Question-------------------------
Followup To
Question -
My friend got married and moved to an army base with her new husband and got on his insurance. We used to go to the same hospital for our pregnancy care (we are both pregnant) and our care was exceptional. Aside from the nightmare that is her new insurance carrier and the horrible runaround she has gotten, she can not be seen by a doctor until mid December. This means she will not have seen a doctor for over 3 months. She had a subchorionic hemmorhage in her first trimester, and has previous female complications. Is there anything she can do to receive better treatment and care, and should she be worried?
Answer -
What were the previous female complications that she had in the past? A subchorionic hemmorhage is not a problem and does not have to be watched. It resolves on its own. Usually, in the army bases, pregnant women are not seen until 12 weeks gestation (three months) and then are followed regularly every month for the remainder of the pregnancy. That is correct standard of care and she does not need more care unless she has some other problem. I'm sure that if she develops another problem (high blood pressure, diabetes, etc) they will accomodate her. Don't worry.
Follow up question: She had a life-threatening cyst rupture on her ovary, and never has used birth control since the age of 17 (she is now 28) and was told it would be very difficult for her to get pregnant without assistance. (that proved to be wrong!) Her pregnancy has been accomponied by regular, and to her, quite alarming cramping, off and on. Her concern is that she hasn't seen a doctor since the middle of September when she was around 12 weeks, and she is now 20 weeks along. That means she will be approximately 25 weeks when she next sees her doctor. She has not had an ultrasound since her first trimester. So, we should not worry that she will have gone from 12 weeks to 25 weeks without once being seen by a doctor, even though she has had cramping (that once put her in the emergency room - turned out she was ok) It will make her feel much better to hear that. However, I must wonder if it is ok not to be seen by a doctor for 13 weeks (the equivalent of 3 regular doctor visits) why then do my doctors, and most medical professionals, stress the importance of regular pre-natal care?
AnswerWe usually see a pregnant patient every 4 weeks until 28 weeks gestation. Then we see them every 2 weeks until 36 weeks gestation. Then we see them every week until the delivery of the baby. I see patients for their first obstetrical visit at 8 weeks from their last period. HOwever, other doctors will not see patients until they are 12 weeks pregnant (from the first day of their last period). If your friend has not seen a doctor for the past 8 weeks, she has missed two visits. She should see her doctor immediately. A sonogram should have been done at 20 weeks. Since ovarian cysts do not have anything to do with conception, I do not know who told her that it would be difficult to become pregnant. A rupture of the ovary is life threatening only because the ruptured fluid can cause pain and the cyst can twist. Otherwise, in 99% of the cases, ovarian cysts are not dangerous at all. It is very important for her to be seen every month (4 weeks) at this point.
