tag:blogger.com,1999:blog-5160381109996491098.post4633653635520823405..comments2024-01-02T06:57:26.352-05:00Comments on Life and Love in the Petri Dish: Question: high risk versus regular OB?Unknownnoreply@blogger.comBlogger56125tag:blogger.com,1999:blog-5160381109996491098.post-1061879736240258672010-11-02T16:14:41.089-04:002010-11-02T16:14:41.089-04:00high risk ob all the way... so glad to hear you...high risk ob all the way... so glad to hear you'll be on top of cervical length checks. sending good energy your way for a long, healthy pregnancy.Breehttps://www.blogger.com/profile/03894396436704042272noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-19690190375649265022010-11-02T09:40:15.981-04:002010-11-02T09:40:15.981-04:00When I had pre-term contractions, my "regular...When I had pre-term contractions, my "regular" OB measured my cervical length all the time. So I know it's possible. <br /><br />I would just make sure you find an OB you feel comfortable with who will meet your needs. I had to change OB's in the middle of my pregnancy because my old OB wasn't attentive to my needs, namely, blowing off my hospitalization for pre-term contractions with a "just come in next week for your regular appointment."Emhttps://www.blogger.com/profile/08850253158062835353noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-84929718058237398412010-11-02T07:30:37.398-04:002010-11-02T07:30:37.398-04:00I hope you have a reassuring u/s today!I hope you have a reassuring u/s today!Lisahttps://www.blogger.com/profile/17961296047588934823noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-61389524704473392322010-11-02T00:11:49.390-04:002010-11-02T00:11:49.390-04:00A regular OB can definitely check cervical length....A regular OB can definitely check cervical length. That's done during a regular vaginal ultrasound.<br /><br />I had a high risk pregnancy (triplets from IVF) and saw my regular OB more than my MFM. He was great! Literally whenever I called with any kind of concern he'd tell me to come in for an ultrasound. It got to the point where I'd hesitate before calling because sometimes I just wanted an answer to my question, not necessarily an entire ultrasound!<br /><br />The right OB will understand you've been through hell to get this pregnancy and may need more reassurance than the typical patient. And he or she will be OK with that and will let you come in for a quick doppler or ultrasound check whenever you need to know for sure.Catnoreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-48093271231326906852010-11-02T00:02:29.316-04:002010-11-02T00:02:29.316-04:00If you can find other women also taking Lovenox po...If you can find other women also taking Lovenox post-IF in NYC, I'd ask for recommendations from that group. I think it depends a LOT on the doctor, regardless of whether it's an ob/gyn or peri.<br /><br />Before we even started ttc, I searched for an ob/gyn who had worked specifically with patients who had dealt with a particular non-IF issue I had. I lucked into a great doctor who is also not afraid to deal with the Lovenox, does not freak out about the intralipids/IVIg/IV antibiotics, etc., lets me come in every week when I'm pg, and does ultrasounds for me at every appointment. However, he's also been an ob/gyn long enough that he doesn't feel the need to be a hero - I know he wouldn't hesitate to send me to a peri if he felt it was something beyond what he could confidently handle.<br /><br />OTOH, I have IF friends who were on Lovenox whose ob/gyns freaked out about that and made them super stressed for their whole pregnancy because of it. <br /><br />I also have IF friends who had to go the peri route for more significant issues than just Lovenox. (One of them was carrying twins, and one of the twins only had one artery (??) in the umbilical cord instead of the usual three.)<br /><br />Even having a much more serious issue than blood thinners, that particular friend didn't actually see the peri in most cases - she had an ultrasound with the u/s tech, and then the peri reviewed the u/s images later that day and someone from the office called her with instructions. So she didn't get to ask the doctor many questions or have many discussions with him directly. That would stress me out. But then again, we live in a place that has one of the most well regarded MFM hospitals in the world, so the doctors in that practice are often busy delivering quads, quits, even sextuplets, so they're super busy and not always available for face-to-face appointments because they're at the hospital a lot.Rebeccahttps://www.blogger.com/profile/09564075022074996137noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-21289303881696881982010-11-02T00:02:08.105-04:002010-11-02T00:02:08.105-04:00This comment has been removed by the author.Rebeccahttps://www.blogger.com/profile/09564075022074996137noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-30309408566548879702010-11-01T23:59:42.556-04:002010-11-01T23:59:42.556-04:00This comment has been removed by the author.Rebeccahttps://www.blogger.com/profile/09564075022074996137noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-5086573943798776942010-11-01T20:56:24.926-04:002010-11-01T20:56:24.926-04:00Will be thinking of you tomorrow!!!!Will be thinking of you tomorrow!!!!Maggiehttps://www.blogger.com/profile/04042958861017903342noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-6536528398924521782010-11-01T20:24:08.609-04:002010-11-01T20:24:08.609-04:00I have no experience in this area, but I know that...I have no experience in this area, but I know that with all my issues (older maternal age, immune issues, et al) that I would go high risk, personally speaking. But I'd shop for one that I really like and felt comfortable with. I know that with lovenox (which I think you are on?), SCH happen more frequently and I would feel happier knowing that my OB knew what to do immediately with my meds.lindahttps://www.blogger.com/profile/06261827387771485458noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-37760307012149061212010-11-01T19:55:39.279-04:002010-11-01T19:55:39.279-04:00oh, and the regular ob wouldn't do a cervical ...oh, and the regular ob wouldn't do a cervical check manually at 16 wks, they made me wait for the hi risk and go to the fancy u/s place which is separate from the practice. however, they can measure via U/S now which is MUCH better than manuallyPaula Kellerhttps://www.blogger.com/profile/11545620300368378897noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-22216400834377207482010-11-01T19:47:57.903-04:002010-11-01T19:47:57.903-04:00I was on lovenox up until a week or so before deli...I was on lovenox up until a week or so before delivery - totally experimental because I'd had 3 m/c. I went with the high risk, but saw ( all 4 docs in the practice). I think that's the way it works usually. <br /><br />I think the lovenox may have been what made the difference, btw. and was worth every poke/bruise.<br /><br />You may get more u/s with high risk.Paula Kellerhttps://www.blogger.com/profile/11545620300368378897noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-45520573323565086792010-11-01T19:45:28.533-04:002010-11-01T19:45:28.533-04:00First off, holy shit you are pregnant! (sorry, thi...First off, holy shit you are pregnant! (sorry, this is what happens when I go away -- I miss the very exciting things!!)<br />Second, I think it depends on the OB -- I get pretty much monthly monitoring/ us from my regular OB just b/c of my age and my IF. If you can find that with a person you really like, then go for it.<br />But mostly, I am so happy for you I could burst!irrationalexuberancehttps://www.blogger.com/profile/05772420700972282324noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-92214303393221229212010-11-01T17:45:25.483-04:002010-11-01T17:45:25.483-04:00Mo... thank you so much for asking this question. ...Mo... thank you so much for asking this question. I was looking into what I should do too! I want to go to an MFM myself. But I have no basis for my decision and was hence wavering!<br /><br />Looks like there is a lot of good advice from folks.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-1127392250593828592010-11-01T16:02:59.691-04:002010-11-01T16:02:59.691-04:00I don't know about the meds issue, but I am se...I don't know about the meds issue, but I am seeing a regular OB and because I am at high risk for preterm delivery, they do check my cervical length on a regular basis. <br /><br />Good luck!The Suburban Princesshttps://www.blogger.com/profile/02723464733111405587noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-45178583081088094282010-11-01T13:22:20.725-04:002010-11-01T13:22:20.725-04:00Posting, then running out to the chiro. Will read ...Posting, then running out to the chiro. Will read all the other comments when I get back. I vote high risk. Simply put, you will get more monitoring. I also don't think a regular OB will necessarily be less busy. I can understand not wanting to go back to the MFM you saw last time. FWIW, I liked my dr in that practice (who, BTW, has an IVF girl of her own). Book the first appts of the day, and you shouldn't feel rushed. And call NOW. I called before by first beta. (I figured I could always cancel.)Dorahttps://www.blogger.com/profile/16255190971670471758noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-29494272249719171582010-11-01T13:20:10.947-04:002010-11-01T13:20:10.947-04:00Due to my crazy-ass pregnancy, I never saw a "...Due to my crazy-ass pregnancy, I never saw a "regular" OB and was a "total care" patient with my perinatologist. I echo what others have said... most women would have to see a regular OB and consult with a peri. <br /><br />I consider it an advantage to have only been followed by a high-risk specialist because although I knew of a really good OB I would have used, the peri that took care of me was always thinking down the road (it seems they are always working out contingency plans for coming complications). But I think even consulting with a peri (if your insurance won't allow them to be primary), would serve the same purpose. <br /><br />As a bonus, I had an ultrasound at every visit, even if it was just to check cervix and heartbeats. I think that would be difficult to do if you only see a regular OB.<br /><br />Happy deciding:)SassyMamahttps://www.blogger.com/profile/00018022347771467869noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-30937112005420954582010-11-01T13:06:12.304-04:002010-11-01T13:06:12.304-04:00I would go with high risk. They are more thorough ...I would go with high risk. They are more thorough and have seen it all. I also found they that they are used to us IF's and all our questions, fears and requests.<br />MAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-89435189672707817462010-11-01T12:56:46.433-04:002010-11-01T12:56:46.433-04:00Hi...I have no experience with High Risk OB's....Hi...I have no experience with High Risk OB's...so I don't have any advice for you. Just wanted to pop in...say I've caught up with your blog (YAY for seeing a gestational and yolk sac!!!!). I'm praying for both of us for good ultrasounds this week!<br /><br />Lots of Love and ((HUGS))Amyhttps://www.blogger.com/profile/14859972086411293652noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-54128285333192911922010-11-01T12:44:00.681-04:002010-11-01T12:44:00.681-04:00I agree with everyone, see the high risk AND the O...I agree with everyone, see the high risk AND the OB. The high risk dr monitors way more than the regular OB. <br /><br />I am currently 20 wks and see both dr's because of my history of miscarriages (and was on lovenox). I see the high risk dr every two weeks to measure my cervix. So glad I get to see the baby that frequently. <br /><br />Good luck!!Life Happenshttps://www.blogger.com/profile/02302134343874268994noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-10818631704085677982010-11-01T11:26:16.393-04:002010-11-01T11:26:16.393-04:00I'm pregnant with twins and see both an OB and...I'm pregnant with twins and see both an OB and a high-risk. I had to go to the high-risk office anyway for the 1st trimester screen, anatomy scan and for bi-monthly cervix checks. My OB recommended I consult with the MFM doctor in case I need their care down the road, I will have established a relationship.<br /><br />This may just be my office, but my OB checks my cervix manually, and the high-risk checks by ultrasound (much more accurate).<br /><br />So far I'm pleased being under the care of two doctors...as long as they are associated, they will take a team approach to your pregnancy.Alisonhttps://www.blogger.com/profile/02010422089639320117noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-69937025830133712422010-11-01T09:53:13.715-04:002010-11-01T09:53:13.715-04:00I would go high-risk. I went for my quads and hon...I would go high-risk. I went for my quads and honestly I got so much more monitoring, and I think you get that kind of monitoring no matter what the circumstances. You might want to have an appt at the regular OB too just so you have your foot in the door and then when you feel safer you could move to the regular OB if you prefer.<br /><br />CONGRATS on your sweet baby! Praying hard that he/she continues to grow strong and soon you see a heartbeat!quadmomhttps://www.blogger.com/profile/17254199098599230245noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-77097886972407942622010-11-01T09:49:40.110-04:002010-11-01T09:49:40.110-04:00My RE referred me to a regular OB. I have a numbe...My RE referred me to a regular OB. I have a number of high risk factors including a massive dose of Lovenox (90 mg twice a day per the hematologist), high blood pressure, and AMA. I asked my RE specifically about a high risk OB/Perinatologist and she said that a regular OB would be the primary and refer me to a Perinatologist when necessary. As an aside, perinatologists are few and far between here in MD due to it being a high risk/low reward practice and insurance laws that are forcing both regular OBs and high risk OBs especially out of practice. That, at least here in MD, can mean long waits for Perinatology appointments. My first appointment with the OB, sure enough she referred me to her sister in law who is a high risk OB. That practice will also perform the NT scan in a day or so and any follow up genetic testing we decide to do. They also provide the genetic counseling while the regular OB manages the more mundane day to day pregnancy issues. I like the OB because she is easy to get in to see, a solo practitioner and on call five days and week and every other weekend, easy to reach by telephone, etc. The Perinatology center is a shared practice and not very accessible, harder to get appointments, etc. but I like their expertise so I'm ok with this hybrid approach.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-80953522301313941482010-11-01T09:40:55.586-04:002010-11-01T09:40:55.586-04:00My 3 cents to add to the pile....
I think it depe...My 3 cents to add to the pile....<br /><br />I think it depends on your regular OB, some docs are comfortable managing pts on meds like blood thinners, or those with more complicated med histories. But my gut says you might do better with a high-risk OB. Both can monitor your cervical length (my regular OB does this because I had a LEEP). <br /><br />And CCRM wants you to see an OB around week 8, so even though you will still be monitored by CCRM for weaning off the supplemental hormones til week 11-12, they want you under OB care after a heartbeat is seen. So it is sooner than you think!Piehttps://www.blogger.com/profile/07331859341593997811noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-74478688680798642582010-11-01T09:14:06.160-04:002010-11-01T09:14:06.160-04:00Thoughts on the OB. When I was pregnant, there wer...Thoughts on the OB. When I was pregnant, there were a few women on lovenox and they went to a regular OB, so I think you can still go to a regular doc. Also, you are right, you might get better (and more sympathetic) care there because they aren't all that used to patients with interesting histories or concerns. I hate the search for an OB. For me, it had to do with doctors that rely too heavily on medical intervention (but I also wanted a REAL doc who would go the medical route IF NECESSARY) and a doctor who would be sympathetic to my panic attacks regarding miscarriages. I got neither! But, I was strong enough to fight for both and, in the end, it worked out. I think you'll be staying with your local clinic for the beginning of the pregnancy, right? At least until you are weaned from meds? After that, definitely test your doc out and have the important conversations early because it is very hard to change doctors after the 2nd trimester. Good luck! looking forward to seeing what you decide:-)<br /><br />BTW...CONGRATS!!! And, I LOVE your boxer puppy! What a cutie! We have 2 boxers and they are amazing with my 8 month old. I swear, boxers are like potato chips, you really do get addicted:-)Suehttps://www.blogger.com/profile/05323373273366929886noreply@blogger.comtag:blogger.com,1999:blog-5160381109996491098.post-7901170271916170182010-11-01T07:25:02.889-04:002010-11-01T07:25:02.889-04:00with your history, i would want to be under the ov...with your history, i would want to be under the overall care of a perinatologist or mfm group. whether you see on ob simultaneously, you want the peri to call the shots. this pregnancy was intensely hard to achieve, and you have valid issues to begin with, so go to the best mfm group you can find and start there. in my own experience, to whitewash the situation ('maybe i am having a normal low-risk pregnancy' lalalala) has always ended up leaving me with regrets- treat the pregnancy as high-risk from the get go. you don't want to be in a situation when you want more care but the ob you chose, while super-friendly etc, is hesitant to give the extra care. you want to have the extra care offered before you even think you may want it, and perinatologists have 'seen it all'- they will know what is coming around the corner. <br /><br />its tough to be thinking about these decisions in early pregnancy, but it the responsible thing to do- just like you take your prenatal vitamin every day, your lovenox shot... setting up the proper care is just part of that process. all the best to you!Anonymousnoreply@blogger.com