Obstetrics

General Practice Information

Our practice is small and personal to better serve your individual needs. Dr. Kirollos is a certified Obstetrician with 20 years of experience in obstetrical medicine. Mary Rooks is a certified Nurse Midwife with 18 years of experience in obstetrical nursing and midwifery. During your pregnancy you will see both providers for comprehensive maternity care.

Obstetrics | Prenatal Care Doctor | Pregnancy Doctor | Saranac Lake NY | Potsdam NYOur practice is limited to the specialty of obstetrics and gynecology. Our providers have advanced training in their field and take courses regularly to keep up with the latest technology. TriLakes Ob/Gyn maintains excellent relations with high-risk maternity centers at Fletcher-Allen Healthcare in Burlington, Vermont, Albany Medical Center and The Perinatal Center in Syracuse, New York. We would advise you to see your primary care provider for non-obstetrical issues. The practice is located in the Medical Office building attached to the main hospital building. For our patients this means there is only a short walk to the main hospital, maternity and surgical wards, laboratory and radiology services. Convenient and free parking is available close to the main hospital entrance.

As part of our comprehensive maternity care, 2 and 3-D ultrasound is now available in the office. This has proved to be an invaluable tool for early and accurate pregnancy dating, diagnosing multiple fetuses, determining placental location, and monitoring fetal health and growth. Some insurance plans may not cover in-office ultrasound and in this case you will be referred to a hospital-based service.


Stafford New Life Center at Adirondack Medical Center

Overlooking Lake Colby, the newly created Stafford New Life Center was opened in 2003. We have three beautifully decorated and private LDRP (labor, delivery, recovery, and postpartum) birthing suites, two private rooms, and one 2 bed suite. Two of the birthing suites have jacuzzi tubs for maternal pain relief during labor and the third room has a shower.

Our nursing staff is highly skilled and trained to provide specialty maternity care with a personal touch and attention. In addition, a board certified Lactation Consultant is on-staff to ensure that all breastfeeding mothers leave with confidence and proficiency.

The maternity center is conveniently located close to the surgical center for enhanced safety and family experience when a Cesarean delivery is necessary. Our birth center has state-of-the-art technology for fetal monitoring and for infant surveillance.


Planning Pregnancy

Each great journey starts with thought and preparation. Your guide to healthy pregnancy planning includes the following:

  • If you smoke, quit now. Smoking in pregnancy has been linked to low birth weight, increased risk of miscarriage, stillbirth, and placental problems such as abnormal location and abruption.
  • Get a comprehensive check-up to reduce the risks of pre-existing health problems, infections, or sexually transmitted problems.
  • Get a dental examination to reduce the risk of exposure to dental anesthetics, x-rays and peri-dontal infections.
  • Avoid alcohol. Research has shown that drinking can cause a serious birth defect called Fetal Alcohol Syndrome (FAS). Since there is no known safe level of exposure, we recommend avoiding alcohol altogether when you are pregnant or even trying to conceive.
  • Avoid exposure to over-the-counter and prescription medicines. If you take a medication regularly for a medical condition, talk with your healthcare provider before you become pregnant. Some medications are harmful to developing babies.
  • Take a multivitamin with folic acid. Studies have shown that taking a folic acid supplement of at least 400 micrograms each day can reduce the risks of serious birth defects called neural tube defects. For women with specific health problems such as a seizure disorder, or for those with a prior or family history of spinal bifida or neural tube defects a higher dose may be advised.
  • Stay healthy and fit. Maintain a healthy weight with a nutritious diet and exercise. Eat lots of vegetables, fruit and whole grains. A healthy lifestyle not only helps you feel well, but can prevent problems such as depression, heart disease, cancer, and constipation. Walking, low-impact aerobics, and swimming are examples of healthy exercise that can be continued during uncomplicated pregnancy.
  • Check your vaccination status. In some cases pregnancy is not advised for up to three months following vaccination. These include vaccinations against rubella, measles or mumps, chickenpox, polio, and hepatitis B.
  • Screening for Cystic Fibrosis (CF), for more information see

www.marchofdimes.com


Prenatal Care

First Trimester (0-3 months)

  • Schedule an exam for confirmation of pregnancy. This may include a urine or blood pregnancy test and a pelvic ultrasound exam.
  • If you have not already done so, start taking a prenatal vitamin.
  • Have prenatal blood and urine tests.
  • For women with specific health problems, complicated obstetrical or family histories or advanced maternal age a consultation at a Maternal Fetal Medicine Center will be arranged.

Second Trimester (3-6 months)

  • Quad Marker blood test at 16-20 weeks to screen for the risks of certain birth defects.
    Anomaly Scan. This is a special ultrasound examination that is used to detect signs of birth defects at 20-21 weeks.
  • Blood work to screen for gestational diabetes and anemia at 28 weeks.
  • Rhogam injection is given at 28 weeks to mothers with Rh negative blood types.
  • Sign up for prenatal education classes.

Third Trimester (6-9 months)

  • Fetal growth ultrasound at 32 weeks.
  • Choose a newborn healthcare provider.
  • Discuss cord blood banking if applicable.
  • For repeat Cesarean delivery review surgical consent, risks, and benefits.
  • Vaginal/rectal Group B strep culture is collected at 36 weeks.
  • Increased fetal surveillance is based on individual needs and may include non-stress testing at the hospital and targeted ultrasound exams.
  • Discuss birthing preferences.

Medications and Special Concerns in Pregnancy

Medications

In general, pregnant women are advised to avoid exposure to any drug or medication. Some medications are known to be quite harmful and associated with serious birth defects. Other drugs are only harmful at specific times during pregnancy. For many other medications, a careful assessment of the risks of exposure verses the benefits of the drug needs to be considered. These include both prescribed and over-the-counter drugs.

Obstetrics | Prenatal Care Doctor | Pregnancy Doctor | Saranac Lake NY | Potsdam NYA special classification system has been designed to identify the risks of medications when used during pregnancy. The truth is that for many drugs, especially newer ones, the effects of that drug on a developing fetus are unknown because it is unethical to study a drug on a pregnant woman. Therefore, most of what is known is from retrograde or observational studies rather than controlled, blind trials. If a medication has to be taken during pregnancy consult with your healthcare provider or pharmacist before taking.


Medications and Special Concerns in Pregnancy

Food & Food Handling

Raw meat or fish may contain bacteria or parasites that can increase your risk of infection or illness. Cooking food destroys bacteria. To minimize your risk, avoid eating undercooked or raw meats and fish such as sushi or ceviche. Also, make sure you wash your hands thoroughly with soap and water before and after preparing raw food. Always wash cutting boards and other food preparation utensils with soap and hot water.

Obstetrics | Prenatal Care Doctor | Pregnancy Doctor | Saranac Lake NY | Potsdam NYPregnant women have been advised to avoid eating fresh fish from the Adirondacks because of high mercury levels. Other fresh fish, especially trout and perch may contain PCBs and other carcinogens (cancer causing substances) and should also be avoided.

Unpasturized dairy products like milk and soft cheeses (brie, feta, cream cheese, goat cheese) should not be consumed during pregnancy to avoid a serious illness called Listeriosis.

Wash fruits and vegetables to rinse off pesticides.

Although most women will not become diabetic during pregnancy, eating like a diabetic may be beneficial. This includes limiting highly processed foods like white flour and sugar and white rice which have high glycemic indexes. By controlling the intake of simple carbohydrates (obviously sweet foods, cakes, candies, etc.) you will avoid the highs and lows of sugar metabolism that can lead to hypoglycemia (low blood sugar). Pregnant women are especially vulnerable to extreme low blood sugar because the placenta is very efficient at binding to blood sugar. These “sweets” then get passed on to the baby, which can lead to large fetal weight. This can increase the risk for Cesarean delivery. Controlling intake of high calorie, low nutritional value food can also help in preventing excessive maternal weight gain.


Medications and Special Concerns in Pregnancy

Saunas and Hot tubs

Pregnant women are advised to avoid hot tubs and saunas that may raise core body temperature resulting in overheating and possible effects on the developing fetus.


Medications and Special Concerns in Pregnancy

Toxoplasmosis

Toxoplasmosis is an illness caused by a parasite found in cat feces, soil, and raw or undercooked meats. If a woman becomes infected during pregnancy the fetus may be at risk of brain damage or other serious birth defects. For this reason pregnant women are advised to not get a new cat during pregnancy and to avoid changing the cat litter box. Good hand washing is essential after handling a cat and before and after preparing food. When working in the garden it is advisable to wear gloves.


Obstetrics

Can I paint while I am pregnant?

You may paint as long as you are in a well ventilated area.

Can I use a tanning bed or a hot tub?

No, the temperature is too hot for the fetus.

When can I find out the sex of the baby?

Usually if the fetus is cooperative the radiologist will be able to tell you the sex of the fetus at your 20 week ultrasound.

I had a previous c-section, can I have a vaginal birth with this pregnancy?

Adirondack Medical Center does not participate in vaginal birth after c-section (VBAC), therefore we no longer allow this type of delivery.

Who do I contact if the office is closed?

Adirondack Medical Center at 891-4141 or the OB department at 897-2361. If your situation is an emergency please call 911.

Can I dye my hair or get a perm while pregnant?

This is not recommended.

Can I have a flu vaccine while I’m pregnant?

Yes. Pregnant women are advised to be vaccinated against seasonal and novel flu virus.

My job requires a PPD test, can I get this while I’m pregnant?

Yes.