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Prenatal care at North York General Hospital

Prenatal care at North York General Hospital. 11 th edition July 2013. North York General Hospital 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

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Prenatal care at North York General Hospital

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  1. Prenatal care at North York General Hospital 11th edition July 2013

  2. North York General Hospital 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

  3. First Prenatal visit • History • Examination • Tests • Discussion • Planning a healthy pregnancy

  4. Prenatal Diagnosis Prenatal Screening ( non invasive) • 12 week NT, with Blood test ( same day) • 16 week blood tests only • 18-20 weeks Anatomical Ultrasound • NIPT “Harmony” Testing Prenatal Testing( Invasive ) • CVS testing • Amniocentesis

  5. Prenatal 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

  6. At 16 weeks • Registration at NYGH • Blood tests are done NOW not at 18 weeks (same day HIV etc) • Prenatal classes • Make sure that you have 18 week ultrasound booked

  7. Other Prenatal Tests • Special blood tests • Amniocentesis ( 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.

  8. % Risk of Chromosomal Problems in pregnancies

  9. How to organize tests • Take the New Prenatal form to the front desk to get dates. • When? • Where? • Always check with office if in doubt • If you cancel REBOOK

  10. Prenatal Testing 2013 Any Questions ? We can contact NYGH Genetics department Keep in contact between 12 -18 weeks If in doubt Please contact us

  11. Other Issues • Diet and nutrition • Exercise • If smoking TRY to Quit • Prenatal classes • Breast feeding • Next appointment

  12. Diet and Nutrition • Regular well balanced diet • Flexible on weight gain • Increase calcium • May take vitamins • Do not OD on any one food • Special diets for vegetarians

  13. Exercise • Keep to what you normally do • Low impact exercises • DO not overdo it. • In high risk pregnancies lots of rest • Speak to me if there are concerns

  14. Smoking • IS bad for you and baby • Carbon monoxide poisoning • Nicotine effects • Stunted babies • Poorer eyesight • More congenital abnormalities

  15. Prenatal classes • More for new moms and dads • Held at hospital and other clinics • Info can be gained from reading etc • Good to meet other “new parents”

  16. Breast Feeding • Encouraged in all patients • Can do things both antenatal and intrapartum • Always worth a try

  17. Next appointments • The office • The Special Tests • Ultrasound • Blood tests • Genetics • Special focused tests

  18. Next appointments • The prenatal testing if appropriate • Next Ultrasound appt. • Next visit to the office 4,2 or 1 weeks • Make sure you know how to contact office

  19. How to contact Dr. Pairaudeau • The office is open Mon-Fri 9am to 5.30pm • Some 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

  20. In 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

  21. Emergency Considerations • DO NOT PANIC • Try to locate Dr. Pairaudeau or office • Remember office is open seven days • Please do not use TELE HEALTH • Use emergency only if appropriate • Avoid walk-in clinic unless advised • Use family doctor as back-up

  22. Emergency Conditions • When you have bad pains or contractions • Waters break • Bleeding more than a period • Fever 38.5 C (fever over 39 C are serious, needs attention) • Bad problems that cannot wait • What to expect

  23. Labour and Delivery • 2nd Floor NYGH Leslie Street site • Go 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

  24. Who delivers You • We have an on call person 24hrs in H • I like to do my own deliveries • As long as I am available I will deliver • We have sign out system at midnight • Maybe at conference • 95% attendance rate

  25. Stay and discharge in Hospital • If normal delivery 24 hours + - • If complicated delivery till well enough • If C\section 72 hours. • Public Health Nurse Program • Must be seen if serious problem by me

  26. Final Round up • See the person at desk • Make appointments • Questions ??? • Medical Registration Fee • Please see added note from desk • Please see ultrasounds

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