Patient Resources

About Your Visit

Lexington OB-Gyn Associates strive to keep our patients’ appointments on schedule. Please arrive 15 minutes prior to your scheduled appointment to allow adequate time for you to complete any required forms. You will need to bring your insurance card and a picture identification card. If you are more than 30 minutes late for your appointment, you may be asked to reschedule. Patients who routinely miss appointments may be discharged from the practice.

Initial Prenatal Visit:

Brochure for Prenatal Visit

This first visit will take 90 minutes. You will meet with a registered nurse that will review your past history and provide comprehensive educational counseling. The physician will review this information, perform a physical exam and answer any questions you may have regarding your pregnancy.

  • 8-31 weeks = monthly visits
  • 32 to 36 weeks = every two week visits
  • 37 weeks to delivery = weekly visits
  • This may vary depending on the health needs of each individual.
  • Cervical checks will be done toward the very end of pregnancy, (38 or 39 weeks) unless you may be having a potential problem (i.e. premature onset of labor or amniotic fluid leak).

8 weeks:

Cystic Fibrosis screening - Cystic Fibrosis (CF) is one of many recessive disorders that can be screened for either prior to pregnancy or in early pregnancy. Cystic Fibrosis is a genetic life long illness causing problems with digestion and breathing. It is usually diagnosed in the first few months of life. Cystic Fibrosis carrier testing is to see if a couple is at increased risk for having a child with Cystic Fibrosis. The test is done on a sample of blood or saliva. It does not detect all CF carriers. If the test is positive on the mother, additional testing is done on the father to determine if the child will be at risk for having Cystic Fibrosis. If one parent is a carrier and the other parent is not a carrier there is still a small chance the child could have Cystic Fibrosis.

9 weeks:

Chorionic Villus Sampling (CVS) is offered at 9 weeks. Women that are at an increased risk for chromosomal abnormalities may consider this test. You will be given an appointment with a perinatalogist (high risk obstetrician), for this procedure. CVS is performed by inserting a small catheter or tube with the guidance of an ultrasound into the uterus to retrieve a sample of the placenta. There is a risk of miscarriage following CVS.

10 - 13 weeks:

Nucal translucency is a test done by ultrasound at 10-13 weeks. It is a measurement of the space behind the fetal neck. Fetuses with a thickened nucal translucency may be at risk for chromosomal abnormalities such as Down syndrome (trisomy 21). Blood testing can be done in conjunction with the nucal translucency to increase the accuracy in detecting chromosomal abnormalities. This blood test does not screen for neural tube defects, so an AFP can be considered at 16-18 weeks of pregnancy. Women that are at an increased risk for chromosomal abnormalities may consider this test. This test is optional and you will be given an appointment with a perinatalogist for this testing.

Cell – Free Fetal DNA screening – These are non-invasive blood tests which quanitify the fragments of fetal DNA floating in the mother’s blood to more accurately determine the fetal risk of chromosomal disorders such as Down syndrome (trisomy 21), Edward syndrome (trisomy18), or Patau syndrome (trisomy 13) from as early as 10 weeks. It may be used to identify other rare conditions resulting from an extra chromosome or missing piece of chromosome (microdeletion). Some insurance companies may not cover the cost of this test, so all patients should check with their own insurance carrier. Counsyl, Harmony, InformaSeq, and Panorama are examples of these tests.

16 to 19 weeks:

Alpha-Fetoprotein Screening is offered between 16 and 19 weeks of pregnancy. A sample of blood is taken from the mother’s arm so no harm can be done to the fetus with this type of test. This test detects 95% risk for neural tube defects, such as spina bifida or anencephaly (absence of skull). There is a possibility that this test will give a false positive result. If your result comes back as a false positive, we will schedule an appointment for you with a perinatalogist for further work up. The Alpha Fetoprotein Test is strictly optional and you and your family should make this decision.

Alpha-Fetoprotein Tetra Screening test combines alpha- fetoprotein (AFP) that is naturally produced by the fetus with three other hormone tests. Abnormal levels may indicate a problem with the fetus. High levels of AFP may indicate that the fetus has a neural tube defect (i.e. anencephaly or spina bifida). Low levels of AFP may indicate Down syndrome or other chromosomal abnormality. The Tetra screen combines the Maternal serum alpha-fetoprotein (MSAFP) with three substances.

  • Human chorionic gonadotropin (HCG), a hormone produced in the placenta
  • Unconjugated Estriol (uE3)- an estrogen produced by both the fetus and placenta
  • Dimeric Inhibin A (DIA)

normally found in the bloodstream of pregnant women increases the sensitivity of Down syndrome detection to almost 80%. Factors that can cause a false positive result include miscalculation of fetal age or a twin pregnancy. A referral to the prenatologist is needed when the risk is estimated to be greater than 1 in 300.

15 to 19 weeks:

Amniocentesis is offered to women that are at higher risk for chromosomal anomalies. You will be referred to a perinatalogist for this test. This test is performed by inserting a needle through the abdomen and into the uterus to withdraw a sample of amniotic fluid, which can directly determine the fetal chromosome count. This is considered a diagnostic test for chromosomal anomalies such as Down syndrome and is almost 100% accurate; but carries a small risk to the pregnancy.

20 to 24 weeks:

Ultrasound is the use of sound waves to create a picture of the baby while still in the uterus. It evaluates the age of the fetus, size, rate of growth, position of fetus and placenta, fetal movements, heart rate, twins, and some birth defects. An ultrasound is usually done at the 20 or 24th week of pregnancy.

22 to 28 weeks:

Gestational Diabetes Screen - this is a blood test that is taken one hour after you finish a Glucola drink that is provided at the time you first arrive for your regular visit. It is recommended that you do not eat any concentrated sugars for eight hours before this test. This is not a fasting test. You may eat, just not anything with a lot of sugar in it.

28 to 42 weeks:

Non-Stress Test - this test is used to check the well being of the baby. This is not a routine test. It is done when there is a suspected fetal or maternal problem. For instance, a women complaining that she hasn’t felt her baby move enough, she develops gestational diabetes or high blood pressure during her pregnancy. At the 28th week visit the nurse will go over an information sheet that allows the mother to keep a record of how often her baby moves in a twenty-four hour period. If the mother detects that the baby is not moving adequately she should immediately notify the office, or if after office hours, the physician on call.

Office hours: 859 278-0396
After office hours: 859 276-2594

36 weeks:

Group B strep screening - this is a vaginal culture performed on the mother to detect if the mother has group B strep present. If group B strep is detected, the mother will be given IV antibiotics when she is in labor. These antibiotics are given to the mother to decrease the chance that the baby will develop a Group B infection. This treatment does not guarantee that the baby will not develop this infection. If your baby develops a fever during the first few weeks of life you must notify your pediatrician so they may culture your baby for group B strep.

Patient Forms

We have provided this section to better serve our patients. After you click on the Patient Portal button below, it will take you to our Patient Portal where you can download and print all of the patient forms. Our office staff will process your request as soon as possible. If this is an emergency please do not use this service.

Portal

Prescription Requests

The decision to approve online prescription refill requests is at your physician/nurse practitioner discretion. Please allow 48 hours for an online request to be completed. All information must be completed in order to process your request.

Insurance Information

Lexington OB-Gyn Associates currently participates with the following list of insurance providers. If you do not see your insurance provider listed, please contact our office to verify we accept your insurance. All insurance coverage is verified at the time of your visit. If your insurance is not active, you will be expected to pay for the service.

OB-Gyn of Lexington, KY Insurances

Insurance copays, coinsurance and deductibles are due at the time of service. Insurance claims are filed daily, except for services for global maternity benefits. Maternity care is filed after your delivery. Maternity patients are expected to pay copays, deductible and coinsurance prior to their 9th month of pregnancy.

Patients without insurance are asked to pay at the time of service Maternity care requires a $500.00 deposit and monthly payments during the pregnancy. The billing staff at Lexington OB-Gyn Associates will provide detailed information on a payment plan at the first visit.

Lexington OB-Gyn Associates accepts Visa, MasterCard, Discover, and debit cards. Any overpayments made by patients or insurance companies will be refunded promptly. Contact the billing department, at (859)278-0396, and ask for Kris Milburn regarding any questions.

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