Top Docs: Fast facts about prenatal testing
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.
631-444-4686
Dr. Leonard A. Benedict
433 Uniondale Ave.
Uniondale; 516-483-8798
Dr. Deborah M. Davenport
100-16 S. Jersey Ave.
631-689-6400
Dr. Michael Gentilesco
48 Route 25A, Ste. 207
631-862-3800
Dr. Joan Haselkorn
556 Merrick Rd., Ste. 200
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.
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
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
516-472-5700
Dr. Allen Ott
595 Hampton Rd.
631-283-0918
Dr. David Rothbaum
233 E. Shore Rd., Ste. 109
516-487-3498
Dr. Gerardo A. San Roman
118 N. Country Rd.
631-473-7171
Dr. Pedro R. Segarra
595 Hampton Rd.
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.
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