Top Doctors: Pregnancy and ultrasound

Burton Rochelson, M.D., Chief of Maternal-Fetal Medicine, North Burton Rochelson, M.D., Chief of Maternal-Fetal Medicine, North Shore LIJ Health System, and Professor of Obstetrics and Gynecology, Hofstra North Shore LIJ School of Medicine, shown with a sonogram machine. (August 9, 2011) Photo Credit: Newsday/Karen Wiles Stabile

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For pregnant women, ultrasound examinations are about more than producing a nifty sonogram photo to show family and friends. They serve as important tools for physicians to monitor the growth of a fetus.

No matter how many sonograms are needed, they're considered safe for women and their unborn children, said Dr. Michael Gentilesco, an obstetrician-gynecologist in Smithtown. "That's important to women who need multiple sonograms," he said. "There doesn't seem to be any risk or cumulative risk."

Here's what you should know about prenatal sonograms, or pregnancy ultrasounds:

1. AN ULTRASOUND CAN INDICATE WHEN YOUR BABY WILL BE BORN.

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"The most common use of ultrasound is to accurately date the pregnancy and determine the woman's due date," said Dr. Natalie Meirowitz, chief of maternal-fetal medicine at Long Island Jewish Medical Center. "Before ultrasound was widely available, we dated a pregnancy using a woman's last menstrual period."

The problem with that approach, Meirowitz said, is that women sometimes don't remember when they had their last period, or their periods may be irregular.

2. ULTRASOUNDS DETECT SIGNS OF PROBLEMS.

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The first ultrasound in a pregnancy, typically within the first three months, confirms whether a woman is having a potentially dangerous ectopic pregnancy, Meirowitz said. At about 20 weeks, ultrasounds are used to detect a variety of birth defects and other abnormalities, although "most ultrasound exams are reassuring and show that the fetus is healthy and growing normally," she said.

In other cases, however, an ultrasound detects problems with the structures of the body, such as organs and bones that are too small or too big, said Dr. Burton Rochelson, chief of maternal-fetal medicine for North Shore-LIJ Health System. That may alert doctors to have specialists on hand to operate on a baby right after birth, he said. The information also can help mothers decide whether to terminate a pregnancy because of a defect, he said.

Ultrasounds cannot detect whether organs such as the brain or lungs are malfunctioning internally, Rochelson said.

3. INSURANCE COVERS SOME ULTRASOUNDS, BUT NOT ALL.

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Insurers cover standard ultrasounds that provide information about the length of pregnancy and allow an inspection of the fetus for birth defects, Meirowitz said. They generally cost a few hundred dollars, but the cost can vary, Rochelson said.

However, insurers balk at paying for computer-simulated ultrasound images that provide what appears to be a 3-D view of the fetus, Gentilesco said.

4. YOU HAVE OPTIONS ON DISCLOSURE OF GENDER.

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Ultrasound examinations can reveal the gender of a child, and Meirowitz said that in her practice, more than 80 percent of mothers want to know what it is.

There are different ways to get the news. "Some ask us to write down the gender and put it in a sealed envelope so they can open it during a private moment with their partner," she said. "Others ask to have the information disclosed to only their partner or to another family member."

5. VERY LITTLE PREPARATION, IF ANY, IS NEEDED.

"In some ultrasound units, the woman is asked to come with a full bladder -- to drink liquids before the exam and not to use the bathroom," Meirowitz said. "We do not instruct our patients to come with a full bladder."

A woman should be prepared to answer questions about her health history, including such things as prior pregnancies, abortions and miscarriages, she said. "She should be aware that the exam may include both a transvaginal and transabdominal ultrasound. She should ask beforehand how many people she can bring into the exam room, since most units will limit the number of people in the room during the ultrasound exam. She may also decide not to have visitors in the room while her history is being taken."

Maternal and fetal medicine

This is the eighth installment of a 26-week series in which Newsday presents Castle Connolly's list of top L.I. doctors. Today: maternal and fetal medicine

Dr. Adiel Fleischer

LIJ Medical Center

Dept. ObGyn

270-05 76th Ave.

New Hyde Park

718-470-7636

Dr. Victor Klein

825 Northern Blvd.

Great Neck

516-472-5700

Dr. Natalie Meirowitz

LIJ Medical Center

Dept. Ob/Gyn

270-05 76th Ave.

New Hyde Park

516-470-7636

Dr. Alan Monheit

6 Technology Dr.

East Setauket

631-444-4686

Dr. Burton Rochelson

North Shore Univ. Hospital

300 Community Dr.

Manhasset

516-562-4458

Dr. Anthony Vintzileos

Winthrop Univ. Hospital

Dept. Ob/Gyn

259 First St.

Mineola

516-663-8657

Obstetrics & gynecology

Dr. David Baker

Stony Brook Univ. Med. Center,

Dept. Ob/Gyn HSCT9030

Nicolls Road

Stony Brook

631-444-4686

Dr. Ann Barbaccia

2000 N. Village Ave.

Rockville Centre

516-678-4222

Dr. Leonard Benedict

433 Uniondale Ave.

Uniondale

516-483-8798

Dr. Deborah Davenport

100-16 S. Jersey Ave.

East Setauket

631-689-6400

Dr. Michael Gentilesco

48 Route 25A

Smithtown

631-862-3800

Dr. Joan Haselkorn

556 Merrick Rd.

Rockville Centre

516-255-2044

Dr. Paula Hirt

83 W. Main St.

East Islip

631-277-5800

Dr. Jessica Jacob

3003 New Hyde Park Rd.

New Hyde Park

516-488-8145

Dr. Mitchell Kramer

180 E. Pulaski Rd.

Huntington Station

631-425-2218

Dr. Eileen Krim

3111 New Hyde Park Rd.

North Hills

516-365-6100

Dr. Douglas Lee

Suffolk Ob/Gyn

118 North Country Rd.

Port Jefferson

631-475-4404

Dr. Laurence Mack

1130 N. Broadway

P.O. Box 1550

N. Massapequa

516-799-3462

Dr. Charles Mann

48 Rte. 25A

Smithtown

631-862-3800

Dr. Martin Matalon

375 E. Main St.

Bay Shore

631-665-8226

Dr. Michael Nimaroff

825 Northern Blvd.

Great Neck

516-472-5700

Dr. Allen Ott

595 Hampton Rd.

Southampton

631-283-0918

Dr. David Rothbaum

233 E. Shore Rd.

Great Neck

516-487-3498

Dr. Gerardo San Roman

118 North Country Rd.

Port Jefferson

631-473-7171

Dr. Allen Toles

1554 Northern Blvd.

Manhasset

516-390-9242

Dr. Kusum Vasudeva

2 Pro Health Plaza

Lake Success

516-608-6800

Dr. Manuel Veloso Jr.

303 E. Park Ave.

Long Beach

516-431-2828

Neonatal-perinatal medicine

Dr. Harriet Boxer

Nassau Univ.

Medical Center

Div. Neonatology

2201 Hempstead Tpke., Box 30

East Meadow

516-572-3319

Dr. Dennis Davidson

Steven & Alexander Cohen Children's Medical Center

Div. Neonatology

269-01 76th Ave.

New Hyde Park

718-470-3440

Dr. Arena Parekh

Stony Brook Univ. Medical Center

Dept. of Pediatrics

Stony Brook

631-444-5437

Dr. Richard Schanler

Chief, North Shore

Univ. Hospital

Neonatal-Perinatal Medicine

300 Community Dr.

Manhasset

516-562-4665

Dr. Andrew Steele

Steven & Alexandra Cohen Children's Medical Center

269-01 76th Ave.

New Hyde Park

718-470-3440

How they were picked

Castle Connolly Medical Ltd. is a health care research and information company founded in 1991 by a former medical college board chairman and president to help guide consumers to America's top doctors and hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of doctors and the medical leadership of leading hospitals.

Castle Connolly's team of researchers follows a rigorous screening process to select doctors on national and regional levels. Using mail and telephone surveys, and electronic ballots, they ask physicians and the leadership of top hospitals to identify exceptional doctors. Careful screening of doctors' educational and professional experience is essential to the committee. Not every good physician makes the list. Rather, the list is a way for patients to get started on their search for the best medical professional. Newsday is not part of the selection process.

Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors.

To see the whole list . . .

Who else is on the list of Top Doctors? More than 6,000 listings are in the New York Metro Area edition of "Top Doctors," published by Castle Connolly Medical Ltd. The softcover list price is $34.95. For more information, go to castleconnolly.com, or call 800-399-DOCS.

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