Some helpful websites:
www.fda.gov - great for fish advisory and mercury calculator
www.acog.org - sets our standard of care and has wonderful patient information brochures
www.womenshealth.gov/pregnancy - great website for general pregnancy information, diet, exercise and weight gain.
www.cdc.gov/zika/index.html - please check your travel plans before booking - ZIKA still requires caution
www.epa.gov - helpful information regarding use of insect repellent. DEET 30% is safe to use in any stage of pregnancy!
www.sema4genomics.com/products/for-pregnancy/ - information regarding genetic panel of inherited diseases/conditions
Pregnancy and Nutrition Advice (a highlighted, not comprehensive, list)
* Chose Fish low in mercury
(avoid: tilefish, shark, swordfish, king mackerel, and limit white albacore tune to 6 oz/week)
* Chose Wild Fish to limit pesticide exposure from farm raised fish
(prefer: salmon, shrimp, pollock, tilapia, catfish and cod)
* Avoid Raw/Undercooked Meat
* Avoid Raw/Undercooked Fish
* Avoid Cold Cuts, Smoked or Cured Meats or Fish (unless served hot)
* Avoid Alcohol (lower limit of safety has not been established)
* Avoid Cigarettes (associated with preterm birth, fetal growth restriction, miscarriage) and Avoid eCigarettes
* Avoid Recreational Drugs (THC in marijuana crosses the placenta and can negatively impact oxygen delivery to the fetus)
* Dairy must be pasteurized (avoid even pasteurized Mexican soft cheese)
* Juice must be pasteurized (limit concentrated sweets in general)
* Have Less than 200mg of caffeine per day (about 12ounce cup of brewed coffee) Decaffeinated Coffee is preferred
(this caffeine restriction mostly is for 1st trimester, until 14 weeks)
Pregnancy Activity Guidelines
Exercise, Intercourse, and Travel are acceptable and encouraged unless bleeding or cramping occurs or there is a fetal growth concern.
To call the office: 212-860-0300.
* Exercise - be able to maintain a conversation – take frequent rest and water breaks
* Intercourse - should be okay, your provider will let you know if not okay
* Travel - Wear moderate compression knee highs for trips greater than two hours in planes, trains or automobiles.
It is important to walk, stretch lightly, hydrate and use the restroom every 1-2 hours.
o Do not travel to areas with the Zika Virus (i.e. Central America, South America, or parts of Asia). Please check the CDC’s website for regular updated information: http://www.cdc.gov/zika/index.html; you can also look at https://www.epa.gov for information about insect repellents.
Genetic Screening and Testing
a Screen estimates risk (an educated guess) and Testing is diagnostic (tells you yes or no as best as possible)
ACOG recommends Basic Testing for all women who are or are considering being pregnant.
More tests may be suggested based on ethnic background:
Cystic Fibrosis, Fragile X, and Spinal Muscular Atrophy
Mount Sinai created the most comprehensive prenatal panel (Sema4) that tests if you (and your partner if relevant) are a carrier of certain inheritable conditions:
* Tests for 283 different diseases and carrier status conditions
* Recommend both partners complete this testing - or start with one with plenty of time for the partner to be tested if needed.
* The results take 2-4 weeks * For more information visit www.sema4genomics.com/products/for-pregnancy/
Screening for Down Syndrome
Down Syndrome is where a fetus has 47 total chromosomes instead of 23 pairs (46 total) and has an extra copy of chromosome 21 (Trisomy 21). It is usually screened for in conjunction with the other next common fetal chromosome trisomies: Trisomy 18 and Trisomy 13.
* Nuchal Translucency Sonogram to be done from 11w5d to 13w and possible Finger Stick blood testing (for patient’s less than 35 years old, to be done 1 week prior to the sonogram)
* Cell Free DNA testing (to be done around 9 or 10 weeks gestation – results usually takes 7-10 days to get results)
You can walk-in to the office (Monday-Friday 9:30am to 3:30pm) to have this testing done at the appropriate time.
o Panorama - 9 weeks
o MaterniT21 (twins and egg donor patients) – 10 weeks
Invasive Diagnostic Testing (miscarriage rate 1/400)
Fast preliminary results in 48 hours, full results in 10-14 days. Microarray results in 4 weeks.
o Chorionic Villus Sampling (CVS) (completed between 10-13 weeks gestation)
o Amniocentesis (Amnio) (completed between 15-20 weeks gestation)
o Please call 212-860-0300 to schedule a visit with a genetic counselor for further discussion.
o Please also refer to www.acog.org for more information.
Birthing, Breast Feeding, Infant CPR, Lactation Consultant – Carole Falletta, R.N. 212-570-0220
Also: Tribeca pediatrics, 92nd Street Y, Tribeca Parenting, Birth Day Presence
Reproductive Psychologist - Dr. Laura Josephs – (212) 249-5244
Reproductive Psychiatrist - Dr. Catherine Birndorf - (212) 369-1765 www.drcatherinebirndorf.com/contact.html
Hospital Tour – Sign up by 20 weeks for a tour of Labor and Delivery around 32 weeks
Breast Pump - please call your insurance company after 24 weeks as most will cover the cost of a breast pump.