Missed Menses* (missed period, 8-12 weeks pregnant)

At this visit we will confirm your pregnancy. A urine pregnancy test will be done in the office along with a pelvic exam. Additionally, it is routine to do a Pap test (if needed), cervical culture, urinalysis with culture, drug screen and other indicated blood work.

Genetic Testing

Genetic carrier screening (cystic fibrosis, chromosomal abnormalities such as Down syndrome, and Fragile X) will be offered. Routine ultrasounds for anatomy will be ordered (performed around 18 weeks). The Nuchal Translucency “NT” part of the Early Risk Assessment or First Trimester Screen will also be offered. After your NT scan you will have blood drawn to screen for birth defects if desired.

New OB visit (11-14 weeks pregnant)

This visit will start your official prenatal record. Your medical and genetic history will be reviewed. Routine prenatal blood work, as well as obstetric labs. Some additional testing if needed may include: gastric labs, liver function, PIH, thyroid or any missing cultures.

Flu shots* will be offered after the 1st Trimester (13 weeks)

During flu season we will offer and administer the flu vaccine to our OB patients. The flu vaccine is safe in pregnancy and is recommended.

18 weeks

Routine OB visit. The provider will verify the anatomy scan has been ordered or completed. Blood work for the Alpha-fetoprotein (AFP) may be ordered.

22 weeks

Routine OB visit. We will review the anatomy scan. Planning for childbirth education will be discussed as well.

26 weeks

Routine OB visit. The hospital packet will be given (pre-registration information to the hospital, the schedule for birthing classes and information about the Family Birthplace). Glucose Tolerance Testing (GTT) drink and instructions will be given. The GTT is a blood test that checks for gestational diabetes.

28 weeks

Routine OB visit. Blood draw, a complete blood count (CBC), the 1 hour GTT and antibody screen will be done. If your blood type is Rh negative (your initial OB labs include a screen of your blood’s Rh factor) you will be given an injection of Rhogam after your blood work. A urinalysis/culture and urine drug screen will also be done.

30 weeks

Routine OB visit. Information regarding the pertussis (Tdap) vaccine* will be provided. Tdap and flu vaccine* will be given (if not given already).

32 weeks

Routine OB visit.

34 weeks

Routine OB visit. Provider will discuss a plan for anesthesia during delivery with you.

36 weeks

Routine OB visit. Vaginal culture for Group B strep (GBS) and a urinalysis/culture will be done. Schedule repeat cesarean if needed.

37 weeks

Routine OB visit. Review signs of labor and delivery expectations.

38 weeks

Routine OB visit. Cervical check performed if desired. Review signs of labor.

39 weeks

Routine OB visit. Consider sweeping of membranes if cervix is favorable. Review signs of labor.

40 weeks

Routine OB visit. Cervical check performed and discuss scheduling an induction.

Think you’re in labor? Give the office a call and head to maternity at Cape Cod Hospital.

*Referrals are required for non-routine OB appointments and vaccinations by some insurance plans (Mass Health, TriCare and HMO plans). If your insurance plan requires referrals, it is best to request referrals from your PCP (6-12 visits) for the length of your pregnancy to avoid being charged for these visits.