Frequently Asked Questions
- Amniocentesis
- Antepartum Testing/Non-Stress Test/BPP
- Appointment
- Billing
- Co-Management in Pregnancy
- Diabetes in Pregnancy
- First Trimester Ultrasound
- Genetic Counseling
- Insurance
- Nuchal Scan
- Sonohysterogram
- Ultrasound / Obstetrical
Amniocentesis
What is an amniocentesis?
An amniocentesis involves the insertion of a needle into the pregnancy sac to withdraw a small amount of fluid from around the baby. This fluid contains some of the baby’s cells, which can be used for chromosome analysis. Amniocentesis is 99 percent accurate for detecting chromosome problems, including Down syndrome.
Are there any special instructions before my amniocentesis?
There are no special instructions prior to your amniocentesis.
How long will the amniocentesis take?
The procedure itself normally takes one minute; however, if you are scheduled for genetic counseling and an ultrasound, the complete visit can take up to two hours.
After my amniocentesis, are there any special instructions?
Some women experience mild menstrual like cramps. This is a natural common occurrence after an amniocentesis. The cramping usually occurs a few hours after the procedure, but occasionally will continue for a day or more. If you are cramping, we advise that you stay off your feet.
How long will it take to receive the results from my amniocentesis?
It takes 14 days for amniocentesis results. The results are sent by the laboratory to our office. A genetic counselor will call to inform you of your results. Please be patient and give the laboratory time to complete the testing before calling the office for results.
Why is genetic counseling required prior to my amniocentesis?
Genetic counseling gives you the opportunity to talk with a genetic counselor who has specific training in genetics. The counselor will explain what the risks are for the baby, review the benefits and limitations of the available testing, and help you decide whether the testing is right for your family.
Antepartum Testing/Non-Stress Test/BPP
What is antepartum testing?
Antepartum testing can include:
- Non-stress testing (NST)
- Biophysical profile (BPP)
- Modified biophysical profile (BPP)
What is a non-stress test?
A non-stress test (NST) is a simple, painless procedure. We will be listening to and seeing your baby’s heartbeat. We do this by electronic fetal monitoring. This monitoring is a way of observing your unborn baby. We will listen to and see the baby’s heartbeat while the baby is resting and moving. It usually takes 20 to 40 minutes to do a NST.
How is a NST done?
You will be more comfortable if you empty your bladder before the NST. Ask your nurse if she needs a urine specimen from you before using the restroom. You will be seated in a recliner positioned with the feet up. The nurse will place two elastic monitor belts around your abdomen; this does not hurt you or your baby. One of the monitor heads listens to the baby’s heart, the other monitor head records any contractions you may have during the test. You will be given a button to push each time you feel your baby move.
Who will do the NST?
It can be performed at most of our locations.
What is a biophysical profile (BPP) and modified BPP?
A biophysical profile (BPP) includes a NST and a special ultrasound to look at the baby’s movement, amount of amniotic fluid and to see if the baby is practicing breathing. It usually takes 15 to 30 minutes to do the ultrasound portion of a BPP. The modified BPP is simply a NST with an ultrasound to measure the amount of amniotic fluid around the baby. This ultrasound only takes a few minutes.
How is a BPP done?
In addition to the NST, you will have an ultrasound done that specifically looks at the amount of amniotic fluid around the baby, the baby’s position and movement, and to see if the baby is practicing breathing.
Who will do the BPP?
The NST portion of the test is done by a registered nurse who specializes in Maternal-Fetal Medicine; the ultrasound portion is done by one of the certified ultrasound technicians. The results of the BPP will be explained to you when the test is done. All BPP’s are reviewed by one of the Maternal-Fetal Medicine physicians before the patient is sent home.
When will I have the test?
BPPs are scheduled according to the order from your doctor.
Where will the BPP be done?
It can be performed at most of our locations.
Appointment
How do I schedule an appointment?
Your doctor’s office will call and schedule your appointment. All patients are referred to our office by their physician.
What if I need to change or cancel my appointment?
You can call our scheduling line at:
- Miami Valley Hospital: (937) 208-2516
- Miami Valley Hospital South: (937) 424-9800
- Vandaila: (937) 387-0930
- Dr. Weigand and Dr. McKenna’s office: (937) 208-8088
- Perinatal Partners, Mason and Middletown: (937) 439-0842 ext. 105
Billing
Who do I contact about a bill I received from Perinatal Partners?
Please call one of our Patient Account Reps at (937) 439-0842 x105.
Who do I contact about a bill I received from Miami Valley Hospital?
Please contact the number on the bill. We do not have access to the hospital accounts.
Co-Management in Pregnancy
What is Co-Management?
When a woman or her unborn baby has certain conditions, her primary care obstetrician may ask that one of the Maternal-Fetal Medicine specialists help to monitor her pregnancy. You will continue to see your primary care obstetrician for routine care and delivery. Our doctors will also see you throughout the pregnancy to monitor your high-risk condition and help determine what testing and treatment you may need in order to assist your doctor in management of the pregnancy. Co-Management complete obstetrical care is by physician or provider referral only.
Why do I need Co-Management?
If you or your unborn baby has certain conditions that make the pregnancy complicated or high risk, you will be able to continue care with your chosen primary care obstetrician and have the added benefit of your high-risk complication being monitored by the Maternal-Fetal Medicine specialist in collaboration with your doctor.
Reasons you may need co-management during your pregnancy include:
- High blood pressure or hypertension
- Preeclampsia (toxemia)
- Diabetes or other endocrine disorder
- Clotting disorders including antiphospholipid syndrome (APA)
- Twins, triplets and other multiple births
Where will I go for my co-managed visits?
You can be seen by our specialists at our Miami Valley Hospital, Miami Valley Hospital South or Vandalia offices.
Diabetes in Pregnancy
What type of diabetics do you see?
Type 1 (juvenile), Type 2 (adult onset) and Gestational (developed during pregnancy)
What can I expect from the program?
You will have an initial consultation, a consultation with the dietitian, ongoing medical management of blood glucose levels and follow up appointments for the remainder of the pregnancy.
What is an initial consultation?
During the two-hour initial consultation we will:
- Review your health history and lifestyle
- Teach specific self-management strategies
- Teach self-blood glucose monitoring, if needed
- Teach insulin self-injection & mixing of insulins, if needed
- Introduce a meal plan
- Do an ultrasound (if not done recently)
Who will I see at the initial consultation?
You will be seen by one of the diabetes nurse-educators, a sonographer (if having an ultrasound) and meet with one of the specialists. At the end of the consultation you will be scheduled for a follow up appointment with the dietitian to personalize your meal plan and a follow up appointment with one of the specialists.
What happens after the initial consultation?
You can expect to be seen in our office every 2 to 4 weeks where we will also coordinate any antepartum testing you may have. Our staff is available Monday through Friday to answer any questions or address any problems. A physician is on call after hours and weekends.
Why might I have a first trimester ultrasound?
A first trimester ultrasound is often used to confirm viability (check for heart beat) during the early stages of pregnancy, to confirm the age of your baby (establish a due date) and to make sure the pregnancy is in the proper location. After six weeks from your last menstrual period, it can be used to determine the number of embryos present and the chorionicity of a multiple gestation.
How early can I have a first trimester ultrasound?
Depending on the accuracy of your last menstrual period and if your menstrual cycle is regular (28 days), it is possible to visualize the embryo (baby) with transvaginal sonography as early as five weeks from the first day of your last menstrual period.
How is a first trimester ultrasound done?
If it is early in pregnancy, a transvaginal ultrasound will allow for early detection of the embryo and fetal heart beat.
What if I am bleeding?
A careful vaginal sonogram will not be harmful to you or the baby and may be helpful in determining the cause of bleeding.
What else can a first trimester ultrasound determine?
Between 11 to 13 weeks gestation, a first trimester scan can determine many major birth defects including brain anomalies, gastrointestinal, skeletal and cardiac defects. It is critical that the ultrasound be performed by an experienced, registered and accredited sonographer and/or physician. Often times, this will warrant further testing in the second trimester as well as referral to one of our genetic counselors.
Genetic Counseling
What are some reasons to refer for genetic counseling?
Reasons for you to receive genetic counseling include:
- Advanced maternal age (35 or older at delivery)
- Abnormal maternal serum screening
- Family history or previous child with birth defect
- Family history or previous child with mental retardation
- Recurrent pregnancy loss
- Abnormal ultrasound
- Abnormal amniocentesis
- Ethnicity screening
- Positive cystic fibrosis, sickle cell or thalassemia screen
- Consanguinity
- Medication or occupational exposure
What is the difference between a screening test and a diagnostic test?
A screening test estimates the risk of the baby having a condition, such as Down syndrome. Diagnostic tests, like amniocentesis, show whether or not the baby actually has Down syndrome.
What is Down syndrome?
Down syndrome is a genetic condition that causes delays in physical and intellectual development. Children with Down syndrome are also at an increased risk for certain problems, including congenital heart defects. While children and adults with Down syndrome
have developmental delays, they are more like other people than they are different. For additional information on Down syndrome, you may wish to contact the National Association for Down syndrome 
or
the
National Down Syndrome Society .
What is Trisomy 18?
Trisomy 18 is another type of chromosomal abnormality, which is a more severe than Down syndrome. Babies who have Trisomy 18 have an extra copy of chromosome #18. As a result, babies with Trisomy 18 often have such significant health problems that they miscarry, stillborn or die shortly after birth.
What are Open Neural Tube Defects?
Open neural tube defects are birth defects, which affect the head and spine of the baby. They occur when the neural tube (the structure that later develops into the brain and spinal cord) remains open instead of closed during embryonic growth in the first month of pregnancy. The two most common types of neural tube defects are anencephaly and spina bifida.
What is a chorionic villus sampling (CVS)?
The CVS is performed between 10 and 12 weeks gestation and provides information about the baby’s chromosomes. Depending on the location of the placenta, the CVS may be performed transcervically using a catheter or transabdominally with a needle.
Insurance
Do you accept my insurance?
We accept many types of insurance but we always ask that you contact your insurance carrier to verify coverage. You can also contact our Patient Account Reps for additional billing information at (937) 439-0842 ext. 105.
Nuchal Scan
What is a nuchal scan or nuchal ultrasound?
The nuchal scan is an ultrasound scan performed between 11 and 13 weeks of pregnancy, during which the fluid at the back of the baby’s neck (the nuchal translucency) is measured. All babies will have some fluid here, but in babies with Down syndrome the fluid tends to be increased.
Sonohysterogram
What is sonohysterography?
Sonohysterography consists of transvaginal sonographic imaging of the uterus and cervix while injecting saline (fluid) into the uterine cavity.
Why should I have a sonohysterogram?
Sonohysterography is used to evaluate abnormalities of the endometrium in women with abnormal vaginal bleeding, in women whose endometrium appears abnormal on pelvic ultrasound, or for evaluation of infertility. Sonohysterography is less invasive than hysteroscopy, dilatation and curettage (D&C), or endometrial biopsy and may detect problems such as polyps, fibroids, or adhesions inside the uterus.
What does the procedure involve?
This test is usually scheduled between days 5 through 10 of the menstrual cycle, when the lining in thinnest. An initial vaginal ultrasound examination is performed. The ultrasound transducer is then removed, and a speculum is inserted into the vagina to help see the cervix. A small catheter is inserted into the cervix. Once properly placed, the speculum is removed. Sterile saline (fluid) is injected while a vaginal ultrasound examination is again performed. This allows for a contrasted visualization of the uterine cavity.
Will it hurt?
Pelvic cramping similar to menstrual cramping can occur during the saline infusion or catheter placement. This usually stops once the infusion stops and the catheter is removed.
Ultrasound / Obstetrical
What is the purpose of obstetric ultrasound?
An ultrasound is a diagnostic test used to help your physician manage your care. It provides information regarding the dating of your pregnancy, viability and number of gestations. No test can detect all birth defects, but a thorough ultrasound in the first and second trimesters can identify several different kinds of birth defects, including birth defects of the heart, digestive system, skeletal system, brain and spinal cord. Ultrasound can tell if the fetus is growing normally, if the placenta is in the correct location and if there is the right amount of amniotic fluid. It is critical for your OB ultrasound to be performed by experienced, registered and accredited sonographers and/or physicians.
What happens if a birth defect is found on ultrasound?
If this happens, our staff will discuss the findings with you and will answer questions. In some instances, you may be referred to one of our genetic counselors to discuss the abnormality as well as discuss what other testing is available in the diagnosis of the condition. We will discuss this information with your primary physician and together we will plan appropriate follow up.
What should I do to prepare for my ultrasound?
Although your bladder does not have to be full, it may be helpful if you do not empty your bladder for about half an hour before your appointment. Otherwise, you do not have to do anything different before or after your appointment.
How long should I expect my appointment to take?
Ultrasound appointments usually take 30 to 60 minutes.
Can my family come with me to my appointment?
A few family members or friends are welcome. We know how exciting the ultrasound can be and we want you to be able to share the experience with your loved ones. But, in order to give you the most accurate ultrasound possible, the person performing the exam needs to be able to concentrate. So, we may ask you to limit the number of people you bring into the ultrasound room, minimize conversation, and avoid distractions. Because of the length of the appointment and darkness of the room, young children often become restless so we encourage you to make other arrangements for their care.
Can I have pictures of the ultrasound?
We will provide you with snapshots of the fetus from the ultrasound. If you would like to have a DVD of your exam you can purchase one of ours. As it is a medical record, there will be a small fee for the copy and release of this documentation.