Prenatal care at North York Prenatal care at North York General HospitalGeneral Hospital

11th edition July 2013

North York General Hospital North York General Hospital Obstetrical care.Obstetrical care.

Average 6000 deliveries per annum 30% C section (19% Primary 11% Repeat 9%

Forceps) Birthing suites with Jacuzzi Good Anesthetic department 24 hours service SPOE Monitoring system First days program 24 hour discharge Advanced Level I1c (30 weeks) Nursery at NYGH

First Prenatal visitFirst Prenatal visit

HistoryExaminationTestsDiscussionPlanning a healthy pregnancy

Prenatal DiagnosisPrenatal Diagnosis

Prenatal Screening ( non invasive)12 week NT, with Blood test ( same day)16 week blood tests only18-20 weeks Anatomical Ultrasound

– NIPT “Harmony” Testing

Prenatal Testing( Invasive )CVS testingAmniocentesis

Prenatal Testing IPS and FTSPrenatal Testing IPS and FTS IPS = FTS + MSS

– 12 weeks FTS(First Trimester Screen) = tests (NT ultrasound, blood tests, PAPP-A, HCG) – results 1 week later

– 16 weeks MSS(Maternal Serum Screen) = blood tests (HCG, MSAFP, ESTRIOL)

– 12 + 16 weeks IPS(Integrated Prenatal Screen) = FTS + MSS – results 1 week later

At 16 weeksAt 16 weeks

Registration at NYGHBlood tests are done NOW not at 18 weeks

(same day HIV etc) Prenatal classesMake sure that you have 18 week

ultrasound booked

Other Prenatal TestsOther Prenatal Tests

Special blood testsAmniocentesis ( picks up Chromosomal

problems) . This is a focused and specific test, that is obtained by needle to amniotic cavity .

Pregnancy loss on average about 0.5% (1:200)

Is NOT the ultimate test.

% Risk of Chromosomal % Risk of Chromosomal Problems in pregnanciesProblems in pregnancies

0

1

2

3

4

5

6

7

30-35 35-40 40-45 45-50

singleTwins

How to organize testsHow to organize tests

Take the New Prenatal form to the front desk to get dates.

When?Where?Always check with office if in doubtIf you cancel REBOOK

Prenatal Testing 2013Prenatal Testing 2013

Any Questions ?We can contact NYGH Genetics

departmentKeep in contact between 12 -18 weeksIf in doubt Please contact us

Other IssuesOther Issues

Diet and nutritionExerciseIf smoking TRY to QuitPrenatal classesBreast feedingNext appointment

Diet and NutritionDiet and Nutrition

Regular well balanced dietFlexible on weight gainIncrease calciumMay take vitaminsDo not OD on any one foodSpecial diets for vegetarians

ExerciseExercise

Keep to what you normally doLow impact exercisesDO not overdo it.In high risk pregnancies lots of restSpeak to me if there are concerns

SmokingSmoking

IS bad for you and babyCarbon monoxide poisoningNicotine effectsStunted babiesPoorer eyesightMore congenital abnormalities

Prenatal classesPrenatal classes

More for new moms and dadsHeld at hospital and other clinicsInfo can be gained from reading etcGood to meet other “new parents”

Breast FeedingBreast Feeding

Encouraged in all patientsCan do things both antenatal and

intrapartumAlways worth a try

Next appointmentsNext appointments

The officeThe Special TestsUltrasoundBlood testsGeneticsSpecial focused tests

Next appointmentsNext appointments

The prenatal testing if appropriateNext Ultrasound appt.Next visit to the office 4,2 or 1 weeksMake sure you know how to contact office

How to contact Dr. How to contact Dr. PairaudeauPairaudeau

The office is open Mon-Fri 9am to 5.30pmSome Weekends for emergency

– Saturday 8.20am to 9.45am– Sunday 8.15am to 9.15am– ALL other times at night or weekend to L and

D @NYGH Triage 2nd floor. No call necessary

In EmergencyIn Emergency

Please call Dr. Pairaudeau– click here for web site (check the FAQ section)– 416 417 9200– if unavailable then call labour and delivery 416

756 6275

Emergency ConsiderationsEmergency Considerations

DO NOT PANICTry to locate Dr. Pairaudeau or officeRemember office is open seven daysPlease do not use TELE HEALTHUse emergency only if appropriateAvoid walk-in clinic unless advisedUse family doctor as back-up

Emergency ConditionsEmergency Conditions

When you have bad pains or contractionsWaters breakBleeding more than a periodFever 38.5 C (fever over 39 C are serious,

needs attention)Bad problems that cannot waitWhat to expect

Labour and DeliveryLabour and Delivery

2nd Floor NYGH Leslie Street siteGo into room and call for the Nurse.The Nurse will see you and call me or the

duty doctor.Please make sure if you are less than 20

weeks and they send down to emerg .call me

Who delivers YouWho delivers You

We have an on call person 24hrs in HI like to do my own deliveriesAs long as I am available I will deliverWe have sign out system at midnightMaybe at conference95% attendance rate

Stay and discharge in HospitalStay and discharge in Hospital

If normal delivery 24 hours + -If complicated delivery till well enoughIf C\section 72 hours.Public Health Nurse ProgramMust be seen if serious problem by me

Final Round upFinal Round up

See the person at deskMake appointmentsQuestions ???Medical Registration Fee

– Please see added note from desk– Please see ultrasounds