Pregnancy

Dr. Crystal is an OB Hospitalist at El Camino Hospital covering emergencies for all patients in Labor and Delivery at either the Mountain View or Los Gatos hospital locations for any physician or midwife.  Because of this, Dr. Crystal has agreed not to see pregnant patients in the office after the first trimester because of a conflict of interest with her other hospital position.

Dr. Crystal will be happy to see you for your first OB visit at 8 weeks gestation and then you would follow up with our other physicians Dr. Teng and Dr. Azad for the rest of your pregnancy.

Am I in Labor? video: 

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Is this Medication safe in pregnancy?

Can I use this Hair Dye in pregnancy or while breastfeeding?

Is my acne cream ok?

For all questions regarding the safety of exposures during pregnancy please contact:

California Teratogen Hotline

(866) 626-6847

www.MotherToBabyCA.org

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Safe Medications in Pregnancy

Pain or Headaches:   Tylenol (Acetaminophen)

Cough:  Robitussin dm (Guaifenesin)

Nasal Congestion:   Afrin nasal spray (max 3 days), Steroid sprays (Nasonex, Flonase)

Constipation:   Metamucil, Fibercon, Miralax-  Also please see below at end of this page.

Sore throat:   Ricola cough drops, Halls drops, salt water gargles

Heartburn:   Tums,  Mylanta, Maalox, Zantac (Ranitidine) after 13 weeks, Pepcid (Famotidine) after 13 weeks

Yeast Infections:   Gyne-lotrimin, Monistat

Seasonal Allergies:  Chlor-Trimeton (Chlorpheniramine), Claritin, Zyrtec, Benadryl, nasal steroids

Insomnia:   Benadryl, Tylenol PM, Ambien

Nausea:   25 mg Vitamin B6 plus ½ of a Unisom tablet,  seabands, ginger, Diclegis

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Pregnancy Precautions:

  • Take your prenatal vitamins with at least 400 micrograms of folic acid (folate) per day.
  • Do not smoke.
  • Do not use alcohol or recreational drugs.
  • Avoid high temperatures (no hot tubs or Jacuzzis).
  • Drink plenty of water when exercising.  Keep your heart rate about 140 or less. Do not do sports where you could fall (no horseback riding, skiing, skating, etc.)
  • Do not eat raw meat or sushi.
  • Avoid soft non-pasteurized cheeses (unless they are heated through on a pizza, etc).  Heat up deli meats before eating.
  • If you have a cat, do not change the kitty litter (risk for toxoplasmosis).  Use gloves when gardening.
  • Do not eat high mercury containing fish: Shark, Swordfish, King mackerel, and Tile fish.  (Tuna depends on where it is caught)
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Pregnancy Time line:             

(Note: CVS and Amniocentesis can be done for women over age 35)

  •  6-8 wks      In office ultrasound.  Schedule NT ultrasound (or CVS).
  • 10 wks        Blood tests: Prenatal labs, 1st trimester screen blood test, Harmony Prenatal test (NIPT)
  • 12-13 wks   NT ultrasound (or CVS) performed.   Schedule Level II ultrasound for 18-20 wks.
  • 15-19 wks   2nd trimester NT blood test. (Amnio)
  • 18-20 wks   Level II ultrasound
  • 20-22 wks   Sign up for Prenatal Classes for 32 wks. (Fetal echocardiograms in certain cases)
  • 26-28 wks   Glucose Tolerance blood test (Diabetes screen)
  • 28-32 wks   Rhogham for Rh negative patients. Take Prenatal Classes. Pre-register at the hospital. TDaP vaccine.
  • 35-36 wks   GBS screen (vaginal swab done in the office).
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Prenatal Testing Centers

(Genetic Counseling, NT, CVS, Amnio, Level II ultrasound, Fetal Echo, NST)

Stanford Genetics Counseling  (NT, CVS, Amniocentesis)   (650) 723-5198

Stanford Perinatal Diagnostic Center  (Level II ultrasound)   (650) 725-7030

Drs McCallum and Liner  (NT, Amniocentesis, Level II ultrasound)   (650) 964-1505

UCSF Perinatal Unit  (NT, CVS, Amniocentesis, Level II ultrasound)   (415) 476-4080

Perinatal Associates SF (NT, CVS, Amniocentesis, Level II ultrasound)  (415) 202-1200

Obstetrix (Campbell)  (NT, CVS, Amniocentesis, Level II ultrasound)   (408) 371-7111 

Stanford Pediatric Cardiology  (fetal echocardiograms)    (650) 721-2121

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Childbirth classes

El Camino Hospital  www.elcaminohospital.org   (650) 940-7302

Lucile Packard Children’s Hospital (Stanford)   www.lpch.org    (650) 723-4600

Birth University  (S.F.)   www.mcmoylermethod.com   (415) 289-0746

SequoiaHospital   www.sequoiahospital.org  (650) 367-5998

MillsPeninsulaHospital   www.mills-peninsula.org   (650) 696-5400

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Constipation in Pregnancy

Constipation is very common in pregnancy because the hormone progesterone tends to slow down bowel function.  Constipation and straining with bowel movements increases the risk of hemorrhoids.

First Line Therapy:

  1. Increase water intake
  2. Increase foods with fiber and try prunes if you are not diabetic
  3. Exercise such as walking can help the bowels to move regularly
  4. Metamucil in a big glass of water 1-3x/day
  5. Miralax

Second Line Therapy:

  1. Colace (DSS or Docusate Sodium)- 100mg-250mg 1-2x/daily.  (There has been a report of a baby with low Magnesium levels in a mother who took more than the recommended dose.)
  2. Lactulose- by prescription
  1. Glycerine rectal suppository- No human studies, but per CTIS there are no reports of problems either.  Very high i.v. doses caused fetal problems in rabbits.
  2. Senna laxatives (Ex-Lax)- probably ok but theoretical risk of uterine contractions so only use if you ask your doctor.

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