High Risk Obstetrics

Prenatal Care

Here is what you can expect at your upcoming appointments and at the different stages of pregnancy. Some things may vary depending on your personal medical history and current situation.

12 to 14 Weeks

The provider will review test results that may have been done at your first visit with us, and will do a fetal heart beat check and answer any questions you may have. We will also have you schedule your anatomy ultrasound at checkout. This will be done at 21-22 weeks in pregnancy.

The following optional testing can be discussed. These tests may or may not be covered by your insurance:

  • The Quad marker screen is an optional blood test that is done between 16-21 weeks. It is a screening test only and does not give a definitive diagnosis. It will assess your risk of having a baby with neural tube defect and genetic disorders such as down syndrome and Trisomy 18. If abnormal, we will advise further testing.
  • Panorama is a DNA screening test that can tell you information about your pregnancy. You can find out if your baby is at risk for having Down syndrome or other chromosomal abnormalities. Panorama can also tell you the gender of your baby. Panorama can be done as early as nine weeks into your pregnancy using a simple blood draw.

24 to 29 Weeks

The provider will do a fetal heart beat check and fundal height measurement as well as answer any questions you may have. If applicable for you, you will be given a glucola drink at this appointment. You will drink this before your next appointment – around 24-28 weeks in pregnancy.

At this stage of pregnancy you should be feeling fetal movement. It is important for you to be aware of your baby’s movements and to know how to do fetal kick counts. For more information, please click Fetal Movement Counting.

32 to 34 Weeks

The provider will do a fetal heart beat check and fundal height measurement as well as answer any questions you may have. They may also discuss the need for a Tdap (whooping cough) vaccine at this appointment.

Tdap is a vaccine recommended by the CDC for all pregnant women in their 3rd trimester. After receiving the vaccine, your body will create protective antibodies and pass some of them to your baby before birth. These antibodies provide your baby some short-term protection against whooping cough in early life.

35 to 36 Weeks

The provider will do a fetal heart beat check and fundal height measurement. Cervical checks may be done as well. If needed a group B strep (GBS) swab may be done during this time in pregnancy.

A Group B Strep test is a vaginal/rectal swab that checks for the bacteria beta-hemolytic streptococcus. This is a normal bacteria found on our skin; but because a baby’s immune system is immature at delivery, they can pick up the bacteria and it can cause an infection. If the test comes back positive, you will be given IV antibiotic during labor.

For Your Information:

After cervical exams or intercourse you may experience some spotting. This is normal. If you have any bleeding that is heavier like a period you should go to Labor and Delivery at your hospital for further evaluation.

If you have any fluid loss or feel your bag of water has broken, you should go to Labor and Delivery for further evaluation.

If you have decreased fetal movement or have not felt your baby move, you should go to Labor and Delivery for further evaluation.

Please note the hospital nursing staff at Labor and Delivery is there to help and reassure you. If you are concerned or just feel that something isn’t right please do not hesitate to go in.

37 to 41 Weeks

The provider will do a fetal heart beat check, a fundal height measurement and cervical check will be done if needed.

For Your Information:

After cervical exams or intercourse you may experience some spotting this is normal. The provider will also discuss with you what to expect at labor.

You should go to Labor and Delivery at your hospital if you experience any of the items below:

  • Bleeding that is like a menstrual flow
  • Fluid loss
  • Decreased or no fetal movement after you have tried fetal kick counts
  • More than 6 contractions in an hour that you can’t walk, talk or breathe through and they have lasted for 2 or more hours

Please note the hospital nursing staff at Labor and Delivery is there to help and reassure you. If you are concerned or just feel that something isn’t right please do not hesitate to go in.