AMNIOCENTESIS


Cairns Obstetrics and Gynaecology

This is done under ultrasound guidance and usually takes about 30 minutes from the start of the consultation to finish. Full written information is provided and any questions answered. Then the actual procedure is carried out and the amniotic fluid obtained sent to the laboratory in Brisbane for testing. A FISH (DNA probe test) result is available within 48 hours in most cases with full culture back usually by 10 days, although this can take up to three weeks. Written advice on what to do and what NOT to do pre and post procedure is given, as well as any sick notes that may be required.

There will be a small out of pocket cost associated with these technically very difficult tests. This is solely at the discretion of the laboratory and not under the control of Cairns Obstetrics and Gynaecology. Please contact our administrative staff for more information on this and contact numbers for the laboratories if required.

PRIOR TO AN AMNIOCENTESIS

This is an invasive procedure, and as such, should be taken seriously. Miscarriage rates are quoted as 1 every 200 times, and to minimise this, Dr. Kiesey-Calding would like you to arrange the day of the procedure and the following day off work.

For the week following the procedure, you should operate at "low activity" and take things very easy. You should not exercise, but gentle walking is okay. If you have a sedentary job, then going back to work should be okay after a couple of days, but not if you have an active job. Travelling should be curtailed for the week following the procedure.

You should not have intercourse for about a week after the procedure. Please arrange for someone to bring you to the rooms for the procedure, and then to take you home afterwards.

If you are a Rhesus negative blood group, you will have an injection of Anti-D at the time of your amniocentesis. This will cover you for the next week or two, but if you have any vaginal bleeding or any trauma to the abdomen, please contact the rooms to discuss the need for a further dose.

After the procedure, you will need to rest for about half an hour at the rooms for observation. You will be encouraged to eat and drink whilst you are here.

Please click here to access a patient information pamphlet

 

DAY PREGNANCY ASSESSMENTS


Cairns Obstetrics and Gynaecology Cairns Obstetrics and Gynaecology

This is a special facility for patients of Dr. Kiesey-Calding. Staffed by our midwife, women with a need for increased monitoring (eg for increased blood pressure, CTG's (see below) etc, are able to attend outside their scheduled visits. Our experienced midwife is available to you during Tuesday to Thursday to give you unparalled access to a midwife who is both familiar to you and has been involved in your care from the beginning of your pregnancy. With close liason with Dr. Kiesey-Calding, a full assessment can be made in a timely fashion, and appropriate action taken. As this is all done on site, there is no loss of time in attending different places for care (for example, to get an ultrasound done, or CTG monitoring done at the hospital). So if everything is okay, you are in, checked and then good to go.

CTG monitoring is done to measure baby's overall activity and cardiac reserves. It is similar to an ECG done on adults to examine the heart, and uses a microphone strapped against a pregnant abdomen to pick up the fetal heart rate. This is then recorded on graph paper over about 30 minutes. As well as the fetal heart rate, any uterine activity ("tightenings" or contractions) will also be recorded, ensuring a full data set for intepretation. This is usually done in our day pregnancy unit, in an armchair for your comfort and privacy.

 

GENERAL


Cairns Obstetrics and Gynaecology

Education

As knowledge is power, please feel free to access the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) by clicking here, to read through patient information pamplets on the common obstetric and gynaecological conditions/procedures. 

Questions about immunisations? Access excellent, evidence based information by clicking here to access the SARAH project from the NCIRS (National Centre for Immunisation Research and Surveillance) to help parents feel confident about immunisation.

Text Reminder

The day before your appointment, a text is sent to your mobile to ensure that it is still convenient for you to attend. A simple "yes" or "no" is all that's required to text in return. If "no" our staff will contact you to arrange a re-schedule if required.

Toilet and Baby Change Facilities

These are located within the rooms themselves; big enough to accommodate a pram, this means that toilet stops with toddlers hopefully become a little easier!

Free On-Site Parking

There are three off street dedicated parking spaces for the practice and ample street parking available on both Martyn Street and on Draper Street, with the driveway running through from Martyn Street to Draper Street in a "one way" arrangement.

Lavazza Coffee, Tea and Herbal Teas with Biscuits

Self explanatory: and it's really great coffee!

 

LACTATION SUPPORT


Cairns Obstetrics and Gynaecology

Post the delivery of your baby, the biggest challenge of all is often successfully breast feeding your infant. Cairns Obstetrics and Gynaecology offers a private environment, with a midwife that you have already met and feel comfortable with during the course of your pregnancy to help you with these challenges in those first few weeks following birth.

Note that there is currently a 30% discount on all existing bra stock, valid from the 20th of October 2016.

 

PATHOLOGY COLLECTION


Cairns Obstetrics and Gynaecology

We acknowledge that your time is as valuable as ours, and for the convenience it offers we have the facility to take any blood tests that you may require for your clinical care, excepting screening for diabetes of pregnancy. Done by our friendly (and gentle!) midwife, this service is an exclusive feature to smooth the journey of your pregnancy. Likewise urine testing or microbiological swabs can also be collected and sent via courier to the laboratory. For testing for diabetes of pregnancy, this requires specific timing, and is done at the collection centre for the laboratory. QML has a collection point located just behind the rooms, open every morning until noon.

 



ULTRASOUND


Cairns Obstetrics and Gynaecology Cairns Obstetrics and Gynaecology

Unfortunately, we are so heavily booked with our obstetric patients, we are unable to offer ultrasound to patients that are NOT booked for pregnancy care with Dr. Kiesey-Calding.

Please note that you will NOT be eligible for the maximum Medicare Rebate if you do NOT bring a separate referral for your ultrasound scan. This must be obtained from your referring doctor prior to your appointment. Forms are available from your doctor at their individual practices or you are able to print the form attached in your email from Cairns Obstetrics and Gynaecology.

Dating Scan

Best done at about 7/8 weeks. This can be incorporated into your booking visit for your pregnancy, or can be done prior to this visit. This will require a separate referral from your doctor to ensure you receive your maximum Medicare rebate. Whilst it is sensible to have a bladder that is not completely empty, we do NOT require you to try and drink large volumes of water prior to the scan.

Nuchal Translucency Scanning

Can only be done between 11 weeks and 13 weeks and 6 days, and even then it still depends on the exact length (CRL or "Crown Rump Length") of the baby. Blood tests are essential to this test, and are ideally done at 11 weeks. Best results for scanning are obtained at 12 weeks. This requires a separate referral to that for antenatal care from your referring doctor. As correct dating is essential to get the best results from this test, your doctor may also refer you for a dating scan at about 7 weeks of pregnancy. While it is sensible to have a bladder that is not completely empty, we do NOT require you to try and drink large volumes of water prior to the scan.

Morphology Scanning

Ideally done between 19 and 22 weeks. This takes between 30 and 45 minutes for the examination. At the end of the assessment, you will have a copy of your report, hard copies of images of your baby and a disc with all images captured as JPEGs to enjoy at home and share with family and friends. As for other ultrasound scans, but especially at this stage, a full to bursting bladder is NOT required.

Monitoring of fetal abnormality

In the unfortunate case that baby has some problem, then monitoring of the condition in a clinical setting privately is possible. It may be as simple as "another opinion" on a previous scan, or monitoring locally of a previously diagnosed problem by a sub-specialist. In any case, full information will be provided to parents as well as a copy of their ultrasound report at the end of the session.

Growth and Well-being Scanning

This examination compares baby to a dataset of "normal" baby values to make a judgement as to whether your baby is bigger than average, smaller than average or just average in size. At the same time, it is usual to make an assessment as to the well being of the placenta, by measuring it's function. If serial (multiple) ultrasounds are needed to monitor baby's progress over time, then all the parameters are graphed progressively, proving a powerful clinical tool to chart the well-being of your baby.

Extra time is allowed at your 28 and 32 week to check these parameters. If all is well, outside of these times, you will have a clinical examination and further scanning will not be performed "routinely". This is in accordance with the first principles of ultrasound scanning; "use the lowest dose of ultrasound required and only when the examination is clinically necessary".