (Similar to the size measurement Vaginal Sucking and of a Small Listening to baby's 40 Pumpkin) - Discharge Swallowing heartbeat streaked with Discussion of blood symptoms 36 Itchy Belly Discuss Plan for Edema (Swelling Delivery in feet and Answering your ankles) questions Varicose Veins Insomnia Nesting Instinct Pregnancy Brain Breast Changes Genetic Screening Tests Screening for genetic disorders is offered at two different times in pregnancy. Screening tests are different than diagnostic tests. Screening tests determine if you are at increased risk for having a baby with an abnormality. Diagnostic tests determine the exact abnormality such as Down syndrome, Edwards syndrome, etc. Your insurance company may or may not pay for these depending on your risk factors. It is your responsibility to check with your insurance company to determine coverage. First Trimester Screen (Nuchal Translucency Testing) The non-invasive test is performed around 12-14 weeks. It involves an ultrasound to look for skin thickening on the back of the baby’s neck and a blood test. When performed together, these tests can detect up to 91% of cases of babies with Trisomy 21/Down syndrome and 97% of Trisomy 18/Edwards syndrome. False positives (when the test indicates a problem, although everything with the baby is normal) occur less than 5% of the time. Further testing, including invasive testing may be recommended in the event of an abnormal test result. Second Trimester Screen (Maternal Serum AFP) This is a blood test offered between 15-19 weeks. It measures alpha-fetoprotein, beta-HCG, estriol, ITA, and DIA levels. Based on the results, a risk ratio is calculated to estimate your risk of certain disorders. A positive result indicates the need for additional testing such as an ultrasound or amniocentesis. This test detects up to 90% of neural tube defects and 83% of Down syndrome. There is a 5% false positive rate. Non-Invasive Fetal DNA Screening: This is a blood test which can be done any time after 10 weeks. Fetal DNA circulates in the mother’s bloodstream. The chromosomes on the fetal DNA are tested for Trisomy 21/Down syndrome, Trisomy 18/Edwards syndrome, and Trisomy 13/Patau syndrome, as well as Monosomy X/Turner syndrome and microdeletion syndromes. The gender of your baby can be determined by this test (if desired). This test has greater than 99% accuracy. However, it would be recommended that a high risk screen be confirmed by genetic diagnostic testing. Cystic Fibrosis (CF) Screening: This is a blood test. CF affects 1 in 3,300 people in the United States. It causes the body to produce abnormally thick mucus. This can cause life threatening lung infections, digestive problems, diarrhea, poor growth, and infertility. CF is the most fatal genetic disease in the United States. 1 in 30 individuals in the US are carriers for CF. If bother parents are carriers of the CF gene there is a chance that each parent can pass the abnormal gene to their child. If the child has 2 abnormal genes, there is a 1 in 4 (25%) chance the child will have CF. If mother’s screen is positive, it is recommended that the baby’s father be screened as well. Diagnostic testing can be done if both parents are carriers to determine if the baby is affected by the disease. Spinal Muscular Atrophy (SMA) Screening: This is a blood test. SMA is the most common inherited cause of infant death in children under the age of two.