Pregnancy Information

It is quite common to have occasional abdominal pains due to stretching of ligaments etc. Panadol can be taken quite safely for these and also for headaches, which are also common in pregnancy. Nose bleeds, dizziness, fainting and pressure in the vagina can also be common but please let Dr Peter Jurcevic know if the symptoms persist or if you are concerned.

Current guidelines recommend no alcohol consumption in pregnancy, and certainly, binge drinking is to be avoided at all costs. However, there is no evidence that a celebratory glass or two on random occasions is dangerous to a developing baby, so enjoy your birthday or anniversary as it arises!
Smoking is harmful throughout the entirety of the pregnancy and is best avoided. Effects on foetal growth and placental function, including the risk of miscarriage and prematurity, are just some of the potential consequences. Dr Peter Jurcevic will help you to wean (still useful) and/or quit (ideal) and recognise that it may be difficult. Support services in the form of the QUIT Line, amongst others, plus the use of aids such as nicotine gum/patches, etc., can be relatively safely used to aid in the process.

Frances Perry House and Parents You’ve Got This conduct antenatal classes on various topics, including labour and birth, postnatal care, and early parenting. Dr Peter Jurcevic encourages both you and your partner to attend.

A small show of mucous and blood is normal in late pregnancy and should not alarm you. If the bleeding is more than a teaspoonful or occurs in the early stage of pregnancy, please contact Dr Peter Jurcevic.

Can I dye my hair? (yes), can I paint a room? (yes), can I use spray tan? (no evidence currently to say it is unsafe), are mobile phones safe near my abdomen? (do we really know?!) and other miscellaneous questions will often arise. Please do not hesitate to ask Dr Peter Jurcevic at your antenatal appointment or call as per the urgency.

Exercise in pregnancy is safe, although it is recommended that you keep the intensity down to a moderate level and certainly stop if the heart rate remains persistently above 140b/min for a prolonged period of time or if you are becoming concernedly short of breath. Always drink plenty of water and avoid potential contact sports such as Netball. Good choices of exercise include walking, swimming, cycling (particularly spinning), pregnancy aerobics, yoga and Pilates.

Your impression of fetal movements helps you assess your baby’s well-being on a daily basis. If you are concerned about change or lack of movement in your baby, particularly after the 28th week, contact either the rooms or the hospital delivery suite. You may need to attend for a foetal heart monitor (CTG) to ensure all is well.

Folate is recommended in the first 12 weeks of pregnancy to help reduce the incidence of spinal defects in your baby. Iron tablets and multivitamins are often required in pregnancy, but Dr Peter Jurcevic will discuss this with you depending on the results of your blood count and your dietary intake.

There are a number of tests available to assess your baby’s genetic well-being, and all will be discussed at your first visit. CVS (chorion villous sampling) and Amniocentesis are both invasive options that are almost always reserved for high-risk pregnancies.
A hormonal blood test between 9-11 weeks (first-trimester maternal serum screen) in conjunction with an ultrasound at approximately 12-13 weeks, focusing specifically on the baby’s neck (the nuchal translucency), has 92% predictive sensitivity in assessing for amongst other things, Down Syndrome. A cell-free DNA blood test after 10 weeks (NIPTS) is, in itself, along with the aforementioned 12-week ultrasound, approximately 99.5% accurate in assessing for Down syndrome. However, it is a few hundred dollars more expensive due to its higher degree of accuracy.
Further tests for Cystic Fibrosis, Fragile X syndrome, SMA (spinal muscular atrophy) and some rarer conditions seen in certain populations, such as the Jewish community, are also available and will be discussed.

Dr Salwyn Al Salihi, Dr Faris Al Shammaa, and Associate Professor Vinay Rane are Obstetricians and Gynaecologists with many years of experience. They are very capable of providing safe medical care for those occasional times when Dr Peter Jurcevic is unavailable.
While practising as individual providers, they each participate in a weekend roster arrangement, which allows each doctor to have a couple of invaluable days off per month to recover from the on-call demands of the profession.
Dr Peter Jurcevic’s holidays are booked 12 months in advance. They will be covered by the same doctors, and notification of my holidays will be provided for all patients who are due on or within a week of the planned holiday. Pleasingly, over 15 years of data collection relating to his availability, he has been able to attend in excess of 95% of all patient deliveries (as a testament to his endurance and general availability).

Certain foods may be infected by a germ called Listeria. This infection can cause serious problems in pregnancy and it is therefore recommended that certain foods be avoided. Brochures and websites on the subject are available, but should you have an episode of food poisoning or gastroenteritis, be assured that this is the least likely cause, with other more typical causes usually of no concern to the baby unless you become profoundly dehydrated.

Most HR requirements are that you are entitled to maternity leave from 34 weeks into the pregnancy (6 weeks before your due date); this can be altered as per the nature of the pregnancy, with some women finding the physicality of the pregnancy hard to manage in the third trimester requiring more time off presumably through negotiated sick leave, or alternatively, feeling well enough to continue, wishing to work right up until your due date. Dr Peter Jurcevic is happy to guide you in this regard, but please remember once the baby is delivered, there are very few days off!

Often, the best advice is to avoid all medicines and herbal therapies. There are certainly a number of medications that can generally be used fairly safely in pregnancy, but if you may have concerns about medications, be they over the counter or prescribed by another practitioner, please don’t hesitate to check with Dr Peter Jurcevic or call The Royal Women’s Hospital on 8345 2000 and ask for the drug information line.
Generally, safe drugs include Paracetamol, constipation agents such as Metamucil, Lactulose etc, asthma agents such as Ventolin and other inhaled steroids, antifungal creams such as Canestan for thrush (including the appropriate insertion of the applicator), anti-heartburn agents such as Mylanta, Gaviscon and Zantac, Maxolon and Vitamin B6 and Ginger tablets for nausea and vomiting and haemorrhoidal agent such as Retinol and Antihistamines such as Polaramine for hayfever. The list is by no means comprehensive, so please don’t hesitate to check where need be.

Both nausea and associated vomiting in pregnancy are common and whilst often referred to as ‘morning sickness’, they can occur throughout the day. In most pregnancies, the symptoms will abate by the 14-week mark but occasionally can continue through to the end. The severity can vary between individuals and from pregnancy to pregnancy, and in its severest form, known as hyperemesis gravidarum, hospitalisation for hydration support, medication and dietary management may be required. Thankfully this is rare.
Often, the simple use of vitamins, rest and dietary adjustments will tide you over, with the addition of medically appropriate medication as necessary. Dr Peter Jurcevic is happy to be contacted or see you to discuss and manage this.

Parvovirus, Slapped Cheek, and Varicella can cause problems in pregnancy, but there are tests and treatments that can be offered, and pleasingly, a substantial proportion of the population is already immune. It is best not to worry about these, but do not hesitate to call if you have any questions or concerns about them. Always exercise good hygiene around potentially sick individuals.

Eventually, it will become difficult to sleep on the flat of your abdomen, but where you do, it is highly unlikely you will ‘squash’ the baby. Sleeping on either your left or right side at any stage is fine, and log pillows can help with this. Avoiding lying on the flat of your back, particularly from the third trimester on, is ideal to avoid potentially compressing the vessels in your womb and to reduce the chances of low blood pressure and feeling faint. Don’t panic if you wake up on your back, as it is highly unlikely you will have caused any harm to your baby.
Sexual activity in pregnancy is usually safe. Occasionally, a small amount of bleeding can occur, and whilst this is normally of no concern to the baby, Dr Peter Jurcevic is happy to advise as needed.
Baths and spas are generally safe (your baby is in its own 37-degree bath!), but avoid prolonged exposure to overly hot water and watch the jets in a spa, particularly to avoid water squirting into the vagina.

Swollen ankles are also commonplace in pregnancy and are usually of no concern. Leg cramps also occur frequently and may improve with daily Calcium/Magnesium supplementation.

Toxoplasmosis is a germ that can be contracted from cats. Cats need not be removed from the house, but good hygiene, including thorough hand washing after exposure and avoiding kitty litter, is recommended.

Interstate travel is generally safe up until 34-36 weeks, and overseas travel up to 32 weeks gestation. For extraneous circumstances, these gestational limits can be extended, but Dr Peter Jurcevic urges caution, as complications arising away from home may preclude a return trip.
Generally, for third-trimester travel, as you will be clearly showing, you will usually require a letter from Dr Peter to take to the airport, and he is happy to provide this for you as necessary.

The current recommendation is that a Flu vaccine should be administered to all pregnant patients when it becomes available. Whooping Cough vaccination is also recommended in the third trimester of every pregnancy, ideally between 28 and 32 weeks. Partners and grandparents with presumed high visitation are also recommended to be vaccinated, but only every 10 years.

There is variable information on this, and genetics may have a large component, but good food choices can certainly have an impact. The average weight gain for pregnancy would be between 8-14kg, and evidence points towards women often retaining approximately 5kg from their pre-birth weight once the baby is delivered and they are several months down the track.
Whilst a large proportion of weight gain will be fluid retention and blood volume increases, as well as the baby’s and placental weight, other weight may be controlled by sensible food choices. If you start the pregnancy worrisomely overweight, it is actually safe to have no weight gain or even some weight loss in pregnancy.

The MBS dictates how much the government and health insurer will pay for medical services. Unfortunately, the current recommendation is inadequate to cover the operating costs of practice, including renting and running the rooms, the secretaries, and the large indemnity insurance fee paid by Obstetricians to care for pregnant women.
To cover these operating costs and also have Dr Peter Jurcevic available on call 24 hours a day, 365 days a year, in case you have an emergency or if you go into labour, regardless of the day of the week or the time of day, the out-of-pocket fee has been set and carefully calculated to compensate for providing this intensive cover.