How does it occur?

Urinary tract infection is the result of bacteria from the vagina, perineum, rectum or a sexual partner, and ascends into the urethra which then travels to the bladder. These bacteria can cause:

• cystitis (bladder infection)

• pyelonephritis (kidney infection)

• urethritis (inflammation of the urethra, the tube that drains urine from the bladder).

What are the symptoms?

The symptoms of UTI may include:

• urinating more often

• feeling an urgent need to urinate

• pain or discomfort (burning) when you urinate

• strong-smelling urine

• pain in the lower pelvis, stomach, lower back, or side

• urine that looks cloudy or reddish

• shaking chills

• fever

• sweats

• nausea and vomiting

• leaking of urine (incontinence)

• change in amount of urine, either more or less

• pain during sexual intercourse

Your symptoms are reviewed and an examination will be done. It is very important to have your urine sample cultured for accurate treatment.

How is it treated?

UTIs are treated with an antibiotic. Uncomplicated urinary tract infections are usually treated within 3 days. For chronic infections or infections it may be necessary to take the antibiotics for a longer time. You should always finish all of the medication prescribed even when the symptoms go away.

How long will the effects last?

Usually the symptoms of the infection stop in 2 to 3 days.

If you have a fever:

• Rest if you have a fever above 100.4 degrees F

• Take acetaminophen to control the fever.

If your symptoms continue for 2 or more days, or if you develop new symptoms, call the office immediately.

How can I help prevent a urinary tract infection?

You can help prevent UTIs if you:

• Drink plenty of water and other no caffeinated drinks.

• Do not hold your urine for long periods of time.

• Wipe from front to back to keep rectal bacteria from getting into the vagina and urethra.

• Avoid using irritating cosmetics or chemicals in the area of the vagina and urethra (such as strong soaps, feminine hygiene sprays or douches, or scented napkins or panty liners).

• Urinate after sexual intercourse.

• Keep your genital area clean.

• Empty your bladder completely when you urinate.

• Wear all-cotton underwear and pantyhose. Change underwear and pantyhose every day.

What is a yeast infection?

A yeast infection is a fungal infection that occurs in the vagina, mouth, or other moist areas on the skin. It is also called candidiasis.

How does it occur?

The fungus Candida lives in small numbers in a health vagina, rectum and mouth. When the vagina's pH balance is disturbed, the organisms multiply and cause infections.

There are several situations in which the yeast may multiply. Sometimes, if you are taking antibiotics, it can kill the bacteria that normally keep yeast levels down. Conditions that cause pH changes, such as menopause, pregnancy, or taking birth control pills or antibiotics, may also cause the yeast to grow.

What are the symptoms?

Symptoms vary from woman to woman. Some women have no symptoms at all. While others, notice the following:

• a discharge from the vagina that is thick and white and looks like paste or cottage cheese. The odor may be unpleasant but it is not foul.

• swollen, red, tender, itching vaginal (labia) and surrounding skin

• burning on urination

• change in vaginal color from pale pink to red

• pain during sexual intercourse

On the skin a yeast infection produces an itchy red rash. Often the rash is a red patch with small red bumps around it. The skin may also start to peel.

How is it treated?

Start with medicines you can buy without a prescription, such as miconazole nitrate (Monistat-7) and clotrimazole (Gyne-Lotrimin, Mycelex-7, and FemCare). You should use the 3 to 7 day treatments for the most effective treatment. If symptoms continue, you may need to be seen and given a prescription.

How long will the effects last?

With proper treatment, the infection usually resolves in a few days to a week.

How can I take care of myself?

If you have a vaginal yeast infection, follow these guidelines:

• Follow the full treatment prescribed.

• Avoid sexual intercourse until the infection is gone.

• After urinating, wipe gently to avoid irritation.

• Use unscented soaps.

• Avoid using douches and other chemicals, such as bubble bath or hygiene spray, in the vaginal area.

• Wear cotton underwear to allow ventilation and to keep the area dry.

How can I prevent a yeast infection?

• Keep the genital area clean. Use only plain unscented soap such as Dove or Ivory.

• Don't use douches, vaginal deodorants or body spray, bubble baths and colored or perfumed toilet paper, tampons or pads.

• Lose weight if you are obese (20% over normal weight).

• If you are diabetic, maintain a normal blood sugar.

• Wear cotton underpants or pantyhose with a cotton crotch.

• Don't sit around in wet clothing, especially a wet bathing suit.

• After urination or bowel movements, cleanse by wiping or washing from front to back (vagina to anus)

• Avoid use of antibiotics unless prescribed by a doctor.

• Nutritional supplements live yogurt, lactobacillus containing probiotics, or Rephresh (an oral probiotic) will help keep the vaginal pH normal. Rephresh also makes a vaginal insert to help with this.

When should I call the office?

You should call the office promptly if you have repeated yeast infections within a 2-month period or a yeast infection that persists despite treatment.

What is bacterial vaginosis?

Bacterial vaginosis is a common inflammation of the vagina caused by bacteria. These bacteria are normally found in the vagina. However, too many of them in the vagina can cause unpleasant symptoms. This is not considered a sexually transmitted infection, however, sexual activity has been linked to the development of this infection. Also, shaving, allowing soaps, perfumes, powder or lotions to get into the vagina can cause this infection. This, too, is caused by a vaginal pH imbalance.

What are the symptoms?

Approximately 50% of women have no symptoms. The most common symptom is a discharge from the vagina. The discharge may be gray, green or yellowish. It often has a fishy odor that may be worse after intercourse. You may also have burning or itching around the opening of the vagina.

How is it diagnosed?

A pelvic exam and a sample of vaginal discharge is obtained to be examined under the microscope.

How is it treated?

There most common antibiotic is called Flagyl that is taken by mouth. Other medicines, such as Tindamax, Metrogel or Clindesse, are also used. Do not drink any alcohol while you are taking Flagyl or Tindamax for 2 days after you finish the medicine. Drinking alcohol while you are taking these medicines may cause nausea or vomiting. You shouldn't have intercourse until your symptoms are gone and you have finished your treatment.

How long will the effects last?

The symptoms may last for a few days after beginning your treatment. If the symptoms do not go away after treatment is completed, you should call the office.

YOU MAY USE:

• Tylenol or Extra Strength Tylenol-up to 4 grams (8 tablets of 500mg) daily, for headaches, colds, fever or back pain.

• Mucinex for congestion or sinus problems.

• Robitussin for cough and/or congestion.

• Chloraseptic throat spray or losenges such as Sucrets, for sore throat.

• Saline nasal spray, such as Ocean.

• Metamucil, Milk of Magnesia, Senkot S tablets or Surfak & Colace can be used for constipation.

• Tums & Rolaids, Riopan, Mylanta, Maalox, Prilosec, Nexium and Pepcid AC for hearburn and indigestion.

• Kaopectate or Immodium can be used for relief of diarrhea.

• Preparation H, Tucks, Anusol and Anusol HC can be used for hemorrhoidal pain.

• 3 Day Monistat vaginal cream (insert ½ way into vagina) may be used for yeast infection.

• Benadryl may be used for itching and trouble sleeping. Tylenol PM may be used for sleep.

• Unisom/Vitamin B6 – 1 tab for N/V in first trimester

DO NOT USE:

• Ibuprofen, Motrin, Aleve, Advil

• Aspirin unless directed by your physician

• Alcohol

• Cigarettes

• Caffeine (in moderation only)

• Tetracycline, Sulfa, Afrin nasal spray, and Accutane

• Tranquilizers and sedatives

• Herbal/Natural Compounds (without your doctor’s permission)

• Pepto Bismol

Nausea and vomiting

This is very common and can occur any time day or night. Try eating some. Eat small meals and drink liquids such as Gatorade while nauseated. Avoid spicy and greasy foods with a lot of preservatives. Eat crackers/dry toast when you wake up and before you get out of bed. You can take a vitamin B6 supplement (over the counter) daily to help. Ginger, peppermints, lemon drops may help some people with nausea.

Remember that no medication will cure the nausea, but if extreme, Bonjesta or Phenergan can help.  Finally, nausea and vomiting usually improve around the third or fourth month of pregnancy. Call your doctor if vomiting is frequent (three or more times a day) and/or you are unable to keep solids or liquids down.

Abdominal pain

This is a common complaint around 16-20 weeks that is due to the rapid growth of your uterus. It is usually a sharp or grabbing pain on one side, in the lower abdomen, especially when coughing or sneezing. It may also be felt in your back and down your legs. This is called round ligament pain, and can usually be relieved by rest and Tylenol.

Swelling

This is normal during pregnancy, especially around the feet and ankles. Change positions often and elevate your feet if possible to relieve this. Some women also complain of hands and feet that are swollen that may have numbness or tingling, this is also normal. A large amount of swelling in the hands and feet should be reported to us.

Glucola Test

Is performed between 24 - 28 weeks to check for diabetes during pregnancy. Sometimes this test may be performed earlier in the pregnancy as well, based on risk factors. Please follow these instructions before coming into the office for this test:

Please DO NOT HAVE any of the following before your glucola test:

• Sugar

• Oatmeal

• Breakfast Bars

• Corn

• Grits

• Regular Soda Driks

• Jelly

• Candy or Gum

• Fruit juices of any kind

• Fruit (canned or raw)

• Milk of any kind

• Sweet tea

• Honey

• Sugared cereals

• Syrup

• Carrots

Suggested items YOU MAY HAVE:

• Sausage

• Ham

• Salads (chef, green)

• Tuna salad

• Water

• Eggs

• Sugarfree candy or gum

Please remember: high proteins and no carbs

When to expect an Ultrasound

Your initial ultrasound will be performed between 8 to 9 weeks gestation to confirm your pregnancy and to provide accurate size and dates. A second ultrasound is performed at 18 to 20 weeks to evaluate fetal anatomy, growth and placental location.

A full bladder is NOT needed for ultrasound evaluation.

3D/4D and Sneak Peek Ultrasounds

Experience the joy of seeing your baby before birth. WHAM offers the latest in 4 Dimensional Ultrasound. With this unique fetal imaging, you can watch your baby while it moves around.

We offer a 16 week sneak peek ultrasound for gender.

What is the difference between a 3D and 4D ultrasound?

A 3D ultrasound is still a 3-dimentional picture. The fourth dimension allows you to see your baby in live motion, 4D ultrasounds are sometimes referred to as a live 3D ultrasound.

Are 3D and 4D ultrasounds safe?

Yes. The ultrasound machine that we use is approved by the FDA for obstetrical ultrasound. Ultrasound has been used for more than 35 years to evaluate pregnancies, and no negative effects have been found on the baby.

When is a good time for a 3D/4D image?

3D/4D ultrasounds can be done at any time during pregnancy. We find that the optimal time period for a 3D/4D ultrasound is between 27 and 32 weeks, when the baby has more fat on its body but still has room to move around. After 32 weeks, the baby may be too large to capture a good picture.

What if my baby is not in the position to get a good picture?

The quality of the ultrasound image depends on the baby’s position and movement, as well as the mother’s size and weight. If the pictures are unsatisfactory, you will be offered a single return visit at no additional charge. However, this will be at the discretion of the ultrasound technician. If a good image is still not captured, you will receive a refund, less a $50 session fee.