Make Use Of Your Primary health care provider-Gyn Appointments to go over Heart Health

 

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Healthy Pregnancy 101

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In a joint advisory, ACOG and the American Heart Association said annual well-woman exams by obstetrician-gynecologists should include a heart disease risk assessment. The advisory emphasizes the value of collaborative care between ob-gyn specialists and cardiologists. Heart disease and stroke are the leading causes of death in American women. Because they are many women’s primary care doctors, OB-GYNs are in a unique position to advise their patients on preventing heart disease.

About nine in 10 women have at least one risk factor for heart disease and stroke, so almost anyone can benefit from talking about heart health. Visits to OB/GYN should include heart health talk: Experts More than half of women consider their OB/GYN to be their most important doctor. As a result, these OB-GYN appointments often involve discussing other health factors, like nutrition, stress, weight and exercise, so extending this to include cardiovascular health (in a more. “In addition to traditional gynecologic health that includes a pelvic exam, Pap smear and breast exam, we evaluate routine screenings for everything from anemia, heart health, thyroid, osteoporosis, cancers, kidney disease, musculoskeletal problems and more.” Dr. LaCorte joined Cape Cod Healthcare.

“In addition to traditional gynecologic health that includes a pelvic exam, Pap smear and breast exam, we evaluate routine screenings for everything from anemia, heart health, thyroid, osteoporosis, cancers, kidney disease, musculoskeletal problems and more.” Dr. LaCorte joined Cape Cod Healthcare in December 2018. A telehealth appointment with a women’s health specialist can help you find relief and may point to the need for additional testing to determine the root cause of your pain.

If recommended treatments do not relieve your pain, your provider may recommend a future in-person appointment. As a general rule, you should discuss conditions that affect the cardiovascular system or other crucial areas of the body with your ob-gyn. Such conditions include high blood pressure, heart disease, diabetes, or autoimmune diseases. An annual wellness exam performed by an OB/GYN can be used to evaluate a woman’s heart health, according to a new joint advisory statement from the American Heart Association (AHA) and the American College of Obstetricians and Gynecologists published in Circulation.

1. Ob/Gyn Ashley Brant, We use your yearly exam to screen for health problems and perform recommended tests. For example, the Pap test helps us.

List of related literature:

Preconceptional counseling Hemodynamic changes occurring during pregnancy Effects of pregnancy on maternal cardiac disease Effects of maternal cardiac disease on pregnancy General measures for the care of pregnant patients with heart disease Management of congestive heart failure (CHF) during pregnancy 7.

“Practical Guide to High Risk Pregnancy and Delivery E-Book” by Fernando Arias, Amarnath G Bhide, Arulkumaran S, Kaizad Damania, Shirish N Daftary
from Practical Guide to High Risk Pregnancy and Delivery E-Book
by Fernando Arias, Amarnath G Bhide, et. al.
Elsevier Health Sciences, 2012

The patient with preexisting heart disease should also be followed by her cardiologist during her pregnancy.

“Foundations and Adult Health Nursing” by Kim Cooper, RN, MSN, Kelly Gosnell, RN, MSN
from Foundations and Adult Health Nursing
by Kim Cooper, RN, MSN, Kelly Gosnell, RN, MSN
Elsevier Health Sciences, 2014

These guidelines provide current recommendations for the management of the pregnant patient with cardiovascular disease.

“Netter's Cardiology E-Book” by George Stouffer, Marschall S. Runge, Cam Patterson, Joseph S. Rossi
from Netter’s Cardiology E-Book
by George Stouffer, Marschall S. Runge, et. al.
Elsevier Health Sciences, 2018

This initial appointment should be regarded as an opportunity for imparting general information about the pregnancy such as diet, smoking and folic acid supplementation.

“Dewhurst's Textbook of Obstetrics and Gynaecology” by Sir John Dewhurst, Keith Edmonds
from Dewhurst’s Textbook of Obstetrics and Gynaecology
by Sir John Dewhurst, Keith Edmonds
Wiley, 2012

Women who are known to have pre-existing heart disease should be advised to seek medical care as soon as pregnancy is confirmed, so that they can have a plan of care established by the multidisciplinary team.

“Oxford Textbook of Obstetrics and Gynaecology” by Sabaratnam Arulkumaran, William Ledger, Stergios Doumouchtsis, Lynette Denny
from Oxford Textbook of Obstetrics and Gynaecology
by Sabaratnam Arulkumaran, William Ledger, et. al.
Oxford University Press, 2019

These authors recommended (and we concur) a comprehensive cardiovascular evaluation before pregnancy be undertaken, including examination, electrocardiography, chest radiography, exercise study, and echocardiography and/or CMR for evaluation of any hemodynamic abnormalities and ventricular function.

“Diagnosis and Management of Adult Congenital Heart Disease E-Book: Expert Consult – Online and Print” by Michael A. Gatzoulis, Gary D. Webb, Piers E. F. Daubeney
from Diagnosis and Management of Adult Congenital Heart Disease E-Book: Expert Consult – Online and Print
by Michael A. Gatzoulis, Gary D. Webb, Piers E. F. Daubeney
Elsevier Health Sciences, 2010

The patient with preexisting heart disease also should be followed by her cardiologist during her pregnancy.

“Foundations and Adult Health Nursing E-Book” by Kim Cooper, Kelly Gosnell
from Foundations and Adult Health Nursing E-Book
by Kim Cooper, Kelly Gosnell
Elsevier Health Sciences, 2018

This is a comprehensive set of guidelines on the management of cardiovascular disease in pregnancy.

“Anderson’s Pediatric Cardiology E-Book” by Gil Wernovsky, Robert H. Anderson, Kumar Krishna, Kathleen A. Mussato, Andrew Redington, James S. Tweddell, Justin Tretter
from Anderson’s Pediatric Cardiology E-Book
by Gil Wernovsky, Robert H. Anderson, et. al.
Elsevier Health Sciences, 2019

All women with heart disease should have an early pregnancy assessment, and a pregnancy plan should be established.

“Practice of Clinical Echocardiography E-Book” by Catherine M. Otto
from Practice of Clinical Echocardiography E-Book
by Catherine M. Otto
Elsevier Health Sciences, 2016

Harvey W: Alterations of the cardiac physical examination in normal pregnancy.

“High Risk Pregnancy E-Book: Management Options Expert Consult” by David K. James, Philip J. Steer, Carl P. Weiner, Bernard Gonik
from High Risk Pregnancy E-Book: Management Options Expert Consult
by David K. James, Philip J. Steer, et. al.
Elsevier Health Sciences, 2010

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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47 comments

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  • When it comes to appointments, this video is pretty much completely accurate! Whether or not you think OB’s or Midwives are better in other ways is beyond the scope of the video, but, my friend had an OB and ended up with interventions that lead to Csection. Her second birth she got a hospital midwife with good stats and had a completely natural labor without even meaning to. She said her experience was so different, and better, with her midwife.

  • great video, thank you, I am also documenting the differences in my experiences, this was actually mild compared to what I have been through with the nurses (because a doctor has never actually even touched me through 6 appointments at the OBGYN’s and an ultra sound for breast cancer).  I believe the stress factor plays a huge role in the outcome of the birthing process.  And for those that worry… even midwives have an OB on backup JUST IN CASE!  We aren’t dumb enough to not praise OBs for what they are trained to do, which is operate when necessary.  Thank you again.  

  • very useful information for the expectant mothers in overcoming the initial troubles of pregnancy.

    https://www.early-pregnancy-signs.com/

  • On the other hand, the midwife I work with had a pt in the hospital that had fetal bradycardia, I took her for a emergent C/S and we all had a good outcome. A good outcome is the whole point of this discussion!

  • I have to say, you stating “When the truth is those of us who choose it do so BECAUSE we are educated” is very stand offish and rude. Im sure that not what you mean’t however it give thin impression that you think people who have a hospital birth are uneducated which is exactly what you don’t like other implying about your choice.

  • Folic acidwill cause you breast cancer and damage your baby. Then go and have unnecessary ultra sounds spree, do not forget 4D, have fun and upload it on youtube. Stop when you notice that your babies brains boling.
    The doctors will induce labour and send you for several days to hell. When baby born they will inject synthetic Vitamin K cocktail with aluminum just to give your baby yellow colour tan and destroy liver. If baby still alive they will inject with first vaccines and they give the name for your baby Colic.
    After, midwife will advice to give your baby Vitamin D3 drops, do not worry your baby is bigger than the rats it will survive. Then will tell you keep your baby sleep on its back, just to keep them awake and to cry more. You husband is preparing to file for divorce, and you are thinking be a single was much more fun. They will advice not to expose your baby to the sun. To improve your child health its a really bad idea when they worked so hard. After you get last shots sell your house because your child will need lots of care. Happy motherhood and follow doctors advice these sociopath (most of them) trained to help you and guide you. Because most of us are really idiots.
    PS Its juts a basic stuff you will need for ultimate healthy baby, antibiotics and various pills will be added on the way. DO NOT BE SELFISH ACCORDING MAINSTREAM MEDIA Mother Earth IS OVERPOPULATED.

  • No one is saying anything against regular doctors. Doctors are there to handle the high risk pregnancies while the midwives are able to guide the low risk pregnancies. As long as their aren’t any looming risks to a pregnancy, a woman should be able to deliver her baby naturally which is beneficial to their biological relationship in the long run.

  • Hi sir, I am having query..!! is Albendazole and Diethycarbamazepine is safe in Lactating mother? coz my baby is one month old and on breast feed..and my wife diagnosed with Intramuscular cysticercosis.
    Do guide me regarding this..!! being clinical pharmacologist i know that its safe but want ur valuable advice.

  • I’d spent about two years helping my mother through her cancer, in and out of hospital. I was pregnant, not ill home birth was the best way to welcome him, with family and friends. The midwife helping me through the 12 or so hours before the birth, where she ‘caught’ my son. The good doctor then took over to sew me up, because my 10lb.-1oz. boy tore me coming out, but we were both too busy learning how to nurse to notice much of the stitching. Besides, I was in love!

  • Haha, I talk about this all the time, the huge difference. I would wait 1.5 hours to see my doctor, see her for 5 minutes or less, she would sigh with exasperation when I asked questions, was bored by my excitement (first baby). I once told her I was having migraines so she hastily wrote a prescription for some drug, handed it to me and rushed me out the door without explaining what the drug was, side effects, nothing… Then I would go to my midwife at the birthing center, I would not wait at all, she would be there waiting for me even when I was early, and then she would take tests and talk to me and help me with my mental AND physical health for an HOUR. These women are amazing, with the doctors I felt like I was bothering them by coming to see them…. I always recommend people get a midwife for their birth.

  • Hi sir, I’m getting negative in pregancy kit, but still I’m feeling like I’m pregnant, I’m not getting periods,stomach is hard,I’m getting milk, and I took abortion pill and I had periods for 3 days very lightly,but still my stomach is same and I’m getting milk, plz someone help me,

  • Candace, you are right! I do believe that most people who give birth in a hospital are uneducated about the process. Not implying there are some women who do some research and still decide, for whatever reason, they want to birth in a hospital. But you & I both know most women do not do any research. They assume the hospital is the safest place to be and blindly trust their doctors to take care of them and believe that “it won’t happen to me.”

  • And a husband had a disastrous hospital birth experience. His wife was killed by an epidural. Also, there have been women who have had disastrous hospital birth experiences and wound up needing a hysterectomy. Birthing regardless of location and care provider can ended in tragedy.

  • Going to my Male PC Doctor for gyno exams makes me want to kill myself, but he doesn’t care & he is insisting & pressuring me to also let him do the exam eventhough I go to a female gyno specialist for yearly pap exams & I have never had any problems. I’m starting to hate my doctor. I’m thinking of dropping my expensive/crappy insurance & never seeing another doctor again! If I die early of something, so be it! I live in Central TX, in the USA.

  • Let it be noted that there are Nurse Midwives (RNs) and non-nurse Midwifes, so education levels are very different.  I would echo the comments made by another that not all OBGYNs provide the level of care noted in this video.  My OBGYN was wonderful, caring and timely.  With that being said, I do feel that it is important to educate yourself and know what you want.  Find a doctor who meets your needs. Also, there are hospitals that have midwives, perhaps not as many as we would like, but it is growing! Doulas are also a wonderful!  After two unmedicated hospital
    births, I was happy with birthing at the hospital.  Howeverit’s after the birth that isn’t so great.  You are a prisoner. For that reason, if we should have anymore children, I will likely choose to birth at home or a birthing center. 

  • I want to know that I have periods but these are less than normal but more than I think implantion and my right ovary is prominant or swelled I felt pain in abdomen bloating and feeling up and down alot.somtime weeping some time laughing.I have fever and headace too.m feeling unusual I am not able to understand went to doctr but not satisfied feeling different little bit nausea.

  • A midwife also does not have to be used in the case of a home birth, am I correct? They can also deliver in hospitals and even order an epidural. I thought that a midwife didn’t have to be specific to a home, natural, unmediated birth.

  • that was true to me!!!! I understand that doctors are important for complications in pregnancy… but normal pregnancy… MIDWIVES ROCK!!!!

  • So true! Sometimes with the OB it wasnt even worth sitting down.
    With my homebirth MW we could be chatting an hour later maybe about birth, or maybe about other stuff.

    Its so important to have that rapport, sense of safety and no power imbalance. Makes it much easier to have that person peering up your bum and to trust them when you’re most vulnerable.
    I’d only have a female birth worker now. Unless I needed medical help, in which case i wouldnt care.

  • It still surprise me, how a lot of people have no idea about Chikepoxim Remedy (search on google), despite the fact that a lot of people completely cure their chicken pox naturally with this remedy. Thanks to my mate who told me about Chikepoxim Remedy, I finally eliminated my pain & embarrassment for good with healthy ways.

  • You’re so needy! Must not have many frinds and feel lonely since you like hugs so much:( Some girls like me prefer OB’s, done and gone.. Maybe because some of us have busier life and dont care about getting strangers hugs lol

  • Yep! That was my experience! I’m in Canada both OB and midwife are covered by our healthcare. I was lucky enough to get accepted by a midwife! They have big waiting lists I was on 4 and so glad one had opening and I switched right away.

  • This brings up the last point before I get off my soapbox. Home births are a bad idea for both the midwife and mother/baby (i.e. Caroline Lovell death). One example I experenced in residency, a midwife labored a patient at home. Baby developed a dystocia and died. The baby was finally removed by the midwife, and mom began to bleed out due to uterine atony…she didn’t have any pitocin etc. to help stop it…she arrived via ambalance with 2/3 of her blood lost. Thankfully we saved her.

  • Haha, my sister’s midwife sent her a link to you video and she then shared it with me. I replied back and told her I’d been watching you for years and had already seen it!:) Just though you’d want to know it’s getting around in the midwife community. Good job!

  • My hubby is a pediatricianwe’ve used both a midwife and an OBand I can say I’ve enjoyed both. I did like the care leading up to the birth with a midwifebut I’ve loved my OB experience too. Having a baby that had to spend some time in the NICU, I have to say I’ll stick with the OB for the future. But both have great attributes. I don’t find it helpful to bash eitherboth are great options.

  • This is correct, a midwife will better help you get through L&D naturally, but that doesn’t mean that you are closed off from other options when necessary or wanted.:)

  • @disagreablesobMidwifery fell out of favor because hospitals made it illegal, you idiot.  It was all about the corporations called hospitals driving out the small business owners, called midwives.  It had everything to do with profit.  It had noting to do with “safety”.

  • “There’s a reason midwives fell out of favor”
    Yes, and it was MONEY, not safety. In countries where women have a choice of hospital or homebirth attended by well-trained midwives, and where surgeons (OB/GYN) are only called in when needed, the outcomes are significantly better than in the US. The obscenely high rates of surgical birth in this country are (or at least ought to be) an embarrassment to the medical profession.

  • @ajdewdrop Of course they are trained so, but not every midwife is the same, just like not every OBGYN is the same. A woman in my community I lived in 10 years ago had a disastrous home birth where there was a delay in getting the mother to the hospital the mother needed a hysterectomy to control her bleeding and the child was born and now has developmental delays. If I made a video of this, would that be an honest, responsible way to portray the entire home birthing/midwifery system? No way.

  • I have one huge problem with this whole lecture. It’s absolutely shameful that this lady isn’t available to teach every single medical professional in the world. I’m in awe of her brilliance and way of drawing in her students. I have never been more drawn to a lecture in all my years of training and practice. Hats off doc!
    YOU
    ARE
    AMAZING!!!

  • Hi doc.. I would like ask, i am in my period for only 2days, and when it about to go heavy, my period suddenly stopped, it bothers me alot, wat shud i do to? And what is the reason y is it happen

  • I fully support midwifery, but in all fairness to the doctors out there, my experience with both my babies (one family doctor and 2 OB/GYNs) was much more like the midwife experience given in this video. It wasn’t exactly like either experience, but I don’t remember having long waits, and I do remember having a decent amount of time to talk with my doctor. And I know we talked a lot about all those things you mentioned throughout my pregnancies.

  • I agree…. but if you’re “not the norm”, I’d want to make certain that a physician was closely available. I would also hope that I would have at least had the opportunity to meet this person (whose schedule is most often emergently dictated) beforehand. And yes, midwives and other “mid level providers” are the ones best qualified to provide “routine” care for families during this pre and post natal time.

  • Last night, my midwife talked to me all about bringing home a new baby to a dog and then after her story apologized for taking up MY time. Can you imagine an OB doing this? Certainly not! I love midwives:-)

  • I would have to say I agree with the sentiment of this video, while my experiences weren’t *exactly* the same, it was pretty close. The first appointment I had was with an OB, and it was my last. She was cold, unfriendly, rude, and seemed inconvenienced by the fact that I had an appointment. My midwife was extremely friendly, sweet, and gentle. She invited me to start the conversations and never pressured me to do something I didn’t want to. If I have another child, I will be using a midwife.

  • Sir I have 6 month old baby. now my wife again pregnancy around 3 month without plan. what should I do weather I keep continue or aversion? Plz suggest me

  • Jennifer Fargar I think your comments are discriminatory against Bluegrass, which is NOT the music of the poor and uneducated, but a sub-genre of Country music classified as “American Roots.” I think it is perfectly appropriate, considering that Mid-Wifery is about Women getting back to the root of who they are and what the birth process is really about.

  • I feel the exact same. I went through multiple OB’s with my first baby and finally found midwives. Second time around, went straight to midwifery care! Learned my lesson the first time:)

  • @vantarinitel “My observation is that 20 years ago, 30 years ago, 70 years ago, hospitals outweighed midwives in quality and health.”

    What? That is absolute NONSENSE!!!! You clearly don’t know much about the history of midwifery and childbirth.

  • I know someone personally who slipped through the program without seeing an actual birth!
    This video is no joke! Now if you choose to not believe this then that’s fine but I’m not lying to you.

  • Some maternity clinics schedule the MD for a pt every 7 min! The midwives get 15min, either way there is so little time for questions….especially if they have their hands on the door handle!

  • I’m 18 and I’ve been educating myself on this as I plan on having kids in the future and my goodness what a great, informative presentation, thank you so much

  • Something I really love about the field of OB/GYN is that as a practitioner, I will be able follow patients from before their pregnancy and long after functioning in the role of primary care provider, gynecologist, obstetrician, and surgeon.  There are very few other specialties that provide this level of continuity of care, which is why I’m pursuing this specialty.  Sometimes labor can become complicated very quickly, and I think it’s nice to not be handed over to a stranger in a moment of high stress.  That said, as a patient, I see a midwife.  Not because I think one is better than the other, but because I think it’s useful to my education.  It really bothers me to see so much negativity surrounding both fields.  Each option has plusses and minuses, there are bad eggs and gems in each camp, and people should be free to pick the option that is right for them without judgement.  

  • Ina May Gaskin is an American midwife. It’s not inconceivable for a midwife from a different continent to assist at 500 births a year.

  • Wonderful! definitely re-affirms me decision the receive care from midwives for both of my pregnancies so far, and hoping to attend school to become a midwife.

  • hello…..i have a quatione 4 u….i’m 27 years old i have a regular period from z beginning but for z last 4 years i haven’t seen my period n the doctors gave me same medicines but it didn’t came also surprisingly i still feel z period cramps between 3 to 4 months all this year….so can you help???

  • Unless there are complications,such as a breech birth,excessive bleeding,an infection,premature or severely underweight birth,either the mother or the baby suffering cardiac arrhythmia or arrest,or any other number of other issues that can threaten the life of a birth mother and an infant.So not always the best.Hence the decline of mid-wifery.

  • My observation is that 20 years ago, 30 years ago, 70 years ago, hospitals outweighed midwives in quality and health. It’s just lately, in the last 10 years that prices have skyrocketed and quality gone down as far as it has.

    You’re not picking “awesome midwife” over “awesome midwife”, you’re picking “somebody that speaks to you” over “somebody with waaaay too much to do, not enough time, and too many weird kinks in the system.” Therefore, the better quality, currently.