Top Doctors: Pregnancy and ultrasound
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.
"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.
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.
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.
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.
718-470-7636
Dr. Victor Klein
825 Northern Blvd.
516-472-5700
Dr. Natalie Meirowitz
LIJ Medical Center
Dept. Ob/Gyn
270-05 76th Ave.
516-470-7636
Dr. Alan Monheit
6 Technology Dr.
631-444-4686
Dr. Burton Rochelson
North Shore Univ. Hospital
300 Community Dr.
516-562-4458
Dr. Anthony Vintzileos
Winthrop Univ. Hospital
Dept. Ob/Gyn
259 First St.
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.
516-678-4222
Dr. Leonard Benedict
433 Uniondale Ave.
516-483-8798
Dr. Deborah Davenport
100-16 S. Jersey Ave.
East Setauket
631-689-6400
Dr. Michael Gentilesco
48 Route 25A
631-862-3800
Dr. Joan Haselkorn
556 Merrick Rd.
516-255-2044
Dr. Paula Hirt
83 W. Main St.
631-277-5800
Dr. Jessica Jacob
3003 New Hyde Park Rd.
New Hyde Park
516-488-8145
Dr. Mitchell Kramer
180 E. Pulaski Rd.
631-425-2218
Dr. Eileen Krim
3111 New Hyde Park Rd.
516-365-6100
Dr. Douglas Lee
Suffolk Ob/Gyn
118 North Country Rd.
631-475-4404
Dr. Laurence Mack
1130 N. Broadway
P.O. Box 1550
N. Massapequa
516-799-3462
Dr. Charles Mann
48 Rte. 25A
631-862-3800
Dr. Martin Matalon
375 E. Main St.
631-665-8226
Dr. Michael Nimaroff
825 Northern Blvd.
516-472-5700
Dr. Allen Ott
595 Hampton Rd.
631-283-0918
Dr. David Rothbaum
233 E. Shore Rd.
516-487-3498
Dr. Gerardo San Roman
118 North Country Rd.
631-473-7171
Dr. Allen Toles
1554 Northern Blvd.
516-390-9242
Dr. Kusum Vasudeva
2 Pro Health Plaza
516-608-6800
Dr. Manuel Veloso Jr.
303 E. Park Ave.
516-431-2828
Neonatal-perinatal medicine
Dr. Harriet Boxer
Nassau Univ.
Medical Center
Div. Neonatology
2201 Hempstead Tpke., Box 30
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.
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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