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Obstetrics and Gynecology - Westlake Village
Congratulations on your pregnancy and welcome to UCLA Obstetrics and Gynecology clinic in
Westlake Village! Thank you for allowing us to be a part of your pregnancy. We are a group of
three female physicians that share call and will take care of you throughout your pregnancy. Please
call our office if you have any questions. We have an answering service after hours, which will route
emergency calls to the physician on call. The office will address non-urgent calls (refills,
appointment changes) the following business day.
Doctors:
Leena Nathan, MD
Ranoo Sabnis, MD
Angela Valle, MD
Staff:
Jeanne - office manager
Danielle - front desk
Theresa - medical assistant
Office Address:
1250 La Venta Drive, Suite 105
Westlake Village, CA 91361
Phone: (805) 557-7180
Fax: (805) 557-7181
uclahealth.org/wlvobgyn
Office Hours: Monday – Friday 8am – 5pm
We will deliver your baby at Los Robles Hospital and Medical Center, which features nine private
labor, delivery and recovery (LDR) rooms and a level III neonatal intensive care unit (NICU).
http://losrobleshospital.com/service/line/family-birthing-center
Los Robles Hospital
215 W. Janss Road
Thousand Oaks, CA 91360
(805) 497-2727
Thank you for choosing UCLA!
Obstetrics and Gynecology – Westlake Village
What To Expect At Each Doctor’s Visit
First Trimester:
First visit:
Make this as soon as you think you’re pregnant (6-10 weeks is average). Please set aside enough time
because this will be your longest visit. Your partner may want to come to this visit. Your physician will
ask about your medical history (menstrual cycle, contraception, past pregnancies, medical history, family
history and medications). Your due date will be established using your last menstrual period and possibly
an ultrasound. Very few women give birth on their actual due date, but it gives a timeline to schedule
tests and procedures at appropriate times. Your doctor will perform a physical exam and perform routine
lab tests. We will also discuss screening tests for fetal abnormalities.
Remainder of visits in first trimester
You will be seen every 4 weeks and each of these visits should be much shorter than the first visit. We
will check your blood pressure, weight and urine at each visit. The urine test is looking for signs of
bladder infection or protein. After about 10 weeks, your doctor will listen to the baby’s heartbeat with a
small device called a Doppler at each visit.
Second Trimester:
Each visit will occur every 4 weeks. Again, you will have your blood pressure, weight and urine checked.
Your baby’s heartbeat will be measured by Doppler. Your doctor will start measuring your uterus or
“fundal height” after 20 weeks to make sure your uterus is growing appropriately. Generally at 20 weeks,
you will start to notice flutters and kicks. You will have an ultrasound around 20 weeks to look at your
baby’s anatomy and to determine gender if you would like to know.
Third Trimester:
Now your visits will occur every 2 weeks until 36 weeks and then every week until you deliver. Again, we
will measure your blood pressure, weight, urine and baby’s heartbeat. You will have a test for diabetes
during pregnancy at 24-28 weeks. You will also be tested for Group B streptococcus around 36 weeks to
test for a bacteria that can cause serious infections in newborns. Your doctor may check your cervix as
you approach your due date and check to make sure your baby is in the head-down position.
Obstetrics and Gynecology – Westlake Village
Routine Tests
First visit
Type and Rh Factor
Determines blood type and Rh factor (for example
– O positive)
Antibody Screen
Screens for abnormal antibodies in your blood
CBC (complete blood count)
Screens for anemia or abnormal antibodies in the
blood
Rubella antibodies
Tests for immunity to Rubella or German measles
Hepatitis B surface antigen
Screens for hepatitis B
RPR
Screens for syphilis
HIV
Screens for HIV
Cystic fibrosis
Screens for CF carrier status
Urine culture
Evaluates for bladder infections
Hemoglobin electrophoresis
Screens for sickle cell trait or disease or other
abnormal blood cells
Pap smear (pelvic exam)
Screens for cervical cancer if needed based on
your age and previous results
Gonorrhea and chlamydia (pelvic exam)
Tests for gonorrhea and chlamydia
Ultrasound
Done at your first or second visit to confirm
estimated due date
Ultrasound and genetic screening – 11-14 weeks
Offered between 11-14 weeks to screen for Down
Syndrome and Trisomy 18
Second & Third Trimesters
Ultrasound – 18-20 weeks
Looks at anatomy of baby
CBC (complete blood count) – 24-28 weeks
Screens for anemia again because your level can
drop at this time in pregnancy
Glucose tolerance test – 24-28 weeks
A 1 hour, non-fasting test to screen for gestational
diabetes
Type and Rh factor – 28 weeks
Needed for patients with a negative Rh factor
(example – A negative)
Group B streptococcus test (vaginal/rectal) – 35-37
weeks
Tests for a bacteria that is carried by some women,
but does not cause an infection in adults. If it is
positive, you will need antibiotics when you’re labor
to prevent transmission to your baby
Obstetrics and Gynecology – Westlake Village
Safe Medications During Pregnancy
Here is a list of medications generally considered safe in pregnancy. Please talk to your doctor if you
have any questions about the medications on this list or other medications you are taking. Do not take
aspirin, Motrin, Aleve or Advil unless recommended by your doctor. If your symptoms do not improve
after a few days, or if you notice high fever, please call the office directly at (805) 557-7180.
Cold Medications
Headache
Allergies
Rash
Anti-diarrhea
Heartburn
Nausea and vomiting
Hemorrhoids
Constipation
Leg Cramps
Yeast Infection
Tylenol – do not exceed 3000 mg in 24 hours
Saline nasal spray (congestion)
Robitussin (cough)
Throat lozenges (sore throat)
Alka-Seltzer
Sudafed – after first trimester
Tylenol – do not take more than recommended
Claritin
Benadryl
Zyrtec
Hydrocortisone cream
Benadryl cream
Caladryl cream
Oatmeal bath (Aveeno)
Kaopectate
Imodium
Tums
Rolaids
Maalox/Mylanta
Pepcid
Simethicone (Gas-X)
Emetrol oral solution
Vitamin B6 (100mg)
Sea-Band
Ginger
Preparation H
Witch Hazel
Anusol
Tucks
Colace (stool softener)
Metamucil (fiber supplement) or Citrucel
Miralax (laxative)
Milk of Magnesia
Calcium 500 mg at bedtime
Potassium (1/2 banana per day)
Monistat 7 or Monistat 3
Vagisil Anti-Itch cream
Obstetrics and Gynecology – Westlake Village
Frequently Asked Questions
How often will I see my doctor?
Each pregnancy is unique, but in general you will be seen every 4 weeks until you reach 28 weeks. You
will then have appointments every 2 weeks until 36 weeks. After this, you will be seen every week. We
will have you see each doctor in the practice during your prenatal visits so you are sure to know the
doctor attending your delivery. The first visit is usually the longest – about 45 minutes. The rest of the
visits are usually 10-15 minutes.
When will I receive an ultrasound?
Your physician will perform an ultrasound at your first or second visit to determine how many babies and
confirm your delivery date. Dr. Dan Kahn, a high risk OB and ultrasound specialist, will be available in the
office approximately once weekly. He will perform first trimester ultrasounds for genetic screening if you
desire. He will also perform a comprehensive anatomy survey around 20 weeks – the gender of your
baby can be determined by this ultrasound if you wish. After this, ultrasounds are generally performed if
there is an indication determined by your doctor.
Is it normal to have bleeding early in pregnancy?
First trimester bleeding can occur frequently and does not necessarily mean there is a problem. Bleeding
can be caused by intercourse, cervical infection or other normal changes in pregnancy. Slight bleeding
often stops on its own. If you notice bleeding, please contact our office.
Is it normal to have cramping in early pregnancy?
It is common to have some cramping in early pregnancy as your uterus grows and stretches to
accommodate your growing baby. You can take 1-2 extra-strength Tylenol, rest and drink plenty of fluids.
If there is no improvement, please call the office.
What is round ligament pain?
This is a common problem that often causes discomfort by the groin. As the uterus grows, the normal
ligaments that attach the uterus to the side of the abdomen are stretched. This can be treated with
Tylenol, heating pads, warm showers. Sometimes a pregnancy or maternity belt can help with this pain.
Typically, this pain will go away as you pass into the second trimester.
Nutrition in Pregnancy
Which prenatal vitamins should I be taking?
Pregnant women should be taking a daily prenatal vitamin to provide additional nutrients needed in
pregnancy. Most over-the-counter preparations are acceptable options. Just make sure your vitamin has
at least 400 mcg of folic acid (folate or Vitamin B9). Other vitamins that should be included are iron (40
mg), calcium (1000 mg), zinc, manganese, iodine and vitamin B6.
What can I take for morning sickness?
Many women experience some morning sickness, which despite the name, can occur at any time of day.
Most women notice worsening symptoms up until 9-10 weeks and it usually improves by 14 weeks or the
end of the first trimester. Eating smaller, more frequent meals about 6 times per day and avoiding spicy
or greasy foods can help limit symptoms. Ginger can be a natural way to help decrease nausea. Eating
bland crackers in the morning may help. Vitamin B6 can be taken up to three times per day and can help
symptoms. If symptoms are still bothersome, there are several medications that can be prescribed by
your doctor that may be helpful. Occasionally pregnant women need to be seen in the emergency room
for IV fluids and medication.
Obstetrics and Gynecology – Westlake Village
Do I need more calories now that I’m pregnant?
Most pregnant women only need an extra 300 calories per day during pregnancy. Your diet should be
well balanced and include fruit, vegetables and protein. The USDA has a great resource for moms and
breastfeeding women. http://www.choosemyplate.gov/pregnancy-breastfeeding.html
Can I drink caffeine during pregnancy?
Moderate caffeine consumption is safe in pregnancy. It is not recommended to drink more than 200 mg
of caffeine (2 8oz cups of full caffeine coffee) per day. High caffeine intake has been associated with
preterm birth and low birth weight infants but the data is inconclusive.
Should I avoid fish during pregnancy?
Fish containing high mercury levels should be avoided in pregnancy – this includes predatory fish such as
shark, swordfish, king mackerel, and tilefish. Raw fish should also be avoided. Try to limit fish intake to
12 ounces per week of lower mercury fish such as salmon, light tuna, shrimp or cod.
What other foods should I avoid in pregnancy?
Unpasteurized milk and soft cheeses, raw or undercooked meat, poultry or shellfish, prepared meats
such as hot dogs, deli meats unless they are heated until steaming hot. Listeria is a bacteria that can be
housed in these foods and when a pregnant woman is infected, this disease can cause miscarriage and
stillbirth. Washing all fresh fruits and vegetables before eating will also help prevent listeria.
How much weight should I gain during pregnancy?
For normal weight women (BMI <25) the average weight gain should be 25-35 pounds.
If you are starting at a higher weight, your doctor will recommend more modest weight gain during
pregnancy.
Is it safe to exercise while pregnant?
Yes. Exercise has many benefits and staying in shape helps increase your energy, improves your mood,
helps prevent back pain and will make you ready for labor. Safe exercises include walking, swimming,
low impact aerobics, and cycling. You should avoid exercises with higher chance of injury such as
gymnastics, skiing, deep sea diving, and horseback riding. You should avoid contact sports like soccer or
basketball. Keep in mind that your balance will be off as you progress through pregnancy.
How vigorously can I exercise?
You should avoid activities that require quick changes in direction. If you were active prior to pregnancy,
you will have an easier time exercising while pregnant. Drink plenty of fluids and wear cool, loose fitting
clothing to prevent dehydration. After the first trimester, avoid lying flat on your back. Stop exercising if
you notice vaginal bleeding, contractions, chest pain, dizziness, or shortness of breath.
What vaccinations are recommended in pregnancy?
The flu shot is recommended for pregnant women and can be given at any time during pregnancy or
during breastfeeding. It should be the shot, not the nasal spray. Pregnant women and their newborns
are at risk of much more severe complications of the flu. TDaP vaccination is recommended to help
prevent pertussis infection in the newborn. The optimal time to give this vaccination is after 28 weeks. All
adults who have close contact with babies under 12 months should be vaccinated at least two weeks
prior to having contact if it has been more than 10 years since last administration.
Obstetrics and Gynecology – Westlake Village
Can I travel during pregnancy?
Yes. The best time to travel is between 14-28 weeks as most problems happen early or late in
pregnancy. During a long car trip, make sure you stop to stretch at least every 2 hours to help prevent
blood clots. Airplane travel is safe, although some airlines will not let you travel after 36 weeks. If you
choose to travel late in pregnancy, you may deliver elsewhere. Please let your doctor know about travel
plans and obtain a copy of your prenatal records to take with you.
How should I wear my seatbelt in pregnancy?
You should always wear your seatbelt in the car. It is important to wear both the lap and shoulder belt.
The lap belt should be low on your hips, below your belly. Place the shoulder belt off to the side of your
belly and between your breasts. It should fit snugly to protect you and your baby from harm.
Are airbags safe in pregnancy?
Yes. They are designed to be used with seatbelts for an added measure of safety. If you are driving, the
steering wheel should be 10 inches from your chest. This may be difficult as your pregnant belly grows.
Try to angle the steering wheel toward your chest to avoid trauma to the abdomen in the event of an
accident.
How do I avoid back pain in pregnancy?
Back pain is common in pregnancy and is often a result of changes in posture, hormones and stretching
of muscles. To avoid problems, wear low-heeled shoes with good arch support (not flats). Always lift
objects by bending your knees and ask for help with heavy objects. Sleep on your side with 1-2 pillows
between your knees. When sitting, use a small pillow for lower back support. A regular exercise routine
with walking or swimming can help prevent back injury.
How can I treat back pain?
You can try heat or ice to your lower back – but never apply heat directly to your belly. Your partner can
massage the affected area. Pregnancy massages are also safe. You can try Tylenol.
Can I still have sex while pregnant?
Yes. You can safely engage in intercourse throughout pregnancy unless you have bleeding, preterm
labor, ruptured membranes or your doctor recommends avoiding sex.
Obstetrics and Gynecology – Westlake Village
Post-partum Contraception
Here is a brief list and description of birth control options after pregnancy. Other methods include
condoms, spermicide, diaphragm, or vasectomy (male sterilization). Please discuss these options with
your doctor to find the best option for you.
Method
How to use
Advantages
Disadvantages
Breastfeeding
Birth control
pills
Take one pill daily.
Have to remember
to take every day
Can be started 4
weeks after
delivery after milk
supply established
NuvaRing
Ring placed in vagina
– three weeks in, one
week out
Safe, effective,
cheap (some as
low as $10/month);
regulates cycle,
improves acne;
decreases risk of
ovarian cancer
Safe, effective.
Convenient - once
monthly dosing.
Requires vaginal
placement
Can be started 4
weeks after
delivery after milk
supply established
OrthoEvra
Patch
Patch placed weekly
for three weeks, then
one patch-free week
Effective,
convenient – once
weekly dosing
Skin irritant
Can be started 4
weeks after
delivery after milk
supply established
Mirena IUD
Small device placed in
uterus in the office 6
weeks after delivery
Effective,
convenient. Lasts
5 years, can be
removed anytime.
Improved bleeding
May cause
irregular bleeding
for first 3-6 mo;
expensive if used
for < 2 years
Safe for
breastfeeding
Copper IUD
Small device placed in
uterus in the office 6
weeks after delivery
Effective,
convenient. No
hormones for up to
10 years
Causes heavier
periods
Safe for
breastfeeding
Nexplanon
Small rod placed in the
arm in the office
Effective,
convenient. Lasts
for 3 years.
Irregular bleeding
for 3-6 months
Safe for
breastfeeding
DepoProvera
Shot every three
months in the office;
can start prior to
discharge from
hospital
Effective,
convenient dosing
4 times per year
Safe for
breastfeeding
Tubal ligation
Can be done after
delivery in hospital or
laparoscopically or
hysteroscopically 6
weeks after delivery
Permanent
Irregular bleeding;
slow return to
fertility after
stopping; weight
gain, can worsen
depression
Permanent
Safe for
breastfeeding