cypress women’s center · constipation: metamucil, surfak, colace, milk of magnesia, benefiber,...

CYPRESS WOMEN’S CENTER

Obstetrics & Gynecology

Office: (281)955-7900 Fax: (281)955-0700

CypressWomensCenter.com

Congratulations!

We would like to welcome you to Cypress Women’s Center. This is a very exciting time in your life!

Our staff is committed to providing the highest quality medical care in a warm and safe

environment.

Our physicians deliver at Memorial Hermann Cypress and they have a philosophy of providing

high quality health care to all of her obstetrical patients.

If you have an urgent pregnancy medical concern such as: bleeding during pregnancy, severe

abdominal pain, premature labor contractions, premature leakage of amniotic fluid, decreased fetal

movement, or severe headaches, please proceed to the Memorial Hermann Cypress Emergency

room and they will contact one of our physicians.

Again, we would like to wish you and your family a sincere congratulation on your new future

arrival!



Office: (281)955-7900 Fax: (281)955-0700


SAFE MEDICATION USE DURING PREGNANCY

Below is a current list of FDA approved medications that are commonly used during pregnancy for various conditions.

There are NO medications that can be considered 100% safe for long term use in pregnancy. Therefore, it is

recommended that you minimize the number of days of use and limit use of all medications.

DO NOT TAKE IBUPROFEN (ADVIL), ASPIRIN, ALEVE, OR EXCEDRIN UNLESS DIRECTED TO DO SO BY DR KIRKMAN.

These over-the-counter medications are most commonly used for the following discomforts and are safe during pregnancy:

Allergies: Actifed, Benadryl, Sudafed, Tylenol Cold & Sinus, Claritin, Tavist, Afrin Saline Nasal Spray, Zyrtec.

Cold/Fever: Tylenol Cold and Sinus (If you have a fever > 100.4° F, please call the office).

Congestion: Actifed, Benadryl, Sudafed, Tavist, Robitussin Expectorant, Tylenol Cold and Sinus, Mucinex.

Cough: Robitussin DM, Triaminic Cold and Allergy

Constipation: Metamucil, Surfak, Colace, Milk of Magnesia, Benefiber, Fibersure, Miralax.

Diarrhea: Imodium, Lomotil, Kaopectate (If you have diarrhea longer than 24 hrs, please call the office).

Headache: Tylenol or Tylenol Extra Strength along with caffeine.

Heartburn: Mylanta, Maalox, Tums, Zantac, Pepcid AC, Axid, Riopan

Hemorrhoids: Anusol Cream, Tucks Pads, Preparation H suppositories

Gas: Mylanta, Lactaid

Nausea: Vitamin B6, Kytril, Emetrol, Seaban (If you are vomiting, even fluids for >24 hrs, call the office).

Sore Throat: Cepacol Lozenges, Chloraseptic Throat Spray, or gargle with Salt Water

IF YOU ARE CURRENTLY TAKING ANY MEDICATIONS NOT LISTED ABOVE, PLEASE VERIFY THEIR SAFETY WITH US.



Office: (281)955-7900 Fax: (281)955-0700


DISCOMFORTS OF PREGNANCY

IF YOU FEEL YOUR CONCERN IS AN EMERGENCY, PLEASE PROCEED TO CYPRESS FAIRBANKS MEDICAL CENTER ER.

BACKACHE: Rest and warm (not hot) baths. Use correct posture and try to avoid heavy lifting. Sleep on a firm bed. Wear low-

heeled shoes. Wear a maternity belt for support during the day. You may also get a perinatal massage at some spas. Hot tubs

are not recommended in pregnancy.

COLD & FLU: Tylenol Cold and Sinus medication & humidifier. You can get the flu shot if you are more than 12 weeks pregnant. If

you have flu like symptoms, we recommend that you follow up with your Primary Care Physician to be evaluated. We do not

recommend that you come to our clinic due to the safety of our other pregnant patients. Please contact the office with

a fever over 101 degrees Fahrenheit.

CONSTIPATION: Increase intake of fruits, juices, bran, and water. Increase your activity such as walking 30-60 minutes per

day. You may add Colace Stool Softener (over the counter) two times per day.

COUGH: Increase your fluid intake. We recommend that you try over-the-counter medications listed on page 2. If you have no

relief after a few days or it has gotten worse, please contact our nurse. Robitussin is safe while pregnant as well as any over

the counter thought lozenge.



Office: (281)955-7900 Fax: (281)955-0700


DECREASED FETAL MOVEMENT: Make sure you eat and drink something cold. Lie on your left side and count fetal movement.

You should feel at least 10 movements in a 2 hour time period. The baby has sleep and awake cycles: Ask yourself: Is the baby

always quiet at this time of day? If there is no movement including hiccups in 2 hours please proceed to Labor & Delivery.

DIARRHEA: Stick to a clear liquid diet: broth, Jello, 7-Up, Gatorade, etc. for the next 48 hours. You may take Lomotil as directed.

If diarrhea continues after 24 hours please contact our office nurse.

DIZZINESS/FAINTING/LIGHT HEADEDNESS: Avoid sudden position changes. After lying down, get up slowly, rolling to the side,

and then push to a sitting position. Sit for a few minutes before standing and then stand a few minutes before walking. Make

sure you are eating small meals every 3 hours to avoid low blood sugar. If you have been experiencing excessive diarrhea

or vomiting please come into the Emergency Room for hydration.

FEVER: Drink plenty of fluids. Call the office if your temperature is > 101° F. You may take Tylenol for fever in pregnancy.

GROIN PAIN: Round ligament pain is usually felt during the 2nd and 3rd trimesters as the uterus sustains a large amount of

growth. The pain is usually sharp, sudden pain in the groin or on the sides of your waist. Move carefully and avoid sudden

position changes, especially twisting movements. Turn over carefully when you are in bed or getting up. You may also use

maternity support belts to help relieve or prevent this type of pain. You can use a low setting on a heating pad and take Tylenol

for pain.



Office: (281)955-7900 Fax: (281)955-0700


HEADACHE: Tylenol or Tylenol ES. If this does not relieve your pain or you have visual disturbances, call the office.

HEMORRHOIDS: Avoid constipation by drinking 64 oz. or more of water each day. Daily exercises such as walking will help to facilitate

regularity. Sitting in a warm bath (not hot) is soothing. You may also use Tucks pads, Preparation H, or hemorrhoid suppositories if

necessary.

INDIGESTION/HEARTBURN: Avoid spicy foods. Drink your fluids between meals instead of with your meals. Take Tums, Maalox, or Pepcid.

Avoid lying down for 30 minutes after meals.

LEG CRAMPS: Wear support hose and low heeled shoes. Increase calcium intake. You should be getting at least 1200-1600 mg of calcium

every day. You can take Citracal (over the counter) .

MINOR ACHES/PAINS: Tylenol or Tylenol ES. DO NOT TAKE IBUPROFEN SUCH AS ADVIL OR ALEVE.

NAUSEA: Try eating something dry upon awakening in the morning such as toast or crackers. It helps to eat something before getting into

the shower. If your prenatal vitamin is making you nauseated, try taking it at night or just take 2 children’s chewable vitamins each day until

you can tolerate the prenatal vitamin. Instead of eating three meals a day, try eating six small meals throughout the day. Make sure you

are eating protein at each meal to help stabilize your blood sugar. If you feel that you are unable to function, there are prescription

medications that can help.



Office: (281)955-7900 Fax: (281)955-0700


DISCOMFORTS OF PREGNANCY

SEXUAL INTERCOURSE: Sexual intercourse during pregnancy is completely normal and healthy as long as you are having a

normal low risk pregnancy. If it is not safe to have intercourse, your practitioner will advise you to abstain. Light pink spotting

24-72 hours and cramping after intercourse is common. If you begin bleeding like a menstrual flow, please call the office.

SINUS DRAINAGE: Humidify your home or bedroom, increase your fluid intake. You may also take Tylenol Cold and Sinus. Afrin

nasal spray may help.

SORE THROAT: Increase fluids. Gargle with salt water, Use Cepacol throat lozenges or Chloraseptic spray.

SPOTTING: Go to bed and rest if possible. Avoid intercourse, tampons, or douching. Nothing should be inserted into the vagina

(birth canal). If cramping or having heavy bleeding like a period, call the office and ask to speak to the nurse.

SWELLING (EDEMA): Swelling is one of the most common problems encountered by pregnant women. You should wear a

support hose especially if you are on your feet all day. Elevate your feet whenever you can. Sit and lie down whenever it is

possible. Lying on your left side allows for optimal blood flow to all your extremities. Avoid high sodium foods and drink plenty

of water.

VAGINAL DISCHARGE: You will have an increase in discharge throughout pregnancy which is normal due to hormonal changes.

If you have discharge that is foul smelling, different in color, or is causing itching or burning, please notify your practitioner.

DO NOT DOUCHE.

VARICOSE VEINS/SPIDER VEINS: Elevate your feet whenever possible and wear support hose. These may go away or shrink

after pregnancy. You can get varicose veins in the vaginal/vulvar area, which is common. You can use warm soaks or ice

packs for comfort. Avoid prolonged standing.



Office: (281)955-7900 Fax: (281)955-0700


IT IS TIME TO GO TO THE HOSPITAL WHEN:

o You suspect that you are leaking amniotic fluid (bag of water).

o Persistent or heavy bleeding like a menstrual flow (spotting after intercourse is common).

o You are having contractions (tightening of the abdomen, baby is balling up) every 5 minutes if you are 35 weeks or if

you are having more than 4-6 contractions per hour and are less than 35 weeks pregnant.

o Severe or sudden abdominal pain or severe headache or vision changes.

o Decreased fetal movement if you are > 24 wks pregnant. ( < 10 movements in a 2 hr period.)



Office: (281)955-7900 Fax: (281)955-0700


WHAT TO EXPECT AT EACH DOCTOR’S VISIT

*Your blood pressure, weight, baby’s heartbeat and urine sample will be done at every prenatal visit.

FIRST TRIMESTER (WKS 6-8)

FIRST VISIT (6-8 WKS): This initial visit is primarily to get to know your health care provider and what to expect throughout each

trimester. You will be asked to urinate in a sterile cup to check for signs of a urinary tract infection (UTI) which is very common

during pregnancy. Once you are in the exam room, you will be seen by one of our health care providers and given this welcome

packet. Dr. Kirkman currently has a physician assistant who will possibly see you for your first OB visit and then alternating visits

throughout your pregnancy. You will be asked about your current complaints, problems, or concerns with the pregnancy and then

you will be asked to provide your health history and the father of the baby’s health history. You will be given a brief physical to

determine any current medical concerns that may affect your pregnancy.

2ND OB VISIT (9-12 WKS): At the time of your second office visit you should have already had a dating ultrasound to give you the

most accurate due date. You will also need to undress from the waist down so that a gonorrhea and Chlamydia culture can be done.

You will also have a pap smear done if it has been greater than a year since your last pap smear. You will be contacted if any of

these results are abnormal, so please refrain from calling the office for your results.

If you are greater than 10 wks at your 2nd visit, we can try to listen for the fetal heartbeat using a device called a Doppler.

The baby is still very small (only about 4 inches) so it can be extremely difficult to trace the heartbeat. You will definitely get to

experience it at your 3rd visit.

You will be given a pamphlet informing you of genetic screening options offered between 15-19 weeks of pregnancy to check

for possible problems such as Spina Bifida and Down’s Syndrome. One test is now known as the Penta Screen. The test is a simple

blood draw that is done by our on-site phlebotomist. It is a screening tool and not a diagnostic tool. Therefore, if your test comes

back positive it does not mean that your baby has the disorder. If your test is positive, the next recommendation would be to



Office: (281)955-7900 Fax: (281)955-0700


preform future genetic studies and counseling. If declining the Penta Screen, we will ask for you to initial your records stating that

the test was offered to you.

Once your exam is completed a lab technician will draw your blood for a panel of lab test. The labs that will be drawn are:

complete infection; hemoglobin and hematocrit to check for anemia; blood type and Rh factor, rubella immunity status to make sure

your vaccination is up to date; hepatitis B, syphilis, HIV, and cystic fibrosis screening test to make sure that you are not a carrier of

the disease. If there is a problem, you will be called and notified of the results. If everything is normal, you will be given the results

at your next scheduled visit. Please do not call the office for these results, since it is highly unlikely that any values are found to be

critical to the pregnancy.

Congratulations, you have made it through the first trimester! Most people feel great during the second trimester and

really get to enjoy being pregnant.

SECOND TRIMESTER (WKS 13-28)

3RD OB VISIT: (13-16 WKS): At this visit, we will listen to your baby’s heartbeat. If you have decided to do the Penta Screen, you will

then have your blood drawn before you leave the office. You will be notified as soon as we have the results if there is a positive

screen. Please refrain from calling the office for results. When you check out you will be scheduling your Anatomy Scan (ultrasound

to check for any physical abnormalities and determine the sex of your baby if you want to know). This ultrasound is done between 18-

20 wks of your pregnancy.

4th OB VISIT (17-20 WKS): Congratulations, you are half way there! You probably know the sex of your baby and have begun to bond

more with your unborn child. After we listen to your baby’s heartbeat, the practitioner will begin measuring your growing belly. The

uterus is typically felt right at your belly button at this time and continues to grow about one centimeter per week. This

measurement usually coincides with the number of weeks you are in pregnancy. If you are 24 wks pregnant than the measurement

is usually 24 cm (+ or – one to two weeks). Your practitioner will tell you if your measurements are falling below or above the

expected measurement. Your next visit will be in 4 weeks.

5th OB VISIT (21-25 WKS): This will be a routine monthly visit. We will ask you if you are having any concerns with the pregnancy.

Your next visit will be in 4 weeks and it will consist of doing your one hour glucose tolerance test to screen for gestational diabetes.



Office: (281)955-7900 Fax: (281)955-0700


6th OB VISIT (24-28 WKS): This visit is for the one hour glucose tolerance test and a routine prenatal visit. You should be feeling

the baby move at this point in your pregnancy. If your blood type is Rh negative, then you will be given orders to go to the hospital for

a Rhogam injection. This injection will be repeated after delivery if your baby’s blood type turns out to be different then mom’s blood

type.

Upon arrival to the office you will be given a 50g bottle of glucose to drink. Your blood will be drawn exactly one hour after

consuming the drink. This is a screening test therefore you do NOT need to fast. If your result comes back greater than 130 mg/dL,

you will be called to schedule a three hour glucose test in which you will be asked to fast the night before. Then you will have your

blood drawn before you drink the 100 gm glucose drink and then every hour after completing the drink for the next three hours. If

two of these four values come back elevated, you will be notified and classified as a gestational diabetic.

This is the last of your monthly visits; you will now be seen every 2 weeks until you are 36 weeks pregnant. When you check

out, please schedule a growth ultrasound for 4 wks. A growth ultrasound is typically done between 30-32 wks of pregnancy to make

sure that the placenta is functioning well and the baby is growing on track.

THIRD TRIMESTER (WKS 29-40+):

7TH OB VISIT (29-30 WKS): This is a routine visit. Please inform us for any concerns such as: frequent tightening of the abdomen

(feel like baby is “balling up”); vaginal bleeding, pain with urination; leakage of fluid, severe headaches, or decreased fetal movement.

Your next scheduled visit will be in two weeks.

8th OB VISIT (31-32 WKS): This is another routine visit Please inform your health care provider for any concerns such as: frequent

tightening of the abdomen (feel like baby is “balling up”); vaginal bleeding, pain with urination; leakage of fluid, severe headaches, or

decreased fetal movement. The health care provider will discuss any concerns regarding your baby’s growth at this time. Your next

scheduled visit will be in two weeks.

9th OB VISIT (33-34 WKS): This is another routine visit. Please inform your health care provider for any concerns. The next

scheduled visit will be in two weeks and we will begin checking your cervix for any dilation or effacement. Dilation is the opening of



Office: (281)955-7900 Fax: (281)955-0700


the cervix into the birth canal. Your cervix must dilate to 10 cm in order to deliver a baby vaginally. Effacement is the thinning of the

cervix. When your cervix is completely effaced we say you are 100% effaced.

10th OB VISIT (35-36 WKS): This visit will be the usual routine. You will also be asked to undress from the waist down so that we

can check your cervix for any changes and we will do the Group B strep culture. This is a bacterium that about 40% of women have

naturally in the birth canal. This does not harm mom, but it can make newborns ill and therefore we screen all pregnant women for

the bacteria. You will be given your culture results at your next visit. If your result is positive, you will be treated with intravenous

(IV) antibiotics when you go into labor. There is no need to be concerned if you are positive, it is rare that term babies become ill if

exposed to the bacteria. Your baby will be closely observed after delivery for signs and symptoms of infection. You will now begin

weekly visits until you deliver.

11th OB VISIT (37 WKS): Routine visit: urine sample, blood pressure, weight, fundal height, cervical exam, and fetal heartbeat. Please

report any concerns such as: leakage of amniotic fluid, vaginal bleeding, frequent contractions, severe headaches, or decreased fetal

movements.

12th OB VISIT (38 WKS): Hang in there, nobody is pregnant forever! This is another routine visit. Please report any concerns you

may have at this time. We will probably schedule you for an induction in 1-2 wks if you do not go into labor on your own. If you are

having a scheduled C-Section this will be scheduled for 39 wks of pregnancy.

13th OB VISIT (39 WKS): You know the routine: Leave us your urine, step on the scale, give us your arm for a blood pressure, lift

your shirt for your fundal height, and we will listen to your baby’s heartbeat. We will also check to see if your cervix has changed.

14th OB VISIT (40 WKS): Let’s convince your little one that it is safe to come on out!!!



Office: (281)955-7900 Fax: (281)955-0700


Pediatric List

Ramsey, Karla, M.D.

21216 N W Freeway, Suite 570

Cypress, TX 77429

Office Phone: 281-469-4377

Texas Children Pediatric Associates

9925 Barker Cypress Rd #200,

Cypress, TX 77433


Pediatric Healthcare of Northwest Houston P.A.

11840 FM 1960 Road West

Houston, Tx 77065




Office: (281)955-7900 Fax: (281)955-0700


Pediatric and Adolescent Center of Northwest Houston P.A.

12015 Louette, Suite 100

Houston, Tx 77070


Shobhana Kamdar M.D.

11307 FM 1960 W., #130

Houston, Tx 77065


Steeplechase Pediatric Center

13611 Skinner Rd., Suite 145

Cypress, TX 77429


21216 Northwest Freeway, Suite 470

Cypress, TX 77429


Blue Fish Pediatrics

915 Gessner Rd. #760

Houston, Tx 77024


cypress women’s center · constipation: metamucil, surfak, colace, milk of magnesia, benefiber,...

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