Blog - West Des Moines OBGYN

Oct
27
2020
How to Perform Your Breast Cancer Self-Exam

Mammograms are one of the best diagnostic tests for detecting breast cancer early, and your annual exam in your doctor’s office also includes a clinical breast exam. Another path to detecting breast abnormalities early is through breast self-exams. Our OBGYN staff believes it is always a good idea to be familiar with your body just in case you notice changes. That is why we recommend monthly breast self-exams. Through a regular familiarity with your breast tissue, you are more likely to detect a change in the way the breast tissue feels or looks.

You can do a breast self-exam at any time, but the most comfortable time is right after your period. At that time, there should be less tenderness than right before your period. Here are a few things to know about performing a breast self-exam.

Look for Visual Changes

First, stand in front of a mirror with your arms by your sides. Are your breasts smooth of lumps and dimples? Are your nipples inverted? Turn to each side to view your profile. Raise your arms and view your armpits, as well. Look for anything outside of your normal appearance. That could include areas of redness or discoloration, depressions or tightness in the skin, and other noticeable differences. Some kinds of cancer are more like spaghetti than lumps. This makes them difficult to detect, but if your breasts are not pointing the same direction, this may indicate a change that you can’t see under the skin. The more familiar you are with how your breasts look on a daily basis will help ensure that you know when to call your doctor about an abnormality.

Perform the Self Exam

You can perform a self-exam in the shower or lying down. As you begin the manual part of the self-exam, you will want to develop a pattern and method so you can more easily remember the feel and detect changes. Plan to use the pads of the middle fingers on your hand to feel the tissue with different levels of pressure. Follow a slow, methodical approach. Begin at the collarbone and move back and forth in sections down each breast. Go all the way to the underarm and rib cage area. Apply different levels of pressure in each area.

If a spot hurts or is numb or feels lumpy, make a note of where that is. Some people find it helpful to chart their breasts so they have a baseline for how their tissue feels. Again, performing this monthly provides the best way to monitor your breast health. If you have questions about how to perform your breast self-exams, please let us know.

Pay Attention to Physical Symptoms

Some symptoms tell us about possible infections or problems. If you have detected any discharge from the nipple, make note of the color, consistency, and any odor. These symptoms can indicate mastitis or other issues. Other physical symptoms include pain, although it can sometimes be difficult to detect the difference between a pulled or strained pectoral muscle and other types of breast pain. Pain isn’t normal, so if it persists, you should make an appointment for a clinical exam.

So, what are other indications that you should see your doctor? If you feel a hard lump anywhere on your breast or near your underarm, or feel changes like fullness or thicker tissue, you should make an appointment with your doctor. If you see bloody nipple discharge, unusual puckering or bulging or a recently inverted nipple, call your doctor. They can perform a clinical exam to determine the cause, and they may order a mammogram or other diagnostic tests. There is no reason to panic when you find these changes. Many changes in breast tissue are benign. Some changes occur due to aging or the stage of your menstrual cycle.

Keep Your Annual Exam Appointment

One of the best ways to control your health is through your annual exam. At this appointment, you will receive a clinical breast exam. Your OBGYN will perform the exam, following a similar procedure to the breast self-exam. You can share what you’ve observed about your breasts, ask questions, and get information about your risk factors. We recommend that women start annual mammograms at age 40. If you have a family history of breast cancer then you may qualify for genetic testing and annual breast MRIs. This can help ensure the early detection of breast cancer.

Mammograms have come a long way in recent years, with a 3D option available from some providers. Using the same machine setup as regular mammograms, the 3D mammogram is a high-resolution method that is especially good for women with dense breast tissue. Dense breast tissue, as opposed to fatty breast tissue, can be difficult for a radiologist to read on a regular mammogram. The breast self-exam will not help you detect the density of your breasts—density is only an issue for mammograms. Read more about dense breast tissue on the National Cancer Institute website.

We always encourage all of our patients to do everything in their power to take control of their health. One of the ways to do this is by performing monthly breast exams at home. It’s an easy way to know your body and potentially detect changes that can indicate minor or serious health issues. Please let your physician at West Des Moines OB/GYN Associates know if you have questions about breast self-exams, breast cancer risk factors, or mammograms.
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Categories:

Preventative Care
Oct
27
2020
Coping with a Miscarriage

Although most don’t speak of it, early pregnancy loss is relatively common. Early pregnancy loss or miscarriage is a term for any loss earlier than 20 weeks of pregnancy. The majority of loss occurs within the first trimester or prior to 13 weeks gestation. Studies have shown that the rate of miscarriage is as high as 15%-20% of all pregnancies.

If you or someone you know has experienced a miscarriage, you are probably aware of how emotionally difficult it can be. However, there are ways to cope with this loss so you can grieve and continue on with life and starting a family.

Call Your OBGYN

If you have bleeding or unexpected pain in pregnancy, call your OBGYN. It is crucially important to address it and determine the cause. Your doctor will likely recommend an initial ultrasound and blood work if you have not yet confirmed your pregnancy.

Know That You Are Not Alone.

Thousands of women experience miscarriage every year. Mainstream media has created an open forum for pregnancy loss and celebrities like Chrissy Teigen have been very open about their personal experience with loss.

While knowing you are one of many doesn’t make it easier, it may provide some comfort to you and your partner to realize others are grieving a similar loss. Keep in mind that your partner will grieve this loss, too. However, their experience may be different than yours. Go easy on yourself and each other. You have both lost something and must grieve it in your own ways.

Be Aware of Your Mental State.

The effects of grief following a loss can present as psychological and physical symptoms. Sadness, anger, and confusion can follow the loss, and it may come up at unexpected times. They say time heals all wounds, but grief does not follow a linear path. Do not ignore symptoms that affect your ability to function. For example, if you are too tired and depressed to do daily activities or take care of your basic needs for days at a time, contact your doctor. Consider seeking support through counseling or online support groups for pregnancy and infant loss.

Make Self Care a Priority.

Self-care is something many women put aside, but it’s incredibly important when you’re grieving a miscarriage. You’ve been through a lot. Give yourself the time you need to heal your body and emotions by taking time for yourself. That could include taking time off from work or spending time with a friend. Other self-care activities include getting a facial, writing in your journal, reading, and crafting. Take time to rest when you need it so you can return to your regular activities when you are ready.

Accept Support.

If your sister brings you dinner, accept it with gratitude. If you need company, call a friend who has reached out to you in the past. Reconnect with people at your own pace, but allow kindness to help you heal your heart.

Your doctor at West Des Moines OB-GYN can help guide you to organizations that help families through the difficulties of miscarriage and loss of a child. The March of Dimes organization has a long history of helping families have healthy babies. Their website also addresses the complications and loss of a pregnancy. Please reach out to your ob-gyn if you are having difficulty coping with a miscarriage.
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Categories:

Obstetrics
Sep
09
2020
What is Uterine Prolapse and How is it Treated?

Uterine Prolapse & Weakened Pelvic Muscles

Uterine prolapse can be a disturbing occurrence. A Uterine prolapse occurs when the uterus drops into the vaginal canal. In severe cases, the uterus can even protrude out of the vagina. While many think it occurs as part of aging, this issue can occur at any age, whether you are past menopause or not. Fortunately, most cases are mild, and there are some steps you can take to strengthen the pelvic floor muscles and ligaments. Receiving prompt treatment for uterine prolapse symptoms may help you avoid a more serious case.

Uterine Prolapse Symptoms

Uterine prolapse occurs when the muscles and ligaments in the pelvis weaken to the point that they no longer provide support for the uterus. It can occur in women of any age, but it is most likely to occur in women who have had multiple vaginal deliveries who are past menopause.

Symptoms to watch for include heaviness or pulling sensations in the pelvis, sexual health issues, and looseness in the vaginal tissue. Constipation, incontinence, urine retention, and recurring bladder infections may also be signs of weakening pelvic muscles. When uterine prolapse occurs, there may be vaginal bleeding or increased discharge as well as tissue protruding from your vagina. You may feel like you are sitting on a ball or something is falling out of your vagina. When the symptoms affect your normal life or cause discomfort, it is time to seek treatment.

Avoid Stress on the Pelvic Floor

Some of the causes of uterine prolapse include delivering a large baby, repeated heavy lifting, obesity, chronic coughing and constipation. These issues may result in stress to the pelvic floor muscles that support the vagina and urethra.

You may be able to protect your pelvic floor by avoiding added stress in that area. Losing weight is one way to reduce the pressure on the organs and pelvic floor muscles. Adding vegetables to your diet can help with weight loss while also avoiding the discomfort and strain associated with constipation. And if you have a chronic cough, be sure to treat it appropriately. Also, avoid stressors such as repeated heavy lifting.

Correct lifting is easier on your body, including your pelvic region. Remember to use your legs to lift. Try not to bear down at the trunk or use your waist or back to lift heavy items or weights.

Complications of Uterine Prolapse

If left untreated, uterine prolapse can become severe and other pelvic organs may begin to prolapse. The tissue around the bladder can weaken and cause the bladder to bulge into the vagina. This is called anterior prolapse or cystocele. A posterior vaginal prolapse is when the tissue around the rectum weakens, causing the rectum to bulge into the vagina.

Diagnosis & Treatment

If you think uterine or pelvic organ prolapse is causing you discomfort and interfering with your life, you’ll want to visit with your OBGYN. Let them know about the symptoms you’re experiencing and expect to receive a pelvic exam. In the pelvic exam, the physician will insert a speculum into the vagina so the vaginal canal and uterus can be examined. The doctor may ask you to bear down in order to evaluate the severity of the prolapse. Your exam may also involve a catheter to check or bladder function.

Mild cases of uterine prolapse may not require intervention, but some simple preventive treatments could help avoid a more serious issue. One thing you can do to strengthen the pelvic floor is to perform Kegel exercises. These simple exercises can be done when the bladder is empty by clenching and releasing the pelvic floor muscles for 10 seconds at a time. Ask your OBGYN for details about Kegel exercises so you do them properly. Pelvic floor physical therapy can also be helpful in reducing symptoms and strengthening the pelvic floor.

Other Treatments

Other treatments include Pessaries and surgery. Some cases of uterine prolapse can be treated by wearing a device called a pessary. The pessary is inserted into the vagina. It fits in the vagina and supports the prolapsing tissue whether it be the uterus, bladder, or rectum. Vaginal estrogen may also be prescribed in conjunction with a pessary to restore hormones needed for the muscles and tissues in the genital region to function well.

Surgery may be required to treat more serious cases of uterine prolapse. A hysterectomy removes the uterus so it can no longer prolapse. Many times a repair over the bladder and rectum are done simultaneously to correct anterior and posterior prolapse. Ligament suspensions are utilized in order to prevent further prolapse of the vaginal vault. A Sacrocolpopexy suspends the vaginal vault utilizing mesh.

How We Can Help

With proper treatment of symptoms, you may be able to avoid a more serious case of uterine prolapse. Contact your gynecologist at West Des Moines OBGYN Associates to learn more about the prevention and treatment of pelvic organ prolapse.
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Categories:

Gynecology
Aug
31
2020
Best Apps for Cycle Tracking

Understanding your time of the month will come in handy when you are trying to conceive, or not conceive. Trying to keep up with your flow in your mind may pose a challenge. That is where today’s technology steps in. Today, technology has made cycle tracking apps you can access right off your phone to keep track of your cycle and fertility days.

We have rounded up this year’s top five fertility apps based on content, reviews, and reliability.

Glow

Taking control of your reproductive health is easy with the Glow app! With Glow, you will be able to track your cycle with the ovulation calculator, while recording your symptoms, sexual activity, and day-to-day moods.

This app allows you to track ovulation ahead of time to help you optimize your fertility days to the fullest. If you are an Apple user, you can even connect the app to your health app. With Glow, you will be able to log your daily health to give you the most accurate cycle predictions to plan out the pregnancy possibility statistics.

Clue

You’ll need no clues with the Clue app. Clue is a period tracker app that uses science and research to learn about your biology. The ovulation calculator will help you plan your chances of getting pregnant by logging your basal body temperature for accurate information. Clue will be able to track your cravings, moods, and even energy levels. To top it off, Clue even keeps tabs on your cycle length.

Clue only gets better the more you use it. It will sync up with your phone health apps, customize what is tracked, and the predictions will get more and more accurate. Your period will no longer be a clue.

Flo

It’s easy to go with the flow with the Flo app. This simple app tracks your period and fertility at the same time. It offers reliable fertility and ovulation calendars to help you stay organized. Flo even notifies you about favorable days for conception.

Tend to forget when your period starts? No worries, Flo will set up reminders so you never miss it. WIth cycle tracking, period length, and PMS symptoms, this app takes all your information and puts it in a handy chart for you.

If all goes well, Flo will even track your pregnancy. This app will even help you keep up with your healthy lifestyle to keep you in shape. Keep things simple with Flo.

Eve

Need a place to log your moods, symptoms, and sexual activities throughout the month? Well, look no further than the Eve app! Eve is a cycling tracking app that includes an interactive interface. This app will break down your health data and create charts that you will be able to read and understand. Need help with ID trends and patterns? Eve has got you covered. Download the app, plug it into the Health app, and get tracking.

Life

Life just wants you to live simply, that’s why it does the period tracking work for you. This app is simple, yet useful. Life app will predict ovulation, schedule cycle reminders, track your symptoms, and even track your moods. What else could you ask for? This app gets straight to the point so you can live your life.

With a period tracking app, you will be able to monitor your period, cycle symptoms, and patterns all in one place. With the period, fertility, and PMS predictions these apps offer, you will always be prepared for whatever your period brings – cravings, mood swings, or cramps. Take back control of your cycle, and your life, with one of these cycle tracking apps.

Gynecology at West Des Moines OBGYN

Our women’s clinic provides a warm, welcoming, and results-oriented patient experience because that is what we, as women, seek for ourselves. Schedule your next appointment at one of our Des Moines metro area women’s clinics near you to experience the difference.
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Categories:

Gynecology
Jul
08
2020
Breastfeeding Tips for New Moms
At West Des Moines OBGYN we believe Fed is Best! We will support you in whatever way you choose to feed your baby. For some people, the benefits of breastfeeding make all the challenges worth it in the end. For example, your breast milk contains the perfect amount of healthy nutrients for your baby. Overall, breast milk is easier to digest compared to commercial formula. The antibodies found in breast milk also boost your baby’s immune system. These are just a few examples of how your baby will benefit if you choose to breastfeed.

However, breastfeeding is no walk in the park. If you decide to give breastfeeding a shot, a little bit of patience and some planning can help increase your chance of success. Here we have listed five proven tips to help you in those early breastfeeding days.

Don’t Be Scared To Ask For Help

Breastfeeding is tough, and it can be difficult to grasp onto, so don’t be afraid to ask for help. It’s okay to have questions and want to learn more techniques and ways to help feed you.

Following delivery, we highly suggest you meet with a lactation consultant while you remain in the hospital to go over any questions you may have. Your lactation consultant can also check the baby’s latch and make sure you are comfortable. They can help fit you with the properly sized flange for your pump. There are also breastfeeding support groups.

When it’s time to leave the hospital, we suggest setting up a specific area or room where you will breastfeed your baby. You will both need to be comfortable. So, having a nice chair, blanket and pillow will all come in handy. Breastfeeding can take a lot out of you physically. Therefore, we also recommend having snacks and water near you when you are nursing.

Let Your Baby Help Guide The Process

Your baby will give off cues when they are hungry. So, make sure you pay extra attention so they don’t become exceedingly hungry and upset. When it’s time to eat, let your baby set the pace. Newborns will more than likely need to be fed every two or three hours. Therefore, always be looking for signs of hunger. Hunger signs can include restlessness, lip pursing/twitching, and sucking motions.

After you feed with one breast, make sure you burp your baby before switching to the other one. Burping in between feedings will help get rid of gas and air. If your baby only wants to eat on one side during a feeding, be sure to pump the other side so it does not become engorged. You may also look into a Haaka pump to place on the opposite breast to catch letdown to store for later use.

Maintain A Healthy Lifestyle

Your personal health can affect your baby’s, so making sure you are healthy is highly important. When breastfeeding, especially, make sure you do the following things:
- Don’t Smoke
- Eat Well
- Stay Hydrated
- Get Plenty of Rest
If you are on any medications or supplements, make sure you let your doctor know. Some medications and supplements can harm your baby and/or your milk supply. Make sure you get everything checked by a health professional before continuing.

Avoid Nipple Confusion

Especially in the early weeks of breastfeeding, try to avoid pacifiers and bottles until breastfeeding is well established. When it comes to sucking on a bottle or pacifier, the motions are different compared to a nipple. Consequently, resulting in your baby getting confused. A pacifier also suppresses hunger cues and will take time away from the breast during a critical time. Avoiding pacifiers until your baby is comfortable breastfeeding is crucial.

Keep Comfortable

Sore Nipples Remedies: One of the first things you will notice from breastfeeding is sore nipples. This soreness is inevitable, but there are some great cream and ointments out there that help. You can also look into silver cups. These cups have been proven to help with nipple soreness with anti-fungal and anti-inflammatory properties.
- Breastfeeding Pillows: While breastfeeding, you will be sitting for a long time so making sure you and baby are comfortable is crucial. Breastfeeding pillows wrap around your whole body and help you stay comfortable while keeping your baby properly positioned.
- Tracking: Whether you decide to use an app or a pen and paper, tracking your feeding time will be very important during those first few weeks of nursing. Tracking feedings can help you and your baby form an eating schedule and keep you from getting engorged.
If you find breastfeeding a lot harder than you imagined, you are not alone so try not to get discouraged. Feeding a newborn baby every few hours can be tiring. However, try to stay positive and remember with time it will become routine. Once you start producing more milk, breastfeeding will begin to feel more natural. Take breastfeeding a week at a time and reevaluate as you go. Also, don’t be afraid to ask for help.

At West Des Moines OBGYN, our priority is you and your baby. We will always put your needs first and develop the appropriate care plan for you. Schedule an appointment today to speak with your OBGYN about questions or problems you are having with nursing.
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Categories:

Obstetrics
Jun
22
2020
IVF Treatment: Is It Right For Your Family?
In Vitro Fertilization, IVF, is a widely known type of assisted reproductive technology that is helping millions of couples conceive every year. Did you know that here in the United States, 1 in every 100 women use IVF treatment to help conceive a baby? IVF works by using a combination of medicines and procedures to help form an embryo and implant it into your uterus.

Why Use IVF?

There are numerous reasons as to why someone may use IVF treatment:
- Your fallopian tubes are blocked or damaged
- The male experiences decreased sperm count or sperm motility
- Experiencing ovulation disorders, premature ovarian failure or large uterine fibroids
- You have had your fallopian tubes removed
- If you have a genetic disorder
- Unexplained infertility
- Prior to egg retrieval in anticipation of attempting conception at a later age or egg retrieval prior to chemotherapy for use after treatment has completed
Am I A Good Candidate?

If you experience these medical conditions, then you should be evaluated by one of our physicians who will work up the possible causes for your infertility. A few reasons why we may recommend consultation with a consultation for IVF or other infertility treatments may be:
- Blocked or removed fallopian tubes
- Inability to ovulate even with medications prescribed by your OBGYN
- Inherited genetic disorders where a couple may wish to use a donor egg or sperm
- Very low/ absent sperm count or testicular disorder
- Prior chemotherapy
Since IVF bypasses the fallopian tubes altogether, many women with blocked or removed fallopian tubes can find success with IVF. For instance, many women wish to delay childbearing and have egg retrieval to increase the odds of conceiving later in life.

The Process

With the IVF egg retrieval and embryo transfer, there are a few steps to the process.

Step 1: Fertility Medication

When beginning the IVF process, you will be prescribed medication that will help stimulate viable egg production. During this process, you will be monitored by blood tests and ultrasounds to check in on hormone levels and egg production. Multiple eggs are desired since some eggs may not develop or fertilize after retrieval.

Step 2: Egg Retrieval

After egg production, your physician will remove the mature eggs in a minor surgical procedure. Firstly, you receive an ultrasound to get a visual, then a thin, hollow tube will be inserted into your ovary and egg follicles. Secondly, once the tube is in, it has a suction that will gently pull the eggs out of each follicle. In addition, medication will be provided during this step to relieve patient discomfort.

Step 3: Insemination

During insemination, your eggs mix with either your partner’s sperm or a donor’s sperm and then stored in a special container where the fertilization will occur. If the sperm has low motility, one sperm may be directly injected into the egg (ICSI- intracytoplasmic sperm injection). This process is carefully monitored by lab technicians as the cells become embryos.

Step 4: Embryo Transfer

About 3-5 days after the egg retrieval, the embryos are transferred to your uterus through the cervix by a thin tube. However, this step is typically not painful. But, prepare to spend the remainder of the day resting. After the transfer, you may have to take pills or shots of progesterone for 8-10 weeks. This helps promote the survival of embryos in your uterus. If the embryos attach to your uterine lining and implant, the pregnancy will be monitored by the infertility specialist until 8-10 weeks and then transferring back to your regular OBGYN for the remainder of your prenatal care

Side Effects

Therefore, you will need to take it easy and rest for the remainder of the day then resume normal activities the following day. As a result, some side effects you could potentially experience during this time include:
- Mild Cramping
- Mild Bloating
- Breast Tenderness
- Constipation
- Passing Fluid (clear or tinged with blood after the procedure)
Some more severe side effects are:
- Ovarian Hyperstimulation Syndrome (OHSS)
  
  OHSS can cause your ovaries to swell and become very painful. OHSS can even cause nausea, vomiting, shortness of breath, and/or severe stomach pain and bloating.
- Heavy Vaginal Bleeding
- Pelvic Pain
- Blood In The Urine
- A Fever Over 100°F
If you experience any of these severe side effects, make sure you contact your physician immediately.

There are many reasons someone may want to pursue infertility treatments including IVF. You may even choose to delay childbearing and freeze your eggs for the future. Talk to your obstetrician at West Des Moines OBGYN about egg retrieval, infertility treatments, and IVF treatment to see if you are a good candidate.
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Categories:

Obstetrics
May
28
2020
How Often Should You Visit Your OBGYN?

Are you feeling unsure as to when or how often you should visit your OBGYN? While sometimes visits to your obstetrician or gynecologist can feel daunting, they are essential to your health and your baby’s health, if you happen to be pregnant. Maintaining the frequency of these visits is important to maintaining your well being. In this blog, we’ll delve into how frequent your visits will be throughout various circumstances, such as pregnancy and changes in your menstrual cycle.

Visiting Your Obstetrician Throughout Your Pregnancy

During pregnancy, visits to your obstetrician’s office will become part of your regular routine and will become more frequent as you get closer to your due date. From weeks 8 to 28, your visits will be monthly. As you move to weeks 28 through 36, you’ll be seeing your obstetrician every other week. The last month of your pregnancy will have you visiting your OB on a weekly basis. The recommended number of visits can increase if you are experiencing a high-risk pregnancy or if other risk factors are present in your pregnancy. Some of the risk factors include having a pregnancy complicated by advanced maternal age (a woman is 35 or older), pre-existing health conditions, and issues that may develop during your pregnancy.

Prenatal care is of the utmost importance, and it is integral that you don’t miss these visits in order to ensure the healthiest pregnancy possible. Expectant mothers who maintain their prenatal obstetrician visits are less likely to give birth to a baby with low birth weight. At these visits, you can expect to get your weight and blood pressure take. You’ll have a urine sample taken, get checked for swelling, and hear your baby’s heartbeat. Typically, we’ll begin listening to your baby’s heartbeat around 10 weeks. As the second-trimester approaches, you’ll begin getting your stomach measured to follow the baby’s size. Between 26-28 weeks you will have a glucose test for gestational diabetes. You will also be screened for anemia and offered the Tdap vaccine. At 36 weeks gestation, we typically perform a group B strep culture and begin checking for cervical change.

Visiting Your Obstetrician With Complicated Pregnancy

If risk factors are present, you may need to undergo increased monitoring. This expanded testing and monitoring may include non-stress tests, ultrasounds, and blood work.

When preparing to visit your obgyn, we encourage you to come with all your questions and concerns. Your OB is there to answer those questions and give you the guidance you need. Also, keep track of any symptoms or bodily changes that you need to discuss with your doctor.

General Health and Well-Woman Visits

When it comes to well-woman and general health visits with their gynecologists, women should be receiving one pelvic exam a year. Typically, the yearly appointment includes a pelvic exam and a wellness check, in which a breast exam will be performed. Depending on your history you may require a Pap smear, blood work, or cultures.

Regardless of whether or not you are due for a well-woman or general health visit to your gynecologist, you should reach out to your physician if you experience symptoms that include, but are not limited to changes in menstruation, pelvic pain beyond menstrual cramping or unusual vaginal discharge. If you need birth control or permanent contraception you should also reach out to your gynecologist. If you have a concern regarding your health, it is always prudent to err on the side of caution.

At West Des Moines OB/GYN, we are committed to your care and are happy to walk you through all stages and concerns surrounding your pregnancy, reproductive health, and overall well being. Learn more about our services and how you can schedule an appointment with us today.
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Categories:

Gynecology

Obstetrics
Apr
10
2020
What to Expect When Having Twins + Types of Twins
If you are pregnant with twins and don’t know what to expect, you are not alone! Your pregnancy is as unique as you are, and at West Des Moines OBGYN Associates we individualize your care plan every step of the way. At West Des Moines OBGYN Associates we provide care for high-risk pregnancies including twin gestations.

Factors that Increase the Odds of Twins

Advancing maternal age. Women in their late 30s and 40s are at higher risk of a twin pregnancy.
Heredity. A woman that is a twin or with twins in her family is more likely to conceive twins.
Assisted Reproductive Techniques. Fertility treatments including Clomid, Femara, and IVF can increase the risk of twins and higher-order multiples.

What To Expect During Pregnancy

With a two fetus pregnancy, you can expect more frequent visits to the obstetrician. You will have more monitoring including ultrasounds during your pregnancy. You may also be referred to a maternal-fetal medicine specialist depending on the type of twins you are carrying.

Common Pregnancy Symptoms and Complications with Multiples:
- Morning Sickness. Morning sickness with two fetuses can be worse than in a woman who is expecting a singleton due to the higher levels of HCG hormones. You may even suffer from hyperemesis.
  
  Back Pain. Worsening back pain is common as the pregnancy progresses and you have more strain on the lumbar region as the fetuses grow larger.
  
  Preeclampsia and gestational hypertension. The risk of preeclampsia and gestational hypertension is higher with twin pregnancies. Preeclampsia is marked by high blood pressure and protein in the urine.
  
  Weight Gain. While weight gain during pregnancy is normal, you may notice you are gaining more weight when you are carrying twins because you are carrying two of everything; babies, placenta, amniotic fluid. You will also require more calories to help feed not only yourself but your two growing fetuses.
  
  Gestational Diabetes. Mothers of multiples have a higher risk of developing gestational diabetes.
  
  Preterm labor and delivery. It is not uncommon for women with a twin pregnancy to have preterm labor and even preterm delivery. On average women with twin pregnancies give birth at approximately 36 weeks. It is typically recommended that women with diamniotic/dichorionic twins deliver by 38-week gestation. Other higher-risk twin gestations are delivered even earlier than this.
What To Expect When Delivering

Mothers expecting multiples can typically expect to give birth several weeks earlier than mothers carrying only one fetus. The mode of delivery will be determined by the position of the fetuses and gestational age. Multiple births occur in the operating room to be prepared for any emergency requiring immediate cesarean delivery.

After your twins are born and you head home, try to get them on the same eating and sleeping schedules. This will also ensure you have time to rest when they are. It is important to also make sure you have set up help and support in advance. Having someone to help cook meals or sit with the babies while you rest is very important. Don’t be afraid to limit the number of visitors and if you feel visitors are causing more harm than help, it is okay to allow them to come sparingly.

What Are The Different Types of Twins?

The chorionicity or type of twin pregnancy is determined by early ultrasound findings. It is important to determine the type of twin as certain types have a higher complication rate. The majority of twins are dizygotic or monozygotic.
- Identical Twins (Monozygotic). Identical twins develop from a single fertilized egg and might even share the same placenta and amniotic sac (monochorionic/monoamniotic). Identical twins are less common than fraternal twins and have identical DNA.
- Fraternal Twins (Dizygotic). Fraternal twins develop after two eggs are fertilized separately by two sperm. Fraternal twins do not have identical DNA like identical twins. Dizygotic twins are always carried in separate sacs (diamniotic) and have separate placentas (dichorionic).
At West Des Moines OBGYN, we’ll always put your needs first and develop the appropriate care plan for you. With our team’s years of experience providing obstetrical care services, you can rest assured both you and your babies will be taken care of.
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Categories:

Obstetrics
Mar
18
2020
Best Ways To Manage Endometriosis
At West Des Moines OBGYN, we know endometriosis affects every woman differently, so there isn’t a treatment plan that’s guaranteed to work for everyone.

Endometriosis occurs in up to 10% of reproductive age women and 38% of infertile women will be found to have endometriosis. Endometriosis occurs when endometrial tissue grows outside the uterus. Endometriosis can be found in the ovaries, fallopian tubes, the tissues that construct the uterus or the outer area of the uterus and bowel. Diagnosis of endometriosis can only be made by evaluating a lesion histologically after it is resected or biopsied at the time of surgery.

Endometriosis represents a significant health problem for women of reproductive age. With March being Endometriosis Awareness Month, we wanted to share tips and tricks for helping make this condition more manageable on a day-to-day basis.

Pain Management

There are many ways that you can manage your endometriosis pain on your own from tracking your symptoms on a cycle app, maintaining a healthy lifestyle through healthy eating and exercising, schedule self-care to help keep you relaxed when days are hard, or even eating foods that are high in omega-3 fatty acids. Here are a few other ways that you can help manage your endometriosis symptoms.
- Electronic Devices. A TENS machine or a Transcutaneous Electrical Nerve Stimulation unit transmits vibrations that can relax muscles and alleviate pain. TENS units are available as a home unit or at a physical therapist’s office.
- Heating Pads. Heating pads are one of the most common home remedies for alleviating endometriosis pain. The heat will help loosen and smooth muscles, making the cramping pain less intense. If you don’t have a heating pad at home, you can make one using a rice sock. To make a rice sock, you need to put uncooked rice in a sock and warm it in the microwave for two minutes.
- Warm Bath. Taking a warm bath can also work the same way a heating pad does to relieve pain and soothe contracting muscles.
- Stay Hydrated. Making sure to stay hydrated and drink water can reduce bloating and cramping. On days when your pain is extremely high, you could be dehydrated.
- Keep Medication on Hand. There are times when your endometriosis is so flared up, that simple at-home remedies may not be able to reduce the pain. Over the counter medications like Midol and Motrin can be helpful.
- Interventional Therapy. After speaking with your gynecologist, they may recommend trying the following types of therapy: nerve block, muscle injections, physical therapy, behavioral therapy, or even acupuncture.
  
  If after trying at-home remedies you’re still experiencing unusually severe or persistent pain, talk with your gynecologist at West Des Moines OBGYN.
Hormone Therapy
- Hormonal Contraceptives. Birth control pills, patches, and vaginal rings can help control the hormones that cause the buildup of endometrial tissue.
- Progesterone Therapy. Certain types of implants, injections and IUD contraceptives can stop periods and endometrial tissue growth to alleviate endometriosis symptoms.
- Aromatase inhibitors. Aromatase inhibitors such as Anastrozole and Letrozole work to reduce the amount of estrogen in the body. This type of hormone therapy is usually prescribed by your gynecologist in conjunction with one of the hormonal methods above.
- Gn-RH Agonist. Gn-RH agonist is a strain of drugs that block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation. Side effects are similar to menopause with hot flashes being prominent. There are add back therapies available to help alleviate this.
- Orilissa (Elagolix). Orilissa is a GnRH antagonist FDA approved treatment for moderate to severe endometriosis.
Surgery and Fertility Issues
- Conservative Surgery. Conservative surgery to remove endometrial implants is an option for those struggling with pain or fertility issues. This often helps to alleviate pain for a while, but symptoms may return. This type of surgery can be done either laparoscopically or abdominally. After surgery, you may be prescribed a hormonal medication to help reduce further growth of endometriosis.
- Hysterectomy. In certain cases where endometriosis management has failed to work and a patient has exhausted all treatment options, a hysterectomy may be recommended. A hysterectomy with the removal of the ovaries and the uterus is most effective.
- Fertility Complications. Endometriosis can lead to trouble conceiving. The exact mechanism is unknown. If you have endometriosis and are having difficulty getting pregnant, your gynecologist may recommend fertility treatment. Fertility treatment ranges from stimulating your ovaries to make more eggs to in vitro fertilization.
Our care team at West Des Moines OB/GYN is here to support you. We provide a variety of convenient services and individualized care for your specific needs. Learn more about our services or schedule an appointment and experience the difference.
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Categories:

Gynecology
Feb
14
2020
Our Guide to Genetic Testing
Genetic testing is when a blood test is given to prospective or expecting parents to look for abnormal genes that can lead to certain diseases in their baby.

Who Should Get Genetic Testing?

Genetic testing is offered to everyone. There are ethnic backgrounds that can be at a higher risk for certain disorders such as Ashkenazi Jews. It is also worth considering if you have any genetic diseases that run in you or your partner’s family such as cystic fibrosis. If you have had a prior pregnancy affected by a genetic disorder or unexplained stillbirth then testing is recommended. Women older than 35 years old at the time of delivery are also at higher risk and should consider genetic testing. Genetic testing is also offered when a structural concern is found on ultrasound.

Genetic Testing Before You Get Pregnant

Before getting pregnant, you can opt to have carrier screening, which is a test to determine whether or not you are a carrier for any genetic diseases or disorders that could possibly get passed down to your child. Everyone can be a carrier, even if there is no family history of the disorder or disease.

If you and your partner are interested in pre-pregnancy genetic testing, you can speak with your obstetrician at West Des Moines OBGYN. We offer the Foresight carrier screen through Myriad Genetics.

Non-invasive Genetic Screening

Genetic screening is also available for women during pregnancy. At West Des Moines OBGYN we offer several different options for genetic screening.
- First Trimester Screening. The first-trimester screening is done during 11-13 weeks gestation. A first-trimester screen can detect early signs of chromosomal conditions, such as down syndrome, trisomy 13, and trisomy 18. This is a test that combines an ultrasound to measure the thickness of the neck called the nuchal translucency and maternal blood work.
- Integrated Screening. Integrated screening is a two-part genetic screen that can be done to detect early signs of down syndrome, trisomy 13, trisomy 18, and open neural tube defects such as spina bifida. This screening is done by performing an ultrasound between 11-13 weeks to measure the nuchal translucency followed by testing the levels of serum analytes in the mother’s blood at 15-19 weeks.
- Quad Screening (AFP 4). Quad screening is a genetic screen that is done during the second trimester to measure the risk of the baby being born with down syndrome, trisomy 13, trisomy 18, and open neural tube defects. The Quad screen is done during weeks 15-19.
- Free Cell DNA Testing. Non-invasive prenatal screening that can detect an increased risk of down syndrome, trisomy 13, and trisomy 18. This test can also provide information about fetal sex. It can be performed any time after 10 weeks of gestation. We offer Myriad Prequel Prenatal Screening at West Des Moines OB-GYN.
Invasive Genetic Testing:

Further testing is available with a consulting maternal-fetal medicine physician if the noninvasive tests are abnormal or result as high risk.

Amniocentesis is a genetic testing procedure that can take place between 15 – 20 weeks gestation. The procedure is done by inserting a hollow needle into a woman’s stomach under ultrasound guidance and gathering a sample of amniotic fluid. The amniotic fluid is then checked for genetic disorders and includes the sex of the baby. This type of genetic testing doesn’t have a small risk of miscarriage.

At West Des Moines OBGYN, our priority is you and your baby. We will always put your needs first and develop the appropriate care plan for you. Whether you’re trying to become pregnant for the first time or are expecting another child, we are here to help you along the way. Schedule a preconception visit with us to discuss maternal cell testing and if it is right for you.
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Categories:

Obstetrics