Teton Obgyn Idaho Falls
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  • About Us
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Planning your pregnancy

3/29/2016

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Ideally, pregnancy planning should begin at least 3 months prior to conception with prenatal vitamins.  These should contain iron for prevention of anemia, folic acid (or methyl folate) for prevention of neural tube defects and DHA to help with fetal neurologic development.  Why so early, you ask?  Well, the critical time for adequate folic acid intake begins even before the first missed menses, so by the time you know you’re pregnant, your body has already begun to utilize its stores of the vitamin.  Still, my big selling point to women who aren’t a fan of taking a vitamin every day is that recent studies have shown women who take a prenatal vitamin for at least 3 months prior to conception have lower levels of nausea and vomiting during early pregnancy. Don’t want to be a “puker”? Take your prenatal vitamins.

So, you’ve been taking your prenatal vitamins for 3 months, and now you’re looking to start trying for your baby.  I’m often asked when is the best time to have intercourse in order to conceive.  For a woman with a 28 day cycle, we would expect her to ovulate between days 13 to 15, although this can vary from woman to woman.  This egg will only last between 12-24 hours, so it is critical to make sure sperm are present to fertilize the egg when ovulation occurs.  Since sperm may live up to 5 days or so within the woman’s body, beginning scheduled intercourse at least every other day (some studies say as frequently as twice a day) from 5 days prior to expected ovulation until 1 day after are the optimal times to be intimate when trying to conceive.  Ovulation can be tracked using a phone app like Glow, home ovulation kits and via basal body temperature.
​

Once pregnancy occurs, your physician will look for three criteria to confirm a successful pregnancy: 1. location within the uterus (womb), 2. presence of the fetal pole (the part that becomes the baby), and 3. the development of a heartbeat within the fetal pole.  This generally requires 7-8 weeks of pregnancy to be able to see all 3 criteria well; otherwise, testing has a higher likelihood of being inconclusive for those measurements.  After these markers have been confirmed, the real excitement can begin!  Whether a long-awaited dream come true or a happy little surprise, come celebrate your pregnancy with Teton Women’s Health Center!

Nick
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Cell-Free Fetal DNA: the Latest in Genetic Screening

3/22/2016

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What is cell-free fetal DNA?
Cell-free fetal DNA (cffDNA) is fetal DNA circulating freely in the maternal blood. Testing of the fetal DNA allows your provider to look at the baby's chromosomes.  So, why is this important?  This test can tell you if your baby is at higher risk of Down's syndrome or other chromosomal abnormalities such as trisomy 18, 13 or monosomy X (Turner's syndrome) as well as the gender of the baby. 




What are the requirements for testing?
You need to be at least ten weeks pregnant and testing requires a blood sample.



Why is this test such a big deal in genetic screening?
Prior to this technology the only way to screen for genetic abnormalities was to have an ultrasound at 11 weeks and additional blood test to determine if you were at high risk for chromosomal abnormalities.  If you tested positive you would need invasive testing such as CVS (scraping of the placenta) or an amniocentesis (needle placed into the abdomen and through the uterus to obtain a sample of cells in the amniotic fluid) to confirm a chromosomal abnormality.   While these latter types of testing are very accurate, the testing is invasive and there was a small percentage of fetal loss associated with both procedures.  

​What do my test results mean?
If your test results are negative (normal), the likelihood of the baby actually having a chromosomal abnormality is less than 1/10,000.  However, since cffDNA is a screening test, if the test results are positive (abnormal), you would be referred to a maternal fetal medicine specialist to determine if additional testing is necessary.


What do we offer at Teton Women's Health Center?
We offer cffDNA testing to all our pregnant patients.  Make an appointment today and come in to speak with one of our providers about whether genetic testing with cell-free fetal DNA is the right choice for you and your baby. ​

​Pam Denson
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Why I became an ob/gyn

3/14/2016

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While my wife rarely, if ever gets asked why she became an obgyn, it's often one of the first questions patients ask me (implied question, "what's wrong with you, weirdo?!"). As it certainly wasn't what I expected to do when starting medical school, I can certainly understand the question. So, let me set the record straight.

I had no intention whatsoever of doing obgyn when I started medical school, and in fact, along with dermatology (which really grosses me out...I know, I know, don't judge), I had completely ruled out the specialty until I did the rotation. I was going to do something manly, like orthopedic surgery. Because, really, who wants to work all day with women who can go from happy to tearful and back in the drop of a hat and then get called at all hours of the night to do deliveries? Well, it turns out I do, and here's why:

1. I like giving good news. Most of my patients are happy and healthy and excited to be in the office. While many other specialties have to share unpleasant news everyday, I get to tell patients how well their pregnancies are going and to take part in the countdown until the baby gets here. Who wouldn't enjoy that? Now if only I could find a way to help women be as excited about their pap smears..

2. It is a surgical specialty, which means that I get to offer real and instant fixes for women's health problems (not to mention play with big toys during robotic surgery), but because of the continuity, I also get to develop relationships with my patients. Being able to get to know them and their families makes the care I provide that much more meaningful. It never ceases to amaze me how fast a baby I delivered is growing from year to year.

3. Lastly, what sold me in the first place: the deliveries. While the joy I experience in delivering a baby most certainly pales in comparison to the bliss of new (or repeat) parents, there's not a lot of jobs cooler than getting to be there to help usher a new life into the world.

So there you have it. Even though I don't get to use power tools on people like the orthopods and my kleenex cost is almost certainly triple theirs, I feel fortunate to be able to offer care that can be so rewarding. That's why I'm an obgyn.

Nick​
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Zika Virus: What you need to know while you are pregnant

3/8/2016

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What is Zika Virus?
Zika virus is spread to people through the Aedes aegypti mosquitoes.  Most people who are exposed have no symptoms.  Concern is really for two populations: pregnant women who may transmit the virus to their unborn child which can lead to microcephaly and those few who may develop a temporary form of paralysis (Guillain
–Barré syndrome) after exposure to the Zika virus. 

What are the symptoms?
The most common symptoms are fever, rash, joint pain, and conjunctivitis (red eyes) within 2 weeks of exposure but only 1 in 5 infected individuals will have any symptoms at all. 

Where is this Zika virus prevalent?
The current outbreaks are in Central America, South America and certain Caribbean countries including Puerto Rico.  The CDC maintains an updated list of areas affected, so please check their website below prior to making any travel plans during your pregnancy. 
http://wwwnc.cdc.gov/travel/page/zika-travel-information

Who is at risk of getting Zika virus in their pregnancy?
Women who are currently pregnant and travel to an area where Zika virus is prevalent are at risk for exposure during pregnancy.  Transmission of Zika to the fetus has been documented in all trimesters.  However if you are infected prior to pregnancy, there is no current data to suggest that you at risk of having birth defects associated with zika virus in a future pregnancy.  Sexual transmission of Zika virus has been reported in a few cases through exposure to semen of males with Zika virus.  If your partner has traveled to countries in which Zika is prevalent abstinence or condoms is recommended for at least 28 days. 

What can happen when a pregnant woman gets Zika virus?
It can cause a neurological disorder called microcephaly- unusually small heads and often damaged brains. These children may experience developmental delays, intellectual deficits, hearing loss or even death. 

How can we evaluate for Zika virus?
If you have traveled to an area where zika virus is prevalent during your pregnancy, you need to let your provider know immediately.  Even if you have not experienced any symptoms of the zika virus you will need blood work to look for exposure and frequent ultrasound surveillance.  There is no treatment or vaccine, but this will help your provider anticipate a pregnancy that may have been affected by the zika virus. 

How can you prevent getting Zika virus?
We strongly encourage you to avoid areas where there is a zika outbreak, however if you are currently pregnant and plan on traveling to an area affected by the Zika virus you should take the following precautions: 
-Cover exposed skin with long sleeves and pants
-Stay in air-conditioned or screened-in areas
-Use bug spray with DEET
-Treat clothing with permethrin 

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