EBPMA | Frequently Asked Questions

Frequently Asked Questions (FAQs)

GENERAL QUESTIONS

•	Who will deliver my baby?
	We have a dedicated team of specialists trained to handle your needs during your inpatient stay at Alta Bates Medical Center, including two OB/GYN physicians who are present in the hospital at all times (24 hours a day, 7 days a week), ready to care for you — from admission through delivery and recovery.

•	Who will I see for my prenatal appointments?
	Whether for a one-time high-risk consultation ordered by your regular OB/GYN, co-management of your high-risk condition throughout your pregnancy along with your regular OB/GYN, or for the complete assumption of your prenatal care for the duration of your pregnancy, we have seven maternal-fetal medicine specialists on staff to provide your care. We try our best to schedule your visits with the same member of our staff for each of your office visits, but because all of our physicians work in more than one of our offices, it is possible you will see more than one physician during the course of your care.

•	What do I need to bring with me to my first appointment?
	Please plan to arrive at least 15 minutes in advance of your first appointment so that you have time to fill out preliminary paperwork. Please bring your insurance card with you. You may bring up to 2 people with you to this informative session.

•	Where will I deliver?
	If your prenatal care is being provided exclusively by East Bay Perinatal Medical Associates, your delivery will take place at Alta Bates Summit Medical Center, located at 2450 Ashby Avenue, Berkeley, CA 94705. You are welcome to visit their website at: http://www.altabates.com/clinical/women_infants.html If your care is being co-managed by our maternal-fetal medicine specialists in conjunction with your regular OB/GYN, the site of your delivery will be determined by your medical team and is largely dependent on the level of complication involved in your care and that of your newborn.

•	What if I have a problem after office hours?
	Our services are available 24/7, even when our offices are closed. If you are experiencing signs or symptoms of a medical complication and need to speak to a physician, all you need to do is call the main office phone number (510) 444-0790 and our answering service will connect you with one of our physicians on duty.

•	How often are my appointments?
	If you are being referred for a high-risk consultation appointment by your regular OB/GYN, you may be seen by one of our maternal-fetal medicine specialists only once, and then return to your OB/GYN for the remainder of your prenatal care and delivery. If your OB/GYN physician prefers that we co-manage your prenatal care, our maternal fetal medicine specialists will manage only the high-risk component of your care, and your visits may be scheduled every 4 weeks (particularly earlier in your pregnancy), or as often as every 1 to 2 weeks (most likely closer to the time of your delivery), depending on the degree of complication and level of care required.

•	Will EBPMA accept my insurance?
	East Bay Perinatal participates in many HMO and PPO plans. Because individual policies vary, we recommend that you contact your insurance carrier directly to determine if East Bay Perinatal Medical Associates is a participating provider under your plan.

•	What will my insurance cover?
	When you call to schedule your first appointment, a member of our front office staff will gather your insurance information to pass on to our billing department, and to assist you in confirming your insurance eligibility, determining your benefits—including co-pay, if applicable—and request an authorization for your services if this is required with your plan.

•	Can I bring someone with me to my appointment?
	Whether you are being seen for a routine visit, or a consult specific to a high-risk diagnosis, you are welcome to bring your husband, your partner or other trusted family member with you to your appointment. In the interest of safety, we recommend that children not be brought into the exam room during your appointment. We do recognize, however, that this is a special time for your entire family; if you wish your child to be present in order to hear fetal heart tones, we will be happy to accommodate you.

•	Can I be guaranteed a female provider at East Bay Perinatal Medical Associates?
	We are very fortunate to have two women among our well-regarded group of maternal fetal medicine specialists. Whether your request for a female provider is for religious reasons or merely personal preference, we will make every attempt to schedule your appointments with one of our female maternal fetal medicine specialists. Our commitment to provide perinatology consultancy services across several East Bay counties, however, means our providers are routinely scheduled in multiple sites. While we promise to make every effort on our end to accommodate your preference, we cannot guarantee all your appointments will be with a female provider.

•	Can I be guaranteed a female provider during my delivery at Alta Bates Medical Center?
	While we do have a large number of women on our hospital panel of perinatal OB/GYN physicians, there may occasionally be times when a female physician is not available to attend a particular delivery. While we promise to make every effort on our end to accommodate your preference, we cannot make that guarantee.

•	What is your policy concerning missed appointments?
	Our appointment slots fill quickly. If you find you have a scheduling conflict and need to reschedule your appointment, please call our office as soon as possible and we will work to schedule you into the next available appointment. Please note: We do require 24 hours notice if you are unable to make your scheduled appointment. Failure to contact our office at least 24 hours in advance of an appointment may result in a cancellation fee.

SWEET SUCCESS QUESTIONS

•	Why am I being referred to your Sweet Success Program?
	You are being referred to our Sweet Success Program by your doctor because you have been diagnosed with gestational diabetes, or you have pregestational diabetes and are currently pregnant, or you wish to become pregnant and are being referred to the program for pre-conception counseling.

•	Who will I see during my first appointment?
	On your first appointment you will be seen by a registered dietitian/diabetes educator who specializes in diabetes and nutrition during pregnancy.

•	How long will the first appointment take?
	Because there is much to cover and we want to answer all your questions so you to feel more at ease with your diagnosis, you should allow 90 minutes for this first appointment.

•	What will be covered my first visit?
	Diabetes during pregnancy Risks of high blood sugar during pregnancy Dietary guidelines Blood sugar monitoring (you will receive your own meter and instruction) Instructions on food and blood sugar records Post partum guidelines

•	How many follow-up visits will I need?
	Follow up visits are determined on an individual basis, but usually consist of at least 2 separate visits, both with the registered dietician/certified diabetes educator and the maternal fetal medicine specialist. During these visits, your blood glucose numbers and food records will be reviewed. Every member of our Sweet Success team is knowledgeable and specially trained to teach you methods to control your diabetes through your diet, exercise—and, if needed, medication—to minimize risk of complications associated with pregnancy and uncontrolled diabetes.

PRENATAL DIAGNOSIS — TESTING AND SCREENING QUESTIONS

•	What is a Prenatal Diagnosis Center?
	A facility that has been designated as a Prenatal Diagnosis Center (PDC) undergoes periodic and regular evaluations by the State of California’s Genetic Disease Branch (GDB) to assess competency and skill.

•	What is a fetal anatomy scan (formerly known as ‘level II sonogram’)?
	This is an ultrasound examination of the fetus, usually done at around 20 weeks gestation, where anomalies may be detected by looking carefully at the fetus. It usually takes about 30 minutes and is performed by a skilled sonographer and reviewed by one of our perinatologists, who are recognized by the State of California as experts in assessing fetal ultrasound examinations.

•	What prenatal tests and screenings are available to determine risk for chromosomal abnormalities, like Down syndrome?
	Different types of testing are available for screening and detecting common chromosomal abnormalities. Screening tests will help determine if you are at increased risk for these problems, but diagnostic testing would have to be performed to determine if any of these problems are present. Tests are available at various times between nine (9) and twenty (20) weeks. The following is a short description of the available tests and when they are performed.

	Screening Tests:

	–	First Trimester Combined Screening involves a fetal ultrasound, performed between 11.5 and 14.0 weeks of pregnancy, and is combined with a blood test performed at 10 to 13 weeks, to indicate if your pregnancy is at a higher chance for Down syndrome, Trisomy 13, or Trisomy 18 syndromes. 5% of all pregnancies are at risk for these anomalies, and this test detects approximately 85% of them.

	–	Second Trimester Ultrasound Screening is an ultrasound examination of the fetus, usually done at around 20 weeks gestation, where anomalies may be detected by looking carefully at the fetus.

	–	Second Trimester Serum Screening is a test performed during the second trimester between 15 and 20 weeks gestation. This screening has been considered to be the standard of care for many years. Second trimester serum screening involves measuring four fetal proteins from your blood. It screens for Down syndrome, Trisomy 18, and open neural tube defects in the pregnancy. Approximately 81% of pregnancies affected with Down syndrome will have an increased risk or a “screen positive” result on a second trimester screening test.

	–	Integrated Screening involves an ultrasound and blood test in the first trimester, followed by a blood test in the second trimester, when you receive your results. This will assess your risk for Down syndrome, Trisomy 18, and open neural tube defects. Approximately 92-95% of pregnancies affected with Down syndrome will have an increased risk or a “screen positive” result.

	–	Sequential Screening is similar to integrated screening, but includes the addition of an interim result after the 1st trimester ultrasound and blood test. If the risk of Down syndrome is low, you will not need a second trimester blood test. However, for a detection rate similar to that of Down syndrome as seen in integrated screening, there is a 3-4 times greater chance you will be identified as being at risk, which may increase the need for an invasive procedure such as CVS or amniocentesis.

	Diagnostic Testing:

	Approximately 5% of patients will be screen positive, but only a small percentage of these patients will actually have a baby affected with Down syndrome or Trisomy 18. If a screening test is abnormal (screen positive) indicating an increased risk of having a baby with either a chromosome problem or an open neural tube defect, you will be offered diagnostic testing for a definitive diagnosis. There are two diagnostics tests commonly offered:

	–	Chorionic villus sampling (CVS) is performed between 10.5 and 13.5 weeks of pregnancy. CVS is performed by removing a small amount of placental tissue, either transabdominally or transvaginally, which is used to test for chromosome problems. The risk of miscarriage is approximately 1 in 300.

	–	Amniocentesis is offered between 15 and 22 weeks of pregnancy. Amniocentesis involves removing a small amount of fluid surrounding the baby. Cells from this fluid are used to test for chromosome problems as well as open neural tube defects and other inherited problems. Both CVS and amniocentesis are considered safe, but are associated with a risk for miscarriage of 0.3-0.5%. Having a baby involves many complex decisions that are best made on an individual basis. There is no one correct answer for all women. Please understand that a normal chromosome result does not guarantee a healthy baby. If you have further questions or would like to be scheduled for a genetic consult to evaluate the genetic risks in your pregnancy, please call 510-204-1507.

•	Is there pain associated with an amniocentesis?
	Most patients experience a small amount of discomfort. This usually lasts a few seconds. Some women experience mild lower abdominal cramping immediately after the procedure.

•	How long does it take to get the results of an amniocentesis?
	Results are typically available in 10-14 days. A member of our staff will call you with the results. (Please be sure we have your most current contact information.)

•	How long does it take to get the results of a CVS (chorionic villus sampling) procedure?
	Results are typically available in 10-14 days. A member of our staff will call you with the results. (Please be sure we have your most current contact information.)

•	Are there any side effects or limitations after an amniocentesis?
	Mild abdominal pain or cramping is normal, as is a small amount of spotting with a transvaginal CVS.

•	What should I do if I think I am having a problem after an amniocentesis or CVS procedure?
	If you experience increasing abdominal pain, fever, chills, vaginal bleeding beyond a small amount of spotting, or leakage of fluid per vagina, you should contact your pregnancy care provider as soon as possible, as this may be the sign of an infection.

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