New England OB/GYN Associates, Inc.
The staff at NEOGA would like to congratulate you on your pregnancy! We welcome
you to our practice and are excited to guide you through this experience. NEOGA has
seven obstetricians: Dr. Vivian Hernandez, Dr. Mari Kim Bunnell, Dr. Merle Monsein,
Dr. Alice Vincent, Dr. Paula Kolbas, Dr. Lisa Lampert, and Dr. Thomas Connolly. You
will pick one obstetrician as your primary doctor, but you will be required to meet all the
physicians in our office. If you go into labor spontaneously, the doctor on call will deliver
your baby.
Please read this entire packet completely as it contains information regarding office
policies, prenatal testing, prenatal vitamins, diet recommendations, and information that
will be useful to you during your pregnancy. If you still have questions after reading this
packet do not hesitate to ask one of our physicians during an office visit or speak with a
nurse via email or the telephone. Below you will find an outline of the information in this
packet for easy reference.
Topic
General Office Information
Online Registration & NEOGA website information
General Obstetrical Information
Obtaining Test Results
Patient Education Tools
Parent Resources
Prenatal Vitamins
General Diet Recommendations
Fish & Mercury Information
Medicine Recommendations during Pregnancy
Cord Blood Information
Prenatal Testing Throughout Pregnancy
This is a guide of tests and visits you will have
Cystic Fibrosis Carrier Testing
Ashkenazi Jewish Genetic Panel
Revised 2-10-2010
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New England OB/GYN Associates, Inc.
Office Information
Office Hours:
Phone Numbers:
Web Site:
Monday – Friday
Main: 617-731-3400
http://www.neobgyn.org/
8:30 AM – 5:00 PM
Fax: 617-566-2224
Emergencies:
After hours call 617-731-3400 and briefly tell the answering service your problem. They
will page the appropriate medical personnel. If you do not get a response within 15
minutes, please call again. In an emergency, if you still haven’t received a response or
you simply cannot get through to the answering service call the Brigham and Women’s
Hospital, Labor and Delivery at 617-732-5435 and ask for the Nurse in Charge. Explain
your situation to her and she will contact one of our physicians.
Contacting the Office:
1. First check to see if the answer to your question is n the literature you have
received or on our website.
2. Try to call during the office hours.
3. If you think you have an emergency, call and tell us immediately – day or night.
4. Be sure to identify yourself, your month of pregnancy and any other pertinent
history (twins, strep culture, breech, history of premature labor, etc)
5. Make the call yourself, as relayed messages may not be accurate.
6. We will always try to answer your call as soon as possible but if it is not urgent,
please be patient.
Labor:
If you think you are in labor please call the office nurse during the day at ext 8. If you are
in labor after hours please call the main number 617-731-3400 and tell the answering
service you are in labor. Generally, when strong contractions are 5 minutes apart or if you
are leaking fluid or your water has broken, be prepared to go to the hospital. If you were
given other instructions or if there are special circumstances that exist- please call.
Revised 2-10-2010
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My Chart Access – please register!
We have a new service designed to enhance the way you can communicate with your
physician and manage your healthcare. We have added new capabilities to our practice
website www.neobgyn.org – My Chart Access so that you are able to:
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Request routine appointments
Ask for a prescription refill
View a summary of your medical chart
Update personal information (such as address or insurance)
Ask a billing question
Ask a nurse a question
Ask your provider a question
Our staff will return your message via a secure email. You can also complete forms
online that we could normally ask you to fill out at the office. The forms are then
transferred via a secure connection to your electronic medical record and reviewed prior
to your visit.
Registration is easy. Visit our registration site at
https://neoga.mymdcare.com/portal/RegistrationConsent.aspx
We will request some basic information about you (including your New England
OB/GYN ID number – ask the registration or scheduling desk for your unique number or
call the Office Supervisor-Geneva) to verify against our records and you will be able to
register with a username and password to quickly access online services.
If you have any questions please contact Geneva (ext. 117) at our main phone number
617-731-3400. We look forward to your participation in this service!
Brigham and Women’s Hospital Registration
In addition to registering for My Chart Access you must obtain a medical record number
from Brigham and Women’s hospital. Before your first visit to NEOGA call: 781-9601101 or 866-489-4056. You will need your insurance card information to register at
BWH so have it ready when you call.
Revised 2-10-2010
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New England OB/GYN Associates, Inc.
Obstetrical Information
Parent and Childbirth Education Classes:
The birth of a baby is an exciting experience. We offer a number of options that allow
you to participate fully and to be as prepared as possible. There will be many personal
decisions for you to make. How can the father or support person be most helpful at birth?
Do you prefer to breastfeed or bottle-feed the baby? How can you help other children
adapt to the new baby?
In order to arrive at the best answers for you, mothers and support persons may select
various prenatal classes, childbirth preparation programs, refresher classes, sibling
classes, and new parent workshops are offered by ISIS Maternity an affiliate of Brigham
and Women’s Hospital. Early registration is encouraged- ISIS Maternity can be contacted
at 617-264-4747 or http://www.isismaternity.com/. You can register for Brigham and
Women’s hospital tours at http://www.isismaternity.com/hospitals/bwh_tours
or by calling (617) 732-4081.
Choosing a Pediatrician:
You must select a pediatrician or family practitioner to care for your baby during your
hospital stay and thereafter. If your chosen pediatrician does not have privileges at the
Brigham and Women’s Hospital, we will be happy to provide a local pediatrician who
can care for your baby during the hospital stay. Please call the BWH Physician referral
line if you need assistance at 1-800-294-9999.
Fees, Billing and Collection Policies:
We will verify your insurance after your first visit and determine your financial
responsibility based on your benefits, deductible and co-payment. PLEASE BE SURE
TO LET US KNOW IF YOUR INSURANCE CHANGES DURING THE
PREGNANCY. Based on your particular insurance we will determine when fees are
payable. All labs, ultrasounds, amniocentesis, fetal non stress tests, circumcision fees and
medications are separate from the global delivery fee and will be billed to you as such.
All insurance claims will be filed to your insurance company by our office. However,
after 60 days this balance becomes the patient’s responsibility regardless of the insurance
claim status and may be subject to collection.
Hospital Fees:
These charges are separate from our charges and will be billed by the hospital. Please call
the phone number on the hospital statement if you have questions.
Revised 2-10-2010
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Test Results:
Routine test results during your pregnancy will be discussed at your next visit. Routine
tests include the initial prenatal panel, GLT (glucose loading test), and group B strep.
If you have one of the following tests listed below and do not hear from the office within
2 weeks please call 617-731-3400 option 4.
Sequential Integrated Testing (7-12 days)
AFP
Genetic Screening
CVS
Amniocentesis
If you would rather communicate via email use our secure messaging at
http://www.neobgyn.org/ (click on My Chart Access/Patient Service/Ask a Nurse)
New England OB/GYN Associates, Inc.
Patient Education Tools
The majority of our patient education information is available via our website – it is very
important that you take the time to review this information – if you have any questions
about the information please ask your provider. If you do not have access to a computer
we have one in our office waiting area for patients or we can request the BWH
Information for you.
Go to our website: www.neobgyn.org
On the left hand side click on PATIENT EDUCATION.
Obstetrical Patients
BWH Guide to Understand and Enjoying your Pregnancy
http://www.brighamandwomens.org/patient/GuideExpecting.pdf
Having your Baby at BWH
http://www.brighamandwomens.org/patient/GuideforExpectantParents.pdf
BWH Pregnancy Planner
http://www.brighamandwomens.org/patient/pregnancy_planner.aspx
Power Snacking for Pregnancy
Losing Baby Fat
Cord Blood Banking
Revised 2-10-2010
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Information on all of the above can be found at:
http://www.brighamandwomens.org/womenshealth/obgyn.aspx
BWH Online Health Information
Please go to the LINKS page to obtain information about organizations that can provide
useful information or services.
New England OB/GYN Associates, Inc.
Parent Resources
Learning to parent does not come automatically after the birth of a baby. It is a learning
process that takes time, patience and a sense of humor. Help yourself by reading about an
infant’s expected growth and development. Seek out the support of your friends and
family, and pediatric care provider. When the opportunity arises, talk with other patients
or join parenting support groups. Parents need the support of each other during this time.
Most importantly, remember that infancy passes quickly, so enjoy the adventure and
discovery of each day as your family develops.
To support your emotional and physical needs during a pregnancy and the postpartum period,
we have compiled this list of available community services, should you need them.
PARENTING SUPPORT
ISIS MATERNITY
617-264-4747
2 Brookline Place
Brookline, MA 02445
www.isismaternity.com
A place for expecting and new Moms, New Mom groups, Mom & Baby yoga, postpartum fitness, retail
store and more.
WARMLINES PARENT RESOURCES OF NEWTON
617-244-4636
www.warmlines.org
Runs workshops, new mothers’ support groups, drop-in playgroups. “Matching Moms” programs,
computerized childcare referral program and “sitter solutions”
MASSACHUSETTS DEPRESSION AFTER DELIVERY
1-800-944-4773
Offers support groups, education and individual referral for women experiencing postpartum mood
changes and depression.
PARENTS HELPING PARENTS OF MASSACHUSETTS
617-267-8077
1-800-882-1250
Offers referrals to self-help groups for parents.
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MOM-TO-MOM JEWISH FAMILY SERVICES-FRAMINGHAM
508-875-3100
Provides home visiting problems and drop-in groups for new moms.
VISITING MOMS PROGRAM, JEWISH FAMILY AND CHILDREN’S SERVICES
617-558-1278
www.jfcs.org
Servicing families of all faiths with programs to support new mothers in regards to feeding, pregnancy
loss, postpartum adjustments, etc.
FAMILIES FIRST
617-868-7687
www.families-first.org
Helping parents build positive relationships with their children may charge a fee.
IMMUNIZATION, DEPARTMENT OF PUBLIC HEALTH
617-983-6800
Offers immunization information.
HOME POSTPARTUM CARE
The following agencies provide a variety of post-partum care services, including newborn
care and homemaking (meals, laundry, house cleaning, errands and sibling care). These
agencies are fee-for-service. Brigham and Women’s Hospital or New England Ob/Gyn
Associates does not incur any liability for the services of these professionals.
NEWBORN SUPPORT SERVICES BROOKLINE
617-965-0315
Provides at home visits to teach and assess infant care and breastfeeding, and provide postpartum
support.
NITE NANNIES
781-821-1200
TRILLIUM DOULAS-LABOR AND POSTPARTUM DOULAS
508-224-7093
Doulas are women who care for women during labor, birth and postpartum
SOSTEK-NEWBORN CARE
617-244-7093
BLUEBIRDS-CARE OF MULTIPLES
978-440-9948
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BREASTFEEDING SUPPORT
BRIGHAM & WOMEN’S HOSPITAL LACTATION CONSULTANTS
617-732-8045
75 Francis Street
Boston, MA 02115
Offers daily in-hospital breastfeeding classes and Breast Pump rentals: 617-732-7092. Call
Lactation consultant contact in your area (fee-for-service)
NURSING MOTHERS COUNCIL OF GREATER BOSTON
617-244-5102
Offers phone counseling, breast pump rental information and support groups.
DRUG INFORMATION CENTER AT THE UNIVERSITY OF ROCHESTER, NY
716-275-0088
Offers drug information for breastfeeding mothers (Call your pediatrician first)
BREAST PUMP RENTALS
Some health insurance policies cover breast pump rentals if written as a prescription by the
pediatrician for the baby, especially if the baby is in the Neonatal Intensive Care Unit.
BWH LACTATION SUPPORT SERVICE
617-732-7092
75 Francis Street
Boston, MA 02115
MEDELA, INC.
1-800-435-8316
Offers listing of rental stations, breastfeeding consultants and catalog of breastfeeding products.
HOTLINES/HELPLINES/CRISIS INTERVENTION AVAILABLE 24 HOURS A
DAY OR AS NOTED
PARENTAL STRESS LINE
1-800-682-8188
Trained volunteers are available 24 hours a day to listen and offer referrals.
POISON CONTROL CENTER
617-232-2120
1-800-682-9211
Provides 24-hour information about emergency measures for accidental poisoning.
CHILD AT RISK: DEPARTMENT OF SOCIAL SERVICES
1-800-792-5200
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Offers phone consultation on suspected child abuse cases. Available after 5 p.m. and on weekends.
During the week, call local Department of Social Services office at 617-748-2000.
STATEWIDE ALCOHOL AND DRUG HOTLINE
1-800-327-5050
Provides counseling and referral to a wide variety of drug and alcohol services, including mother-baby
programs. Available until 11 p.m.
MASSACHUSETTS COALITION OF BATTERED WOMEN-JANE DOE, INC.
617-248-0922; available 9 a.m. – 5 p.m.
14 Beacon Street
Boston, MA
TRANSITION HOUSE (DOMESTIC VIOLENCE)
617-661-7203
24-hour hotline offering counseling, shelter and referral for women and their children. Spanishspeaking counselors available.
SAMARITANS SUICIDE PREVENTION
617-247-0220 or 617-247-8050
24-hour hotline for depressed and suicidal individuals.
NATIONAL CONSUMER PRODUCT SAFETY COMMISSION
1-800-638-2772
Product safety hotline.
MASSACHUSETTS HEARING EVALUATION PROGRAM FOR INFANTS AND TODDLERS
1-800-882-1435
MA CITIZENS FOR CHILDREN (MCC)
1-800-CHILDREN
www.masskids.org
Protecting children against sexual abuse.
NATIONAL CENTER FOR MISSING AND EXPLOITED CHILDREN
www.missingkids.com
1-800-843-5678
SAFELINK
1-877-785-2020
24-hour hotline for battered women
CHILDHOOD INJURY PREVENTION PROGRAM
BOSTON PUBLIC HEALTH COMMISSION
617-534-5197
Revised 2-10-2010
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CAR SAFETY
CAR SEAT CHECK
www.seatcheck.org
CHILD PASSENGER SAFETY INFORMATION
www.fitforakid.org
NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION
www.nhtsa.dot.gov
MASSACHUSETTS AUTO SAFETY INFORMATION LINE
1-800-CAR-SAFE (1-800-227-7233)
Offers car seat safety information.
AUTO SAFETY HOTLINE-U.S. DEPARTMENT OF TRANSPORTATION
1-800-424-9393
For information on recalls, safety notices and replacement parts for car seats
CHILDCARE RESOURCES
HARVARD UNIVERSITY CENTER FOR PARTENTING
617-432-1615
Offers assistance on a variety of family-related issues.
CHILDCARE RESOURCE CENTER, INC.
CAMBRIDGE
1-617-547-1063
1-617-547-9861
MASSACHUSETTS SOCIETY FOR PREVENTION OF CRUELTY TO CHILDREN, BOSTON
617-983-5800
Provides information regarding parent education, mothers support groups and referrals to community
resources.
CHILD CARE CHOICES OF BOSTON
617-542-5437
PROJECT BABY AT BOSTON MEDICAL CENTER
617-414-6012
PARENTS-IN-A-PINCH CHILD CARE
617-739-KIDS
FINANCIAL ASSISTANCE
BOSTON MAYOR’S HEALTHLINE
617-534-5050
Offers information and referrals to health care for Boston residents with low income and no health
insurance.
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Available 9 a.m. to 5 p.m., Monday through Friday
WIC (WOMEN, INFANTS AND CHILDREN)
1-800-942-1007
GREATER BOSTON LEGAL SERVICES
617-371-1234
MULTIPLES SUPPORT GROUPS
MA MOTHERS OF TWINS
781-646 TWIN
KEEPING PACE WITH MULTIPLE MIRACLES
www.keepingpace.org
BLUE BIRDS-MOTHER/INFANT CARE FOR MULTIPLES
978-440-9948
WWW.TWINSMAGAZINE.COM
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New England OB/GYN Associates, Inc.
Prenatal Vitamins
Prenatal vitamins are available over the counter at most pharmacies. We
have listed some recommendations below. All prenatal vitamins should
contain at minimum 27 milligrams of iron and 800 micrograms of folic acid.
Supplemental DHA may also be taken – 200 milligrams daily. There are
combined products available. In most cases it is more cost effective to
purchase your prenatal vitamins over the counter than through your health
insurance as a prescription.
CVS Prenatal Vitamins & Enfamil Expecta (DHA) – these are 2 separate
products
Walgreens Pharmacist Support Prenatal Plus DHA – this is a combined
product
One A Day Women’s Complete Prenatal Vitamin plus DHA Liquid Gel tabs
- this is combined product
Similar products are available at other pharmacies - please confirm with
your pharmacist that these ingredients are included in the vitamins:
27 milligrams of iron
800 micrograms of folic acid
200 milligrams of DHA (optional)
If you are pregnant with twins – total of 2 mg of folic acid and 60 mg of
iron.
If you have any questions regarding your prenatal vitamins please contact
our office at 617-731-3400 option 2 or via our website www.neobgyn.org
(My Chart Access then “Ask a Nurse” option).
Revised 2-10-2010
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NEW ENGLAND OB/GYN ASSOC.
GENERAL DIET RECOMMENDATIONS
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Thoroughly cook all raw meats and fish.
Wash raw vegetables thoroughly before eating.
Keep uncooked meats separate from vegetables and from cooked and ready to eat
foods.
Wash hands, knives, and cutting boards after handling uncooked meats and dairy
products.
Avoid unpasteurized milk or beverages or foods make from raw milk
Always thaw ready to eat frozen food in the refrigerator or microwave, not on a
counter.
Thoroughly reheat food until steaming hot.
Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican style
cheese (hard cheeses, processed cheeses, cream cheese, and yogurt need not be
avoided).
Hot dogs and luncheon meats (cold cuts) should be heated (or microwaved) until
steaming hot.
Avoid refrigerated pates or meat spreads.
Avoid refrigerated smoked seafood (Lox, Nova) – okay if in a casserole and cooked.
See advice for Large Atlantic fish (mako shark, swordfish, tuna, king mackerel)
below.
Avoid deli potato/pasta salads and coleslaw unless fresh and reliable.
Limit caffeine to one cup of coffee or equivalent per day.
No smoking or alcohol.
Revised 2-10-2010
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MERCURY IN FISH AND SHELLFISH
U.S. FOOD AND DRUG ADMINISTRATION
U.S. ENVIRONMETAL PROTECTION AGENCY
Fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high
quality protein and other essential nutrients, are low in saturated fat, and contain omega-3
fatty acids. Women and young children should include fish or shellfish in their diets due
to the many nutritional benefits.
However, nearly all fish and shellfish contain traces of mercury. For most people, the risk
from mercury by eating fish and shellfish is not a health concern. Yet, some fish and
shellfish contain higher levels of mercury that may harm an unborn baby or young child’s
developing nervous system. The risks from mercury in fish and shellfish depend on the
amount of fish and shellfish eaten and the levels of mercury in the fish and shellfish.
Therefore, the FDA and the EPA are advising women who may become pregnant,
pregnant women, nursing mothers, and young children to avoid some types of fish and
eat fish and shellfish that are lower in mercury.
3 Safety Tips
By following these 3 recommendations for selecting and eating fish or shellfish, women
and young children will receive the benefits of eating fish and shellfish and be confident
that they have reduced their exposure to the harmful effects of mercury.
1. Do not eat shark, swordfish, king mackerel, and tilefish because they all contain high
levels of mercury.
2. Eat up to 12 ounces (2 average meals) a week of a variety of fish and shellfish that are
lower in mercury.
 Five of the most commonly eaten fish that are low in mercury are shrimp,
canned light tuna, salmon, pollock, and catfish.
 Another commonly eaten fish, albacore “white” tuna has more mercury than
canned light tuna. So, when choosing your two meals of fish and shellfish,
you may eat up to 6 ounces (one average meal) or albacore tuna per week.
3. Check local advisories about the safety of fish caught by family and friends in your
local lakes, rivers, and coastal areas.
 If no advice is available, eat up to 6 ounces (one average meal) per week of
fish you catch from local waters, but don’t consume any other fish during that
week.
Follow these same recommendations when feeding fish and shellfish to your young child, but serve
smaller portions.
FDA’s toll-free line 1-888-SAFEFOOD
FDA’s Food Safety website www.cfsan.fda.gov/seafood.html
Environmental Protection Agency’s Fish Advisory website www.epa.gov/ost/fish
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EPA’s actions to control mercury: www.epa.gov/mercury
NEW ENGLAND OB/GYN ASSOC.
MEDICINE RECOMMENDATIONS
The following medications are generally considered safe in pregnancy if taken as
prescribed and used in moderation:
Pain Relief:
Tylenol (Acetaminophen)
 Avoid all products containing aspirin and ibuprofen (Motrin, Advil, Nuprin,
Aleve, etc.)
 Avoid Pepto-Bismol as it contains aspirin.
Cold and Flu or Allergy
Tylenol Cold
Robitussin
Zyrtec
Benadryl
Sudafed
Chortrimeton
Claritin
Antibiotics
There are many antibiotics that are generally considered safe in pregnancy if you are not
allergic to them. Please consult your doctor before taking any antibiotics. Topical
bacterial creams for the skin (bacitracin, etc.) are safe.
Stool Softeners
Metamucil
Colace
Senokot
Milk of Magnesia
Glycerine suppositories (check with provider if history of early deliveries)
Dulculox suppositories (check with provider if history of early deliveries)
Antacids
Mylanta
Maalox
Tums
Zantac
Pepcid Complete or Pepcid AC
Sleeping Aid
Tylenol PM (acetaminophen + benadryl). Not recommended every night.
Revised 2-10-2010
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Cord Blood Banking: Is It for Me?
Massachusetts Department of Public Health Information
for Families
Please visit the following web site for information regarding Brigham and
Women’s Cord Blood Donation Program or ask for an informational packet
at your next visit.
http://www.brighamandwomens.org/womenshealth/corddonor/value.aspx?su
bID=submenu2
What are cord blood banks?
Cord blood banks freeze and store blood and blood products from the placenta and/or
umbilical cord.
Why do some families bank their babies’ cord blood?
Stem cells can be obtained from stored cord blood and used in stem cell transplants to
treat some diseases, including certain genetic diseases, cancers and disorders of the blood
and immune system. Researchers are trying to learn how to use stem cells to treat other
conditions in the future.
Some families donate cord blood to support treatment and medical research. Others save
it in case a family member needs a stem cell transplant.
Do I need to plan for cord blood banking before my baby is born?
Yes, if you want to save the cord blood. To save it, you must sign a consent form and
other agreements with a cord blood bank, usually several weeks before the baby is born.
How is the cord blood collected? Does the collection always work?
Cord blood is collected after the baby is born and the umbilical cord is cut. The delivery
room medical staff or a technician collects the blood from the cord and the placenta.
Sometimes, the collection does not produce enough stem cells or the cord blood is
otherwise unsuitable for transplant. When this happens, the stem cells are not transplant
quality and may not be useful for treatment, but may be used for research.
Does collecting cord blood pose any risks to me or my baby?
There are no physical risks. The delivery of the baby is the same, whether you save the
cord blood or not.
Many banks require the mother’s blood to be tested for infectious diseases and genetic
conditions. As a result, you may learn about a disease or condition that you did not know
about previously. The bank may be required by law to report your test results to public
Revised 2-10-2010
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health officials. Read the consent form carefully and talk with your physician about any
concerns you have.
What kinds of banks collect cord blood from infants born in MA?
There are two kinds of banks: private and public. Public banks, which may be operated
by private corporations, accept donations for research and treatment for anyone in need.
Families pay private banks to store the blood for exclusive use by their child or family
members. Several public and private banks store cord blood for MA families. Turn this
page over to compare costs, benefits, and risks of each kind of bank.
Who can help me learn more about cord blood banking?
 Talk with your primary care doctor, obstetrician, pediatrician and other
medical providers. You may want to discuss your family’s medical history,
risk for diseases, treatment options, and the likelihood of finding a stem cell
match from a stranger, if a stem cell transplant were ever needed.
 Contact banks about their procedures and about the agreements you will sign
with them. Public and private banks advertise on the internet and answer
questions by phone. Ask them who can use the cord blood after collection,
where it is stored, how it is stored, and how your privacy is protected.
 The national Marrow Donor Program’s Center for Cord Blood has a website
www.marrow.org with cord blood information for parents. The National Cord
Blood Program also has a web site www.nationalcordbloodprogram.org
REMEMBER: Information is changing quickly. Only time will tell which additional
diseases stem cell transplants will be able to treat and how long cord blood can be stored.
Carefully review materials from many different sources. Use these materials when you
prepare to talk with your doctor about cord blood banking.
Revised 2-10-2010
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Cord Blood Banks: Public vs. Private
Public Cord Blood Banks
The family pays no fee to the public bank
Costs
MA law says that the family may not be
charged for cord blood collection, including
by the physician or hospital that delivers the
baby or for storage when donations are for
research.
Benefits
Your donation may help others. Anyone in
need who is a good match may use it. It is
not reserved for you or your family.
Your donation will help ensure that people
of diverse ethnic and racial backgrounds
who need transplants will get them and that
research will benefit everyone.
Cells that are not transplant quality can be
used instead for research that may help your
family and others in the future.
Risks
If donors need a transplant, some banks
may provide stem cells free of charge if a
good match is available.
If the donor child or other family member
needs the donated stem cells, they may not
be available. If a good match is available
elsewhere, you may have to pay those cells.
Your donation is “owned” by the bank. The
bank controls what happens with it, within
the limits of your consent.
 Review the consent forms carefully
 You may want to get information about
the bank’s history
 What types of stem cell research or
treatment does the bank support?
 Does the bank sell some of its cord
blood to other companies or
researchers?
 Does the bank use the cord blood to
create products for sale?
Private Cord Blood Banks
The family pays fees to private banks.
Compare the fees:
 Are fees fixed or allowed to increase
over time?
 Is there any refund if the collection is
not transplant quality?
Ask if your doctor or hospital charges fees
for collection and who pays those fees.
Cells you bank are held for you, so if your
child or a family member requires a
transplant later and your stored cells are
transplant quality, you can use them.
If a sibling has a treatable condition, it may
be possible to treat the condition with the
newborn’s stem cells.
In the future, if research succeeds in
finding ways to treat other conditions, cord
blood you stored at the time of birth may
be available to your family for the newest
types of treatment.
You may pay for something you do not
use, for at least three reasons:
1. Very few families will ever have a
need for stored cord blood. Most
families that have used cord blood
stem cells in the past already had an
older child who needed treatment
when they chose to save the cord
blood.
2. Some stored blood does not yield
transplant quality cells.
 Compare how the banks ensure
the quality of the cord blood.
 Find out if there is quality testing
before the blood is stored
3. In some cases, it may be better to use
stem cells from someone else. For
example, some children with leukemia
may have leukemic cells in their own
cord blood
Find out what happens to your stored stem
cells if the company goes out of the cord
blood business or if you are unable to pay
storage fees.
Revised 2-10-2010
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New England OB/GYN Associates, Inc.
PRENATAL TESTING
First Trimester
When you first become pregnant, we will schedule you for an 8 week nursing visit or
phone call. At this visit the nurse will order a standard prenatal lab panel which consists
of a blood draw testing for blood type, rh factor, complete blood count, etc.
You will also meet with the physician for a full physical at 10 weeks. At this visit you
will have a full physical which includes a breast exam, pelvic exam, and pap test. During
this visit you will also hear the baby’s heart beat. At this time the doctor will review the
First Trimester Screening test, which is an early risk assessment for Down Syndrome and
Trisomy 18/13. If you decide to have this testing you will have your blood drawn at 10
weeks and the doctor will schedule you for a 12 week ultrasound.
After your 10 week appointment you will see the physician approximately every 4 weeks.
Second Trimester 12 – 18 weeks
Most women will return to the office at 15 weeks to see the physician (you will have part
2 of the sequential done at this time if you consent to this testing). Then you will have an
ultrasound (18 week fetal survey) and appointment with the doctor during your 18th
week. Around week 25-28 you will have the glucose tolerance test (orange drink and
blood draw). You should be meeting all of the OB providers at this time.
Third Trimester 28-40 weeks
During weeks 32-36 you will be seeing the physician about every 2 weeks. At 35 weeks
your physician will start performing pelvic exams and will also conduct a vaginal swab
testing for group B strep.
During weeks 36-40 you will see the physician each week and the physician will continue
conducting pelvic exams at this time.
Test Results:
Routine test results during your pregnancy will be discussed at your next visit. Routine
tests include the initial prenatal panel, GLT (glucose loading test), and group B strep.
If you have any other testing done your physician will inform you of the time it will take
to obtain the results. For non-routine test results please call the office and use ext. 4.
If you would rather communicate via email use our secure messaging at
http://www.neobgyn.org/ (click on My Chart Access/Patient Service/Ask a Nurse)
Revised 2-10-2010
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New England OB/GYN Associates, Inc.
PRENATAL TESTING
Cystic Fibrosis
The following information was gathered from the Quest Diagnostic website
www.questdiagnostics.com. Go to the Patient Health Library and then type in Cystic
Fibrosis Carrier Screening or Ashkenazi Jewish Population Carrier Screening.
You can also go to http://www.questdiagnostics.com/kbase/topic/centers/center1030.htm
which is part of the quest website dedicated to topics involving pregnancy and labor.
What Is Cystic Fibrosis?
Cystic fibrosis (CF) is an inherited disease caused by a change (mutation) in the cystic
fibrosis transmembrane regulator (CFTR) gene. It is a chronic, progressive disease that
causes mucus to become thick and sticky. The mucus builds up and clogs passages in
many of the body's organs, but primarily in the lungs and the pancreas. In the lungs, the
mucus can cause serious breathing problems and lung disease. In the pancreas, the mucus
can cause digestive problems and malnutrition, which can lead to problems with growth
and development.
Cystic fibrosis is usually diagnosed during childhood. On average, people who have
cystic fibrosis live into their mid-to-late 30s, although new treatments are making it
possible for some people to live into their 40s and longer.
What Causes Cystic Fibrosis?
Cystic fibrosis is a genetic disorder. A child must inherit two defective CF genes (one
defective gene from each parent) to have the disease.
A person who has inherited only one defective CF gene is a carrier of cystic fibrosis and
does not have the disease but can pass it on to his or her children. This person can also
pass on carrier status.
 If only one parent is a carrier of a defective CF gene, the child will not have CF.
But there is a 50% (1-in-2) chance that the child will be a CF carrier.
 If both parents are carriers, there is a 25% (1-in-4) chance that the child will have
CF, but a 50% chance that the child will be a carrier.
What is the cystic fibrosis carrier screening?
 Inherited, or genetic, diseases like cystic fibrosis (CF) are passed from parents to
their children. This often occurs when neither parent has the disease. For a child
to inherit CF, both parents must have an altered gene that causes CF; that is, both
parents must be carriers of an altered CF gene.
 CF carrier screening tells you what your chance, or risk, is for carrying an altered
CF gene. Carrier screening can also tell you what your chance is of having a child
with CF. Carrier screening, cannot, however, tell you if your child will have CF.
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Who Should Be Screened?
Genetic testing is available to screen people who want to determine whether they may be
carriers of CF. This type of genetic testing allows parents to find out if they have an
increased chance of having a child with CF. Anyone who is interested in knowing his or
her carrier status can request the test, but the test can be ordered only by a health
professional. Genetic counseling to help you understand the meaning and possible results
of the test is recommended prior to genetic testing.
CF carrier screening is recommended for:
 Adults with a positive family history of CF.
 Partners of people with CF. If one partner has CF and the other partner has the
defective CF gene, a child will have a 50% chance of having CF.
 Couples planning to have children.
 Pregnant women (and their partners) who seek prenatal care, regardless of family
history.
What If I Am a Carrier?
If tests show that you are a carrier of CF, your partner should also be tested. Both parents
must be carriers of CF for a child to have the disease. If tests show that your partner is not
a carrier of the CF gene, there is a very small chance that you will have a child with CF.
If you and your partner are both carriers of CF there is a 1-in-4 (25%) chance that your
child will have CF.
 If you are not already pregnant, you may wish to have genetic counseling to
understand your risks and options if you decide to have children.
 If you are already pregnant, you may wish to have further testing (amniocentesis
or chorionic villus sampling) to determine whether your baby has CF.
Is Screening Accurate?
The blood test can detect whether a person is a carrier of CF in about 90 out of 100 CF
carriers. This rate is not the same among all racial and ethnic groups. There is a small risk
that you may be a CF carrier even when the test results are negative.4
Why Not Be Screened?
There may be reasons you would choose not to have carrier testing.
 You think that your risk of being a carrier is low. This may be true if you are an
African American or an Asian American. The incidence of CF is lower in these
groups.
 You are already pregnant and the information obtained from testing will not affect
your decision to continue your pregnancy. Remember, though, that CF test results
can provide valuable information for the care of your unborn child.
 Carrier testing is expensive. You may decide not to have testing if your insurance
does not pay for it.
 Testing does not identify all people who have a mutation in the CF gene. There is
a small chance that you are a carrier even if the results are normal (negative).
For Further Information you can go to:
Cystic Fibrosis Foundation at www.cff.org
Revised 2-10-2010
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6931 Arlington Road
Bethesda, MD 20814
Phone: 1 800 FIGHT CF or 301 951 4422
Fax: 301-951-6378
Email: info@cff.org
Genetic Alliance at www.geneticalliance.org
4301 Connecticut Avenue NW
Suite 404
Washington DC 20008-2369
Phone 1 800 336 GENE or 202 966 5557
Fax: 202 966-8553
Email: info@geneticalliance.org
Carrier Screening in the Ashkenazi Jewish Population
What are Ashkenazi Jewish Genetic Diseases?
Ashkenazi Jewish genetic diseases are a group of rare disorders that occur more often in
people of Eastern European (Ashkenazi) Jewish heritage than in the general population.
Even though most of these diseases are severe and life-limiting, some can be treated to
reduce symptoms and prolong life. Some of these diseases can be found during
pregnancy through chorionic villus sampling (CVS) or amniocentesis. This testing is
done usually if one or both parents are carriers of a genetic disease.
Diseases in this group include:
 Bloom syndrome. Babies with this disease are born small and remain shorter than
normal as they grow. Their skin may look red, and they have more lung and ear
infections than children normally have.
 Canavan disease. This disease gradually destroys brain tissue.
 Cystic fibrosis. This disease causes very thick mucus in the lungs and problems
with digesting food.
 Familial dysautonomia (FD). People with this problem cannot feel pain, they
sweat a lot, and they have trouble with speech and coordination.
 Fanconi anemia. People with this problem do not have enough blood cells and
have problems with the heart, kidneys, arms, or legs. They also are more likely to
get cancer.
 Gaucher disease. This disease causes a type of fat called glucocerebroside to build
up in certain cells of the liver, spleen, and bone marrow.
 Mucolipidosis IV. This problem causes the nervous system to break down, or
deteriorate, over time.
 Niemann-Pick disease (type A). This disease causes a type of fat called
sphingomyelin to build up in cells of the liver, spleen, lymph nodes, and bone
marrow.
 Tay-Sachs disease. This disease causes a type of fat called ganglioside to build up
in the cells of the brain and nervous system.
Revised 2-10-2010
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
Torsion dystonia. People with this problem have ongoing spasms that twist the
muscles in their arms, legs, and sometimes their body. Testing for this condition
may not always be done.
What Is an Ashkenazi Jewish Genetic Panel (AJGP)?
An Ashkenazi Jewish genetic panel (AJGP) is a blood test that looks for genetic diseases
that occur more often in people of Eastern European (Ashkenazi) Jewish heritage. These
diseases do not just affect people of Ashkenazi Jewish heritage but are more common in
this group of people. Other racial and ethnic groups have genetic diseases that are more
common in their groups.
An AJGP test tells parents if they have an increased chance of having a child with certain
genetic diseases. Anyone who is interested in knowing his or her carrier status can ask for
the test, but a doctor must order the test. Different labs may have different tests in the
panel.
Talk to your doctor about which diseases are important for your family. Genetic
counseling can help you understand the test and possible results so you can make the best
decision for you
What Is Carrier Screening?
A carrier is a person who can pass a genetic disease on to his or her children but does not
have the disease. Carrier identification is a type of genetic test that can help show
whether people of high-risk groups (certain ethnic groups or a family history of a disease)
for a specific disease are likely to pass that disease to their children. This type of test can
guide a couple's decision about having children and making choices about diagnostic
tests during a pregnancy.
An Ashkenazi Jewish genetic panel (AJGP), done on a blood sample, can see whether
you or your partner is a carrier of genes that cause certain genetic diseases. If positive, the
test can help show whether you and your partner have an increased chance of having a
child born with one of these diseases.
Who Should Be Tested?
Genetic tests can be done for anyone who wants to know whether he or she is a carrier of
certain diseases. The Ashkenazi Jewish genetic panel (AJGP) shows the chance of having
a child with a disease that is more common among people of Eastern European Jewish
heritage. Anyone who is interested in knowing his or her carrier status can ask for the
test, but a doctor must order it.
Genetic test results often raise ethical, religious, or legal concerns. You should have
genetic counseling before making a decision about testing. Genetic counselors are trained
to explain the test and its possible results clearly. A genetic counselor can help you make
well-informed decisions.
An AJGP may be recommended for people of Eastern European Jewish heritage,
including:
 Partners of people with diseases on the test panel. For example, if one partner has
cystic fibrosis (CF) and the other partner has the CF gene change; a child will
have a 50% chance of having CF.
 Couples planning to have children.
Revised 2-10-2010
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

Pregnant women (and their partners) who seek prenatal care, whether they have a
history of genetic diseases or not.
Adults with a positive family history of a disease that is on the test panel.
What if I Am a Carrier?
It is more common to be a carrier of a genetic disease, such as cystic fibrosis (CF), than
to have the disease. If tests show that you are a carrier of a disease, your partner should
also be tested. Both parents must be carriers of a disease for a child to have the disease.
The tests are not 100% accurate, so a person may test negative and yet be a carrier. If you
are a carrier and your partner tests negative, there is still a very small chance that you will
have a child with the disease.
If you and your partner are both carriers of a genetic disease, there is a 1-in-4 (25%)
chance that your child will have the disease.
 If you are not already pregnant, you may wish to have genetic counseling to
understand your risks and options if you decide to have children.
 If you are already pregnant, you may wish to have tests, such as amniocentesis or
chorionic villus sampling, to help find out whether your baby has a disease.
Is the Test Accurate?
About 90% of the time, the test accurately shows whether or not a person is a carrier of
an Ashkenazi Jewish genetic disease. So, there is a small chance that you may be a carrier
of one of these diseases even if the test results are negative.1
Should I Be Tested?
The decision to be tested is a personal one. You may wish to be tested if you are
concerned that you or your partner might be a carrier of a disease that is on the test panel.
Being a carrier is more likely if you have a family member with the disease.
Some people decide to be tested to know their chances for having a child with a disease.
For example, among people of Eastern European Jewish heritage, about 1 in 25 is a
carrier of a gene for cystic fibrosis (CF). The CF gene is less common in other racial and
ethnic groups.
Carrier tests are expensive. Another factor that may guide the decision to have the tests is
whether the cost of the tests is covered by your insurance company.
You may decide to have carrier tests if you are already pregnant and the test results will
affect your decision to continue your pregnancy or help you make decisions about caring
for your baby.
Why Not Be Tested?
There may be reasons you would choose not to have the carrier tests.
 You are already pregnant and the results will not affect your decision to continue
your pregnancy.
 Carrier tests are expensive. You may decide not to have the tests if your insurance
does not pay for it.
 The tests are not 100% accurate. There is a small chance that you are a carrier
even if the results are normal (false-negative).
Revised 2-10-2010
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