High Risk Pregnancy Appointment Calendar · PDF fileHigh Risk Pregnancy Appointment Calendar...
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High Risk Pregnancy Appointment Calendar Due Date:____________________________ Primary Physician:____________________________ Appointments Date/Physician Week 7 o Blood work Date: _________________________________ Week 11-13 o 1 st Trimester Genetic Screening (ultrasound & bloodwork) *ultrasound @ suite 207__________________ o Be sure to drink 20 oz. of water 1 hr prior to ultrasound office visit: ____________________________ Week 16-17 office visit:_____________________________ o Visit with other MD o Other Genetic Screening or AFP o Early Diabetes Screening if required o If needed, schedule repeat C-Section with your MD o Week 20-21 o Anatomical survey Ultrasound *ultrasound @ suite 207_________________ o Be sure to drink 24 oz. of water 1 hr prior to ultrasound office visit: ___________________________ Week 25-26 (1 hour visit) o Diabetes Test Test: __________________________________ Week 30 o Ultrasound *ultrasound @ suite 207_________________ o Visit with other MD ; Rhogam & tdap (if needed) office visit: ___________________________ o Start kick counts, pediatric information provided Week 32 NST two times weekly 1 st NST____________2 nd NST_______________ Week 33 o Growth ultrasound **if diabetic or hypertensive *ultrasound @ suite 207__________________ o Visit with other physician office visit:_____________________________ o NST two times weekly 1 st NST____________2 nd NST_______________ Week 34 o NST two times weekly 1 st NST:___________2 nd NST_______________ o Office Visit office visit:_____________________________ Week 35 o NST two times weekly 1 st NST ____________2 nd NST _____________ o Office Visit Office visit: ___________________________ Week 36 o Group B Strep test Test: _________________________________ o NST two times weekly 1 st NST:______________2 nd NST___________ o office visit office visit :___________________________ Week 37 o Ultrasound *Ultra Sound @ suite 207 ________________ o NST two times weekly 1 st NST _________________2 nd ____________ o Office Visit Office Visit: ___________________________ Week 38 o NST NST: _____________________________________ o Visit with other physician Office Visit _______________________________ o C section or Induction Date Date:____________________________________ Schedule up to 26 Weeks at your first OB Visit. Schedule remaining OB visits at your 26-week appointment.
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Transcript of High Risk Pregnancy Appointment Calendar · PDF fileHigh Risk Pregnancy Appointment Calendar...
High Risk Pregnancy Appointment Calendar
Due Date:____________________________ Primary Physician:____________________________
Appointments Date/Physician
Week 7
o Blood work Date: _________________________________
Week 11-13
o 1st Trimester Genetic Screening (ultrasound & bloodwork) *ultrasound @ suite 207__________________
o Be sure to drink 20 oz. of water 1 hr prior to ultrasound office visit: ____________________________
Week 16-17 office visit:_____________________________
o Visit with other MD
o Other Genetic Screening or AFP
o Early Diabetes Screening if required
o If needed, schedule repeat C-Section with your MD
o
Week 20-21
o Anatomical survey Ultrasound *ultrasound @ suite 207_________________
o Be sure to drink 24 oz. of water 1 hr prior to ultrasound office visit: ___________________________
Week 25-26 (1 hour visit)
o Diabetes Test Test: __________________________________
Week 30
o Ultrasound *ultrasound @ suite 207_________________
o Visit with other MD ; Rhogam & tdap (if needed) office visit: ___________________________
o Start kick counts, pediatric information provided
Week 32
NST two times weekly 1st NST____________2ndNST_______________
Week 33
o Growth ultrasound **if diabetic or hypertensive *ultrasound @ suite 207__________________
o Visit with other physician office visit:_____________________________
o NST two times weekly 1st NST____________2ndNST_______________
Week 34
o NST two times weekly 1st NST:___________2nd NST_______________
o Office Visit office visit:_____________________________
Week 35
o NST two times weekly 1st NST ____________2nd NST _____________
o Office Visit Office visit: ___________________________
Week 36
o Group B Strep test Test: _________________________________
o NST two times weekly 1st NST:______________2nd NST___________
o office visit office visit :___________________________
Week 37
o Ultrasound *Ultra Sound @ suite 207 ________________
o NST two times weekly 1st NST _________________2nd ____________
o Office Visit Office Visit: ___________________________
Week 38
o NST NST: _____________________________________
o Visit with other physician Office Visit _______________________________
o C section or Induction Date Date:____________________________________
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Week 39
o NST NST:_____________________________________
o Office visit office visit :_______________________________
o C section or induction date Date: __________________________________
Delivery Date: Date: __________________________________
Postpartum Visit Date: ___________________________________
o 4 weeks after delivery for C-Section
o 6 weeks after delivery for vaginal delivery
Acceptable medications in pregnancy as well as other information may be obtained on our website:
www.rushcopley.com/whca
(630) 978-6886
