Dr. Jessica Jacob, an obstetrician/gynecologist, performs a sonogram in her...

Dr. Jessica Jacob, an obstetrician/gynecologist, performs a sonogram in her office in New Hyde Park. (Aug. 6, 2012) Credit: Newsday/Audrey C. Tiernan

As most any pregnant woman can confirm, the barrage of possible prenatal tests -- to monitor the health of mother and baby and detect potential problems -- can be overwhelming. Here's what you need to know:

1. GET SCREENED BEFORE YOU'RE PREGNANT

"If there's one message you can get out to people, it's to undergo genetic testing before you become pregnant," said Dr. Jessica Jacob, an obstetrician-gynecologist who practices in New Hyde Park and delivers babies at North Shore University Hospital in Manhasset. "I'm astounded at how many women walk into my office pregnant, and no gynecologist has ever talked to them about screening for genetic diseases."

If pregnancy is on the agenda, she said, both partners should be genetically screened for cystic fibrosis, spinal muscular atrophy and a condition called fragile X syndrome, which causes a common form of mental retardation. Genetic testing is especially important for African-Americans, Ashkenazi Jews and people of Italian and Greek heritage, who all face special genetic risks, she said.

"People often say, 'It doesn't run in my family, and I don't need to get tested,' " Jacob said. But, in reality, she said, whatever genetic risk you face "can go generations, and no one gets it until, boom, someone marries the wrong person."

But if tests reveal a genetic problem, Jacob said, that doesn't have to mean pregnancy should be avoided. In many cases, it's possible to perform in vitro fertilization using embryos that are free of disease.

2. GET PRENATAL TESTING REGARDLESS OF YOUR BELIEFS ABOUT ABORTION

Even if a woman is sure that she would not have an abortion if something was wrong with the fetus, Jacob said, couples should still undergo prenatal testing.

The tests "provide more information to monitor what happens later in pregnancy and interpret it," she said. "The information itself is crucially important. It's extraordinarily helpful to know what to expect and be ready for complications of delivery."

3. NOT EVERYONE GETS THE SAME PRENATAL TESTS

No prenatal tests are mandatory, "although doctors have a responsibility to recommend those applicable to each individual patient," said Dr. Laurence F. Mack, associate director of obstetrics and gynecology at Mercy Medical Center in Rockville Centre.

Common tests, he said, include sonograms, screening for diseases such as measles and mumps, so-called AFP screening to look for genetic diseases, including Down syndrome, and screening for diabetes. "All of these are recommended for all patients, in general," Mack said. In addition, he noted, newer tests given in the first trimester -- 11 to 13 weeks -- use sonograms and blood tests to estimate the risk "earlier than ever" that mothers will give birth to babies with Down syndrome.

Mack and Jacob agreed that there's no standard number of prenatal tests because what's appropriate depends so much on each woman's medical history and background. But the number of tests available today is far greater than in the past, Mack said.

4. DON'T BE PANICKED BY ULTRASOUNDS

Ultrasound examinations may pick up signs of problems, but Jacob said it's important to not be disabled by anxiety and fear.

"Women tend to worry when they're told anything is off, but so many things end up being fine in the end," she said. "Women have to brace themselves for not panicking when they're told about small issues and small problems. There's a lot of unnecessary panicking that goes on."

5. NEW TESTS OFFER EARLIER ALERTS

Some of the newer prenatal tests, in conjunction with sonograms, allow signs of conditions such as Down syndrome to be detected earlier than ever before, Mack said.

In addition, blood tests are now being developed that will allow genetic problems that cause such conditions to be detected within the first three months of pregnancy without amniocentesis, he said. Amniocentesis, which is usually performed after four months of pregnancy, can detect signs of genetic problems, but it's potentially dangerous to the fetus and generally reserved for women at higher risk for a problem.

 

Obstetricians and gynecologists

 

This is the eighth installment of a 26-week series in which Newsday presents Castle Connolly's list of top Long Island doctors.

OBSTETRICS & GYNECOLOGY

Dr. David A. Baker

Stony Brook Univ. Med. Center

Dept. Ob/Gyn HSCT9030

6 Technology Dr.

East Setauket

631-444-4686

Dr. Leonard A. Benedict

433 Uniondale Ave.

Uniondale; 516-483-8798

Dr. Deborah M. Davenport

100-16 S. Jersey Ave.

East Setauket

631-689-6400

Dr. Michael Gentilesco

48 Route 25A, Ste. 207

Smithtown

631-862-3800

Dr. Joan Haselkorn

556 Merrick Rd., Ste. 200

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.

Ste. 407

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 S. Lee

Suffolk Ob/Gyn

118 N. Country Rd.

Port Jefferson

631-475-4404

Dr. Laurence F. Mack

1130 N. Broadway

P.O. Box 1550

North Massapequa

516-799-3462

Dr. Charles T. Mann

48 Route 25-A, Ste. 207

Smithtown

631-862-3800

Dr. Martin Matalon

375 E. Main St., Ste. 4

Bay Shore; 631-665-8226

Dr. Michael Nimaroff

825 Northern Blvd.

Fl. 3-Ste. 301

Great Neck

516-472-5700

Dr. Allen Ott

595 Hampton Rd.

Southampton

631-283-0918

Dr. David Rothbaum

233 E. Shore Rd., Ste. 109

Great Neck

516-487-3498

Dr. Gerardo A. San Roman

118 N. Country Rd.

Port Jefferson

631-473-7171

Dr. Pedro R. Segarra

595 Hampton Rd.

Southampton

631-283-0918

Dr. Allen W. Toles

1554 Northern Blvd., Fl. 5

Manhasset 516-390-9242

Dr. Kusum Vasudeva

Pro Health Plaza

2 Ohio Dr.

Lake Success 516-608-6800

Dr. Manuel A. Veloso Jr.

303 E. Park Ave.

Long Beach 516-431-2828


MATERNAL & FETAL MEDICINE

Dr. Adiel Fleischer

LIJ Medical Center, Dept. ObGyn

270-05 76th Ave.

Rm. 471

New Hyde Park

718-470-5466

Dr. Victor R. Klein

825 Northern Blvd.

Ste. 301

Great Neck

516-472-5700

Dr. Natalie Meirowitz

LIJ Medical Center

Dept. Ob/Gyn

270-05 76th Ave.

Rm. 471

New Hyde Park

516-470-7636

Dr. Burton L. Rochelson

N. Shore Univ. Hosp.

Dept. Maternal/

Fetal Medicine

300 Community Dr.

Manhasset

516-562-4458

Dr. Anthony M. Vintzileos

Women's Contemp. Care Assoc.

120 Mineola Blvd., Ste. 100

Mineola; 516-663-8657


NEONATAL-PERINATAL MEDICINE

Dr. Harriet Boxer

Nassau Univ. Med. Ctr.

Div. Neonatology

2201 Hempstead Tpke.

Box 30

East Meadow 516-572-3319

Dr. Dennis Davidson

Stony Brook

Children's Center

101 Nicholls Rd.

T-11060

Stony Brook

631-444-7653

Dr. Aruna Parekh

Stony Brook University

Medical Center

Dept. of Pediatrics, HSC T-11 060

Stony Brook

631-444-5437

Dr. Richard Schanler

Chief, Neonatal- Perinatal Med.

North Shore Univ. Hosp.

300 Community Dr.

Manhasset 516-562-4665

Dr. Andrew M. Steele

Steven & Alexandra Cohen Children's Medical Center

269-01 76th Ave.

Ste. 344

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 top hospitals. Castle Connolly's established survey and research process, under the direction of a doctor, involves tens of thousands of top doctors and the medical leadership of leading hospitals.

Castle Connolly's physician-led team of researchers follows a rigorous screening process to select top doctors on both the national and regional levels. Its online nominations process -- located at castleconnolly.com/nominations -- is open to all licensed physicians in America who are able to nominate physicians in any medical specialty and in any part of the country, as well as indicate whether the nominated physician is, in their opinion, among the best in their region in their medical specialty or among the best in the nation in their medical specialty.

Careful screening of doctors' educational and professional experience is essential before final selection is made among those physicians most highly regarded by their peers. The result -- Castle Connolly identifies the top doctors in America and provides the consumer with detailed information about their education, training and special expertise in their paperback guides, national and regional magazine "Top Doctors" features and online directories. Doctors do not and cannot pay to be selected and profiled as Castle Connolly Top Doctors. (Newsday is not part of the selection process.)

Physicians selected for inclusion in this "Top Doctors" feature may also appear as Regional Top Doctors online at castleconnolly.com, or in one of Castle Connolly's Top Doctors guides, such as America's Top Doctors® or America's Top Doctors® for Cancer.

 

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.

Rockville Centre Diocese settlement ... New cannabis shops ... Manorville Christmas Tree farm Credit: Newsday

CEO shot ... Diocese settlement ... New cannabis shops ... Manorville Christmas Tree farm

Rockville Centre Diocese settlement ... New cannabis shops ... Manorville Christmas Tree farm Credit: Newsday

CEO shot ... Diocese settlement ... New cannabis shops ... Manorville Christmas Tree farm

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