Teton Obgyn Idaho Falls
  • Home
  • About Us
    • Our Physicians
    • What Our Patients Say
  • Contact
  • Our Services & Treatments
    • Obstetrics
    • Office Gynecology
    • Advanced Gyn Surgery
  • FAQs
    • Pregnancy FAQ
    • Gynecology FAQ
    • Surgery FAQ
  • Blog
  • Patient Resources
  • Home
  • About Us
    • Our Physicians
    • What Our Patients Say
  • Contact
  • Our Services & Treatments
    • Obstetrics
    • Office Gynecology
    • Advanced Gyn Surgery
  • FAQs
    • Pregnancy FAQ
    • Gynecology FAQ
    • Surgery FAQ
  • Blog
  • Patient Resources

Should I Stay (at home) or Should I Go NOW (to the hospital)?:  an overview of symptoms that should be evaluated in the hospital

12/20/2016

0 Comments

 
Picture
​One of the toughest challenges as an ob/gyn is trying to determine if a patient needs evaluation in the hospital or if it’s ok to wait out the situation and follow-up in clinic.  Sometimes it’s pretty self-explanatory (see the cartoon above), but most of the time it’s not.  Below are some of the symptoms that definitely merit a check in the hospital setting.

In early pregnancy, some of the biggest concerns for patients that may require evaluation are vaginal bleeding and lower abdominal pain.  Occasional spotting or a small amount of blood with wiping may be normal, particularly after intercourse; however, heavy bleeding (soaking through more than a pad per hour) with or without passage of clots or tissue may indicate a miscarriage and usually requires an emergency workup.  Unfortunately, our ability to intervene and save a pregnancy is pretty limited until the baby can survive outside of mom (around 23-24 weeks at the earliest), but it is important to determine if surgery is necessary to treat the bleeding.  The same sort of evaluation may is also indicated in a woman who has lower abdominal or pelvic pain despite rest, hydration, change in position or extra strength Tylenol.  If the pain goes away with any of those measures, it generally isn’t expected to have a negative effect on mom’s or baby’s health, but if the pain continues despite those interventions, the number one priority is confirming that the pregnancy is inside the uterus.  Ectopic pregnancies (those outside the uterus) can’t result in delivery of a baby, but they may require surgical (or in some cases medical) intervention to prevent maternal heavy bleeding into the abdomen.  Additionally, non-pregnancy emergencies may also present with worsening pain.

In addition to heavy bleeding and persistent pain, there are a few other considerations that require evaluation at the hospital later in pregnancy.  I can’t count the number of calls I’ve had where someone asks me if she’s in labor, but no matter how many times I’m asked, I can’t know for sure unless a patient has an exam and is monitored over time.  I have learned how to text finger emojis, but I still haven’t figured out how to do a cervical check over the phone ;)  Generally, painful contractions every 5 minutes or so are a good indication of the onset of labor, although this may vary from person to person.  Monitoring of the baby’s response to contractions as well as their frequency helps let us know how to manage your care.  Even if you came to the office, you’d generally still require evaluation on labor and delivery for persistent contractions as your cervix may change over the course of a few hours.  Besides, my staff would kill me if they had to clean up after a delivery in the office :O  Other than labor checks, if there is concern your bag of water has broken, then you should go in for evaluation.  This is important even if you aren’t having contractions because you may need medicine to augment labor.  Even if your group B strep test was negative, if delivery is delayed for too long after your water breaks, you can still develop an infection in the uterus that can negatively affect the health of both mom and baby.  Lastly, if you feel that your baby isn’t moving, and he/she hasn’t moved enough to be adequate according to the guidelines of your provider, then monitoring and testing of your baby is indicated, either in the office or on labor and delivery.

While the blog doesn’t cover every potential situation, this should be a helpful start on deciding whether or not to go in for evaluation.  That being said, be sure to also pay attention to any other specific warnings given by your provider, as these may vary from patient to patient.  Also, it is generally to err on the side of caution, so if you have a specific concern that’s not in this guide, either call your doctor or go in to have it checked out.  Even if it’s frustrating to be sent home after everything checks out OK, it’s still better to be sent home than not to be seen for something that change the course of your care.  That being said, the majority of pregnant women and their babies do very well, and even if you develop some of the above symptoms, it doesn’t necessarily mean your pregnancy won’t be successful.  Good luck with your pregnancy, and let us know if we can be of help!

Dr Nick

0 Comments

Top Baby Names: Did your baby make the list?

12/13/2016

0 Comments

 
Picture
Picture
Finding a name for your baby isn’t easy.  You want to pick something that you really love and something that as your child grows up they won't hate!  It's a very personal decision, but of course everyone from your third aunt to the guy that bags your groceries will have an opinion.  For new parents, looking at lists can help with the process.  There are lots of lists online that claim to know the most popular baby names for the year.  Since the year isn’t even over yet I’m not sure how they come up with these lists.  The most accurate list out there is of course the one published by the Social Security Administration.  As they hand out social security numbers, they keep data on this type of information.  Every year they publish this information on their website: http://www.ssa.gov/oact/babynames.  You can look up the most popular names by birth year and it even breaks it down by decade and state.   So did your baby make the list?  Below are the 2015 most popular names nationally and in the state of Idaho.

​Dr Pam
0 Comments

Pitocin: Magic Potion for Good or Evil?

12/6/2016

0 Comments

 
Picture
As I near the end of the prenatal visits with patients, I often hear “Whatever you do, I hope I don’t need pitocin,” but when I ask why, there’s never really a clear answer.  It’s usually that they heard from someone who had a friend who had a cousin, or they read online that someone said it was bad.  With this blog, I hope to help sort some of the fact from fiction.
​

What is pitocin?  Here’s the fancy answer:  “it’s a nonapeptide protein.”  That’s the one you can use to sound smart.  Here’s the simple answer:  it’s the synthetic form of oxytocin, which is a hormone released by your very own pituitary gland.  Oxytocin is produced in response to labor and helps stimulate contractions, and it also is released during breastfeeding.  Those cramps you have while breastfeeding?  You can thank pitocin.

Why does your ob/gyn use this medication?  There are 2 main reasons:  it can be used to increase the strength of contractions, and it can also be given after delivery to help prevent bleeding (it helps the uterus contract and squeeze blood vessels closed).  During labor, you might think, “My contractions are plenty strong on their own, thank you very much,” but occasionally they aren’t.  Generally, the ideal strength of contractions that are strong enough to change the cervix in a timely manner without being so strong as to stress out your baby is 200-300 MVUs.  The strength of the contractions can be measured with an internal monitor placed beside the baby called an IUPC, and this monitor helps the nurse adjust the medication into the appropriate range to achieve the contraction strength noted above.  This can help the labor progress in the optimal timeframe to help minimize the chance of intrauterine infection and decrease the  chance of cesarean section once your labor has started or your water has broken.  Pitocin can also be used to stimulate contractions in order to initiate labor when medically indicated.  During inductions when the cervix is unfavorable (ie closed and not thinned), this is the time when we may  see an increase in the need for cesarean delivery with pitocin.  However, sometimes deliveries are medically indicated in patients with an unfavorable cervix, such as in patients with certain blood pressure issues, diabetes or other situations where to continue pregnancy has greater risk to mom/baby than ending it.  Without pitocin, though, medically indicated deliveries in patients with an unfavorable cervix would almost certainly have to be via cesarean delivery.

Is it safe?  Oxytocin is unavoidable during labor and breastfeeding, and your body has been designed to utilize this hormone in both cases.  When used at doses to obtain appropriate strength of contractions, both mom and baby tend to tolerate this medication well.  Even if the baby shows some element of stress, the half life of pitocin is only 3-5 minutes, so the effects end shortly after the medication is stopped.  Additionally, medications such as terbutaline can also be used to relax the uterus if needed.  Lastly, oxytocin used immediately after delivery decreases the chance of hemorrhage.  Postpartum hemorrhage is the leading cause of maternal death worldwide and the main reason that the maternal mortality rate is 239 per 100,000 in developing countries vs only 12 per 100,000 in developed countries.

Are there any other options?  At this time, pitocin tends to be the most effective and safest option that we have.  Some researchers have looked into the use of nipple stimulation to release natural oxytocin to stimulate labor, but at this time, there has been limited success, probably due to the fact the nurses’ hands must have gotten really tired ;)  Besides, there’s really only so much that lanolin can do for the breasts after a long labor like that!

So, while not all pregnancies require pitocin, it may be required during labor or after delivery.  When dosage is titrated to the optimal contraction strength, pitocin is often the most effective method to help obtain a safe outcome for mom and baby.  And for us, this helps us to reach our ultimate goal, which is to conclude the pregnancy with a healthy, happy mom and baby :)

Nick

0 Comments
    Call Us

    Teton Women's 

    We address the topics you need to know about regarding pregnancy and women's health issues.

    Archives

    March 2021
    February 2021
    January 2021
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    August 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016

    Categories

    All
    Babies
    Breast Feeding
    Contraception
    Cord Blood Banking
    Delayed Cord Clamping
    Diet And Exercise
    Diet And Exercise In Pregnancy
    First Trimester
    Genetic Screening
    Guest Blogs
    Gynecologic Surgery
    Health And Fitness
    Hormones
    Induction Of Labor
    Infertility
    Just For Fun
    Menopause
    Overview Of Pregnancy
    Ovulation Prediction
    Pain Management In Labor
    Pap Smear
    Postpartum Depression
    Pregnancy Planning
    Second Trimester
    Sexual Health
    Sleep
    Vaginal Discharge
    Women's Health
    Zika Virus

    RSS Feed

Location

Teton Women's Health Center
2001 S Woodruff Ave #10
Idaho Falls, ID 83404

Contact Us

Tel: 208-523-2060
​Fax: 208-523-9874

Office Hours

Mon - Thurs: 8:00 am - 12:00 pm & 1:00 pm - 5:00 pm
Fri - 8:00 am - 12:00 pm

Be sure to follow us on social media for the latest updates at Teton Women's Health Center!

**While we are excited to answer your questions, please be aware that the links below are not intended to provide urgent or emergent medical advice.  Thank you!