UPMC Pinnacle Obstetrics and Gynecology Specialists

Gynecology is the specialty of medicine that deals with the diagnosis and treatment of disorders of the female reproductive system (uterus, vagina, and ovaries). Besides routine well woman care, we evaluate and treat problems such as menstrual irregularities, urinary disorders, abnormal bleeding, and vaginal and pelvic infections. We also provide cancer screening.

Our team of providers have expertise in the gynecologic care of women from adolescence through menopause and beyond. We understand the importance of patience, gentleness and counseling in caring for adolescents beginning gynecological care. We also focus on the concerns of mature women such as hormone replacement therapy, sexual dysfunction and urinary problems. Our physicians continue to be at the forefront in our community in adopting new advances in both gynecologic surgery and non-surgical alternatives.

We perform our surgical procedures at UPMC Hanover. Using advanced surgical techniques, our expert gynecologic surgeons diagnose and treat a wide variety of gynecologic conditions and disorders.

Gynecologic Conditions and Disorders We Treat

• Endometriosis
• Cysts
• Infertility
• Uterine fibroids
• Incontinence
• Pelvic inflammatory disease
• Dysfunctional uterine bleeding
• Excessively heavy periods (menorrhagia)
• Painful periods (dysmenorrheal)
• Chronic pelvic pain
• Pelvic organ prolapse
• Gynecological cancers

Adolescent Gynecological Care

A young woman’s first gynecological examination should be a positive experience. Our thoughtful and caring providers can offer answers to the many questions that teens have today. We take pride in providing the kind of one-one-one care that makes you feel comfortable talking about your health in a safe and confidential environment.

Some common conditions for our adolescent population include:

• Dysmenorrhea (painful periods)
• Menstrual irregularity – a significant variation in menstrual cycle length and flow
• Ovarian cysts – fluid-filled sacs formed on the ovaries
• Polycystic ovarian syndrome (PCOS) – a hormonal disorder of women in reproductive age, sometimes causing menstrual irregularity and excessive hair growth
• Premenstrual syndrome (PMS)
• Pubertal menorrhagia (heavy periods)
• Sexually transmitted diseases (STDs)

In-Office Sonography

Our office is equipped with the latest and most advanced ultrasound machines and is accredited by the American Institute of Ultrasound in Medicine (AIUM). The convenience of our accredited facility allows the patient to receive a high-quality examination from one of our registered sonographers and to have the results interpreted by the physician shortly thereafter. We have provided a TV monitor for the patient to view their sonogram during the exam. A sonogram takes about 30 to 60 minutes.

In gynecological evaluations, pelvic sonograms can be used for routine ovarian screenings––a valuable tool in the detection of ovarian cancer. We also use pelvic sonograms to determine the cause(s) of problems such as pelvic pain, uterine fibroids, ovarian cysts, and irregular bleeding.

Examples Gynecologic Procedures Performed

• Hysterectomy
• Pelvic laparoscopy to examine pelvic organs
• Tubal ligation – during this surgical procedure of sterilization, the fallopian tubes are clamped and sealed to prevent eggs from reaching the uterus for fertilization
• Fibroid removal for abnormal bleeding and infertility
• Dilation and curettage (D&C) – the widening (dilation) of the cervix and surgical removal of part of the lining of the uterus and/or contents of the uterus by scraping and scooping (curettage)
• Hysteroscopy for dysfunctional uterine bleeding
• Treatment for pelvic organ prolapse

During Your In-Office Procedure

In-office procedures can help you avoid a trip to the hospital, as well as the anxieties and costs that may be associated with them. These procedures are performed at our familiar and convenient Hanover location. If you are interest in learning more about any of our in-office procedures and what to expect, we recommend that you speak with your health care provider at our office to determine whether or not you are a candidate. Below are some examples of the in-office procedures performed by physicians at our Hanover location:

• Cystometric Studies (Cystometeogram or CMG) – to evaluate the bladder, to determine what is causing the voiding problem
• Essure® – tubal ligation performed through a hysteroscope, with a small occlusive device placed in both tubes, which can be done with minimal anesthesia
• Hysteroscopy
• D&C
• Birth control implants, such as Lilleta®, Nexplanon®, ParaGard®, and Skyla®
• Endometrial ablation (such as NovaSure®) for premenopausal women with excessive and abnormal bleeding between menses. This procedure is not for women who still wish to have children.
• Prolia®

During Your Surgery

Before surgery, your physician will thoroughly explain the surgical procedure – its risk and benefits. This is an opportunity for you to ask him or her any questions you might have. Our surgical coordinator will then discuss with you other aspects of your surgery and provide educational material and an idea of what to expect before, during, and after surgery. This person can be used as a resource for other questions you might have and will serve as your liaison between Mountain View OB-GYN (Hanover Medical Group) and UPMC Hanover in the coordination of your surgical procedure and post-operative care. We encourage family members to sit in on these visits.

After your questions are answered, you will be asked to sign a legal consent form. When you are scheduled for your surgery, you will likely have routine tests, such as an EKG, chest x-ray, urine test, and/or blood test. These tests provide your physician with a “baseline” before you go to the hospital for surgery. As you are recovering from surgery, these tests may be repeated, and the results compared to your preoperative tests. Recovery from surgery is different for each patient. Factors that influence your recovery include your age, the type of surgical procedure you had, and your general health.

The thought of your first visit to a gynecologist may seem mysterious or even frightening, but it doesn’t have to. In fact, your first gynecologic visit is a great opportunity you and your health care provider to get to know each other. It’s also an opportunity to get honest, expert information about many different issues, including: your body and how it’s changing, diet and exercise, acne, cramps and problems with your period, emotional ups and downs or depression, sex and sexuality sexually transmitted diseases (STDs), birth control, alcohol, drugs, and smoking.

Talking with your health care provider about these issues is an important part in staying healthy. You also can find out what to expect at future gynecologic visits. There is no need to be scared or embarrassed. If you are nervous about it, talk to your health care provider, your parents, or someone else you trust. Knowing what to expect will help ease your fears. Becoming more comfortable with your gynecologic exam will help you take more of an active part in something that should become a regular part of your adult life: what is known as a “well woman exam”.

Questions You May Be Asked

Your health care provider may ask a lot of questions about you and your family. Some of these questions may seem personal. Your provider needs to ask them to best know how to care for you and keep you healthy. Giving open and honest answers to these questions is key to your care. Questions you may be asked:

• What is the reason for your visit?
• Do you have any health problems?
• Have you started having periods?
• If so, how old were you when you started your period?
• What was the date of your last period
• How often do you get your period?
• How long does your period last?
• What is the amount of flow (light. medium, heavy)?
• Do you have cramps?
• What is your family’s medical history (for instance, has anyone in your family had cancer)?
• What did you eat yesterday?
• Do you exercise or play sports?
• Do you take any medicines?
• Do you take any vitamins, herbs, or supplements?
• Do you use tobacco, alcohol, or other drugs?
• Have you ever had sex? If so, when was the last time you had sex?
• What do you do when you have sex?
• Do you use birth control?
• Within the last year, have you been hit, slapped, kicked, or been physically hurt by someone?
• Are you in a relationship with a person who threatens or physically hurts you?
• Has anyone forced you to have sexual activities that made you feel uncomfortable?
• Do you ever feel sad or as though you have nothing to look forward to?

This is a good time to ask your physician any questions you might have. Don’t be embarrassed. This is a chance to get answers.

Symptoms Requiring Care

It is important to see your health care provider if you are having any of the following symptoms: severe pain in the lower abdomen; bad cramps during your period; periods that are not regular; pain around the vagina or swelling, itching, or discharge; blood in your urine; you think you may be pregnant (for instance, you have missed your period); or signs you may have a sexually transmitted disease (STD) (for instance, you feel burning or itching or have discharge).

What to Expect During Your First Gynecologic Exam

Young women should begin to see an OB/GYN around the time when they become sexually active or when they experience problems with their menstrual period. You should see a gynecologist at age 21 if you have not already done so. Most gynecologic visits include the following:

• Physical screening – A nurse or medical assistant will measure your height, weight and blood pressure, and ask you questions regarding your age, your most recent menstrual period, any previous pregnancies, miscarriages, abortions or surgeries, your use of birth control, and any personal or family history. You may be given vaccination shots if you need them. Vaccinations are shots that help prevent some infections. They are part of routine care.
• Preparation for the examination – You may be escorted to an examination room for more questions or be given a cloth gown and a few minutes to change into it. You or your physician may request to have a nurse, family member, or friend in the room with you.
• Physical exam – Many gynecologic examinations start with the patient in a sitting position. During this part of the exam, your heart, lungs, thyroid glands, and breasts may be examined. After this, you may be asked to lie down.
• Breast exam – You will be asked to lie on the exam table and open your gown. The provider will examine your breasts by moving his or her fingers around your breasts in a pattern. He or she will check for signs of any problems such as a lump. If the exam is done just before your period, your breasts may be sore.
• External genital exam – While you are still lying down and covered by your gown, you will be asked to place your feet in footrests (also called “stirrups”). The provider will lift your gown and check your genitals for unusual color or tone, and for things such as sores, lesions or discharge. If you have any specific questions, you can request a mirror and show the provider any areas that concern you.
• Vaginal examination – The provider then uses a medical instrument called a speculum, which is inserted into the vagina to spread the walls of the vagina so that the cervix can be seen. The provider will look at your reproductive organs for signs of problems.
• Pap test – This test is usually performed only for women who are age 21 and older. As part of the vaginal exam, the provider will use a small brush to collect a sample of surface tissue from your cervix. This sample will be sent to a lab to be studied for abnormal cells in the cervix which detect cervical cancer and certain types of infection. It is best to have a Pap test when you are not having your period. It is a good idea not to put anything in the vagina for two to three days before the Pap test. This part of the procedure can be a little uncomfortable, and it may cause spotting later. The cells then are sent to a lab to be studied.
• Bimanual exam – After the speculum is removed, the provider may check the size of your uterus, see if there is any pain when your cervix is moved, feel your ovaries, and check for abnormalities in the pelvic area. This part of the exam is done manually, with the provider using lubricated gloved fingers and the pressure of her other hand against your abdomen. A rectal exam may also be conducted.

Preparing for Your First Gynecologic Exam

Here are a few suggestions for preparing for your appointment:

• When you call the office, tell the scheduler that this will be your first gynecologic examination. If there is a specific reason for your appointment, such as a problem with your period, let the scheduler know. If you prefer to have someone accompany you during your exam, let the scheduler know, and ask about the office’s policies.
• If this is a non-emergency visit, try to schedule it between menstrual periods. For two days prior to the exam, do not use tampons, douches, or insert anything into your vagina (avoid intercourse or other penetration).
• If you have questions for the health care provider, write them down ahead of time. Be prepared to discuss your medical history and current medications including vitamins and supplements, and bring old medical records if you have them.

Confidentiality

Many young women want to talk to their health care provider, but are afraid that what they tell their physician will not be confidential and the provider will tell someone else, like their parents. If you are concerned about confidentiality, you and your physician should talk about it before you answer any questions. Your physician needs to talk about confidentiality with your parents, too. It may be good for all of you to sit down together to discuss this. Or, your doctor may choose to talk alone with each of you.

Obstetrics is the specialty of medicine concerned with pregnancy, labor, and postpartum period. Our dedicated team of health care providers and staff pride themselves in providing excellent quality of care in a warm, comfortable setting.

Pregnancy and birth are two of the most important events you will experience in your life. Both deserve careful and thoughtful consideration. Our experienced team of obstetricians and midwives provide you with a full spectrum of pregnancy and childbirth care, as well as gynecologic care before and after pregnancy. We work collaboratively with the childbirth team at UPMC Hanover, where we perform all of our deliveries. When you go to the hospital to deliver, you will be cared for by the same integrated nursing team that specializes in caring for all of our childbirth patients. This dedicated team has years of experience in providing care in a full spectrum of childbirth scenarios.

We provide an individualized birth experience for you and your family. We are committed to working with you to understand and respect your personal preferences and your individual birth plan. Whether you choose a natural childbirth or are seeking help understanding your birth options after a previous C-section, our team works with you to understand your options, inform you about what to expect during the labor and delivery process, and respect your choices throughout your entire pregnancy and childbirth experience. Should high-risk pregnancy care be required, your obstetrician will work hand-in-hand with maternal-fetal medicine specialists to provide unparalleled care.

General Obstetrics Care

We provide comprehensive obstetric care from preconception to postpartum. Our experienced medical team provides general services to guide women through each and every step of their pregnancy to ensure proper growth and development, as well as a successful delivery. Our facilities are also fully equipped with the technology and equipment to help make your pregnancy as simple and efficient as possible.

During your pregnancy, you will visit our providers on a regular basis for physical examinations, blood tests, and ultrasounds in order to monitor the growth and development of your baby. We will also discuss with you your options for the delivery process, and then work with you to ensure that labor and delivery is comfortable and stress-free. Postpartum care is also available to help women become acclimated to the motherhood lifestyle while maintaining their health as well.

Midwifery Care

A certified nurse-midwife (CNM) is an experienced registered nurse who has completed an accredited education program in nurse-midwifery and has passed a national certifying exam. Certified nurse-midwives provide prenatal care, deliver babies, and offer regular gynecologic care for healthy women with uncomplicated pregnancies. Our nurse-midwives believe that birth is a natural and normal process. They take a personal approach to childbirth, stressing the importance of educational and emotional support for parents. Your nurse-midwife will provide you with comprehensive care, including childbirth education, nutrition and exercise counseling, breastfeeding instruction and early parenting information.

Infertility

Our experienced team of obstetricians and midwives keep abreast of the most advanced treatment options to assist infertile women and men who wish to conceive children. Using the most advanced procedures and laboratories to increase the likelihood of conception, we are dedicated to helping couples suffering from infertility and recurrent early pregnancy losses, realize their dreams.

In-Office Sonography

Our office is equipped with the latest and most advanced ultrasound machines and is accredited by the American Institute of Ultrasound in Medicine (AIUM). The convenience of our accredited facility allows the patient to receive a high-quality examination from one of our registered sonographers and to have the results interpreted by the physician shortly thereafter. We have provided a TV monitor for the patient to view their sonogram during the exam. A sonogram takes about 30 to 60 minutes.

During pregnancy, we use sonograms to look at the growth and development of your baby. An early sonogram in the first trimester confirms the accuracy of your baby’s due date. At around 20 weeks of gestation, we provide a detailed evaluation of the baby’s anatomy and can determine the gender of your little one! Additional sonograms may be necessary in high-risk patients.