Kull OB/GYN

Gynecological Disorders

Virtually every woman will suffer a gynecological condition at some point in life. Most of these conditions will be minor and easily treatable. Some conditions, however, can pose serious risks to a woman’s health or impact her ability to have children.

Gynecological Disorders / Conditions

• Breast cancer
• Cervical cancer
• Ovarian cancer
• Painful intercourse
• Pelvic pain
• Sexually transmitted diseases (STDs)
• Urinary incontinence
• Urinary tract infection (UTI)
• Uterine fibroids
• Vaginal cancer

If you are experiencing pain or symptoms indicating an issue, please contact our office to schedule an appointment.

Birth Control

While birth control can be used to prevent pregnancy, it can also be used to regulate hormones in women who have chronic health conditions that deplete the body's normal supply of estrogen and progesterone.

Birth control is also beneficial for women who have chronic conditions such as endometriosis, fibroid tumors, or excessively difficult periods.

Age, weight, overall health, and other factors can influence the effectiveness of various types of birth control. We offer knowledgeable and supportive counsel in choosing among the various birth control methods available.

Birth Control Methods Offered

• Birth control patch (Ortho Evra)
• Birth control pills
• Emergency birth control ("morning-after pill")
• Injectable birth control (Depo-Provera)
• Progestin-only birth control pills ("mini pill")
• Tubal ligation

If you would like more information regarding birth control and which method may be best for you, please contact our office to schedule a consultation with one of our physicians.

Vaccinations

Vaccinations help promote immunity to common illnesses and serious diseases. While most vaccines are administered during childhood, there are a few vaccinations recommended for adults as well. Our office offers the following vaccines as recommended by the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control (CDC).

Vaccines Offered

• HPV – series of three vaccines for ages 11-26
• MMR (Measles / Mumps / Rubella) – one booster as an adult
• TDAP (Diphtheria / Tetanus / Pertussus) – booster every 10 years
• Shingles – given once over age 60
• Pneumonia – given once over age 65 or younger with a chronic illness

If you are in need of a vaccine or a booster, please contact our office to schedule an appointment.

Surgical Procedures

Our skilled physicians are equipped with state-of-the-art equipment and technology to provide you with the most optimal results from gynecological surgery. We focus on the safest, most effective methods of care for your procedure and recovery.

Procedures Offered

• Abdominal hysterectomy
• Abdominal myomectomy
• LEEP procedure
• Vaginal hysterectomy
• Hysteroscopy
  • Endometrial ablation
  
  
  • Endometrial polyps
  
  
  • Fibroids
• Laparoscopy
  • Bilateral tubal ligation
  
  
  • Endometriosis treatment
  
  
  • Hysterectomy
  
  
  • Ovarian cyst removal

Please contact our office to schedule a consultation with one of our physicians.

Prenatal Care

Prenatal care allows the doctor to monitor the progress of both mother and child during development. These visits can help identify avoidable risks and identify any potential health issues early.

For most patients, our physicians will follow the schedule outlined below for prenatal visits. Frequency of visits may increase if a pregnancy is determined to be high risk.

Prenatal Visit Schedule

• Once a month between 4 weeks and 28
• Twice a month between 28 weeks and 36
• Every week from 36 weeks to labor and delivery

Beginning with the initial prenatal visit, you will undergo routine assessments, tests, and screenings at each appointment. Depending on age, personal health, family history, ethnic background, and initial test results, additional screenings or assessments may be required.

Routine Assessments

• Blood pressure
• Weight
• Urine specimen
• Uterine size
• Fetal heart rate

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Initial Prenatal Visit

Your first prenatal visit is typically 8 to 12 weeks after your last menstrual period.

What to Expect

• Medical history review with nurse / physician
• Lab work
• Pelvic exam
• Physical exam
• Extensive counseling and patient literature
• Brief ultrasound (depending on the length of pregnancy)

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First Trimester Screenings

First trimester screenings are typically done during the 11th and 13th week of pregnancy.

What to Expect

• Ultrasound - confirms due date and multiple gestation
• Blood work screenings for:
  • Blood type
  • Rh factor
  • Anemia
  • Hepatitis B / Syphilis / HIV
  • Immunity to German measles (Rubella) and Chickenpox (Varicella)
  • Cystic fibrosis
  • Down syndrome (optional)

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Second Trimester Screenings

During this trimester, we will be seeing you every four weeks. Once you have your glucose tolerance test – typically sometime between 24 and 28 weeks -- you will be seen every two weeks.

What to Expect

• Ultrasound - reveals gender and anatomical abnormalities
• Amniocentesis - (optional) detects neural tube defects and genetic disorders
• Glucose tolerance test (GTT) - screening for gestational diabetes
• Blood work screenings for:
  • Down syndrome
  • Open neural tube defects
  • Trisomy 18

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Third Trimester Screenings

During the third trimester, you will continue to have visits every 2 weeks until week 36 when you will be seen every week. We will continue to monitor your blood pressure, weight, and require a urine sample at each visit.

Fetal malposition and preeclampsia will also be determined this trimester. Detection of a baby presenting in the wrong direction after 36 weeks allows for the possibility to turn the baby to the “head down” position.

What to Expect

• Ultrasound - evaluate fetal growth (optional)
• Non-stress test - measures the baby's heart rate as it moves
• Group B streptococcus (GBS)
• CBC/Blood count - checks for anemia
• Antibody screening - women with Rh negative blood type

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When to Call Our Office

Your body will undergo many changes as a routine part of pregnancy; however, some symptoms may occur that warrant a call to our office.

Symptoms that Warrant a Call

• Heavy vaginal bleeding or clotting
• Light bleeding that lasts more than one day
• Passage of grayish or pinkish tissue (1st trimester)
• Bleeding accompanied by cramps, fever, chills or dizziness
• Severe abdominal pain or pain in your shoulder area
• Dehydration
• Fever higher than 101°F
• Painful urination
• Watery vaginal discharge
• Sudden swelling of the face, hands, or feet
• Significant decrease in fetal movement after the 24th week
• Signs of premature labor (2nd or 3rd trimester)
  • Regular uterine contractions
  • Lower back pain
  • Feeling of heaviness in the lower pelvis or abdomen
  • Diarrhea
  • Slight spotting or bleeding
  • Watery fluid or mucus discharge

If you are experiencing any of the above listed symptoms, please call our office as soon as possible.

Labor & Delivery

Labor

One of the questions asked most often is, "How can I tell when I'm going to go into labor?" Your baby's due date is merely a point of reference, so it is difficult to know precisely when labor will begin. It is common for labor to begin as early as three weeks before the due date or as late as two weeks after it.

Your body will begin preparing for labor as much as one month before you give birth. You may notice some, if not all, of the early signs that labor is most likely imminent.

Early Signs of Labor

• Lightening - your baby's head drops down into the pelvis
• Bloody show - passage of a small amount of blood-tinged mucus
• Frequent diarrhea
• Ruptured membrane - your "water breaking"
• Intense contractions

Our physicians have compiled a list of questions to help determine if what you’re experiencing is true labor or false labor contractions (Braxton Hicks contractions).

	True Labor	False Labor
How often do contractions occur?	Regular intervals lasting 30-70 seconds and get closer as time passes	Irregular intervals and do not get closer together
Do contractions change with movement?	Continue even when you move or change positions	May stop when you walk, rest, or change positions
How strong are the contractions?	Generally increasing in strength as time passes	Usually weak and do not get stronger or start strong and gradually weaken
Where is the pain felt?	Usually starts in the lower back and moves to the front of the abdomen	Usually only felt in the front of the abdomen or pelvic area

Delivery

Vaginal Birth vs. Caesarean Section (C-Section)
There are significant factors to consider when choosing your birthing method. While many women labor with a vaginal birth, for some women, labor doesn’t progress as it should. In these instances, the baby may be in the wrong position, the contractions may not be strong enough to dilate the cervix, or her body may not go into labor on its own.

In these situations, medical intervention may be necessary, and depending on the circumstances, our physicians may recommend medication to help with labor or a caesarean delivery.

If you are experiencing contractions and are unsure about whether or not your contractions are signs of true or false labor, please do not hesitate to call our office.

Postpartum Care

The postpartum visit is an important part of your overall pregnancy care. This exam ensures that you are recovering well from delivery. The postpartum visit also serves as an opportune time to review the pregnancy and delivery and focus on possible red flags, discuss family planning, and address any ongoing concerns you may have about how you are feeling.

Please contact our office if you experience any of the following symptoms prior to your initial postpartum exam.

Symptoms that Warrant a Call

• Fever and chills (temperature exceeding 100.4°F)
• Severe depression
• Foul smelling or purulent vaginal discharge
• Severe pain
• Heavy vaginal bleeding with clots

Healthy Vaginal Deliveries

An initial postpartum exam is scheduled at 4 to 6 weeks following your delivery.

Healthy Caesarean Deliveries

Postpartum visits are scheduled at 1 to 2 weeks following delivery and again at 4 to 6 weeks.

We generally plan a return visit to resume comprehensive wellness exams at 3 to 4 months following delivery.

Should any concerns arise, we will be happy to schedule as many visits as needed to assure your continued good health and comfort.

If you are experiencing any of the above listed symptoms, please call our office as soon as possible.