PREGNANCY

Recurrent Pregnancy Loss

Recurrent pregnancy loss is when a woman has multiple (2 or more) consecutive miscarriages (1 miscarriage after another).

Often the pregnancy loss may be diagnosed early in the first trimester and is not always accompanied by bleeding or cramping.

The most common cause of pregnancy loss is the result of a chromosomal abnormality in which the chromosomal arrangement is incompatible with the survival for the fetus.

Other medical reasons for pregnancy loss could be an inheritable clotting problem, an acquired clotting problem involving antiphospholipid antibodies, or abnormal hormone function. In order to diagnose the cause, we perform imaging of the woman’s uterus and both partners have bloodwork done.

We will follow you and provide support in the early stages of any subsequent pregnancies.

Intrauterine Fetal Demise

Intrauterine fetal demise is when the pregnancy makes it until the second or third trimester before the fetus dies. This is a devastating outcome, and, at this point, the pregnancy is considered high risk and an obstetrician needs to oversee the pregnancy.

Our standard is to perform tests to find out if there is a maternal infection or medical reason that caused the demise to occur.  In some cases, the parent (s) consent to testing the fetus in an autopsy to evaluate the anatomy. Sometimes tissue can be tested from the fetus for chromosomes. All of these tests could be valuable to determine if there is a potentially recurrent cause for the fetal demise. However, we decide with the parent (s) how much, or if, testing is desired.

High Risk Pregnancies

Most pregnancies are low risk and your primary care provider can assume your care if we have assisted you to conceive. However, with some women and/or couples we need to provide ongoing medical care during the pregnancy alongside their primary care provider. This maybe because you are carrying multiple fetuses (twins or more) which require ongoing monitoring or because of chronic or acute medical conditions, obstetrical complications, or a new fetal diagnosis that requires management. We also provide a consultation service for clients who have a prior c-section and would like advice about mode of delivery and management. We expedite access for referrals for clients who have a new diagnosis in pregnancy that warrants care by an obstetrician.

Birth

Helping to deliver babies is one of the privileges of this specialty. Obstetricians work with a skilled team of nurses, midwives and family physicians to provide safe and client-centred delivery care to women in Prince George. The on-call structure of the physicians ensures 24/7 coverage of service, but the doctor you met in consultation may not be the one on call when you come to the hospital in labour.

Postpartum

During the postpartum period, there are many new adjustments. We are a skilled team of obstetricians, nurses, midwives, family doctors and pediatricians that work to ensure safe care of the mother and newborn during the postpartum phase.

If you are a low risk client who had a hospital delivery, your discharge usually occurs 1 day postpartum. If you require a cesarean delivery, you will typically stay up to 3 days before being discharged.

The baby will need a follow up one-week post delivery in order to rule out failure to thrive and worsening jaundice. The follow up for moms and babies can be done by the midwife or family doctor at 6 weeks. If you require advice about a cesarean section wound or postoperative issue you may phone our office to determine if you need to be seen urgently.

Our community benefits from having a level 2B NICU in case the care of a premature baby is needed. Our hospital can take care of babies at 30 weeks and over, so many premature deliveries from outlying communities are transferred to our community for this level of care. The rooming in design of our NICU is family-friendly, so moms can sleep in the same room as their baby receiving intensive care.