Patient Education

For most women with an uncomplicated pregnancy, exercise is healthy, enjoyable, and recommended. Try to exercise at least five days per week, at least 30 minutes each time.

Safe activities:

• Walking and hiking
• Swimming
• Cycling
• Aerobics and water aerobics
• If you were a runner before you became pregnant, you often can keep running during pregnancy, although you may have to modify your routine
• Golf
• Tennis
• Cross country skiing
• Weight training – if done carefully. Joints and ligaments change during pregnancy due to hormone changes. You are at a slightly increased risk of injuring yourself while pregnant.

Things to avoid:

• Activities in which there is a high risk of falling:
  • Gymnastics
  • Water skiing
  • Horseback riding
  • Ice skating
• Sudden forceful contact sports
  • Soccer
  • Hockey
  • Basketball
  • Football
• Downhill skiing – due to change in balance and increased risk of altitude sickness

Things to be aware of when exercising during pregnancy:

• Avoid becoming overheated. This may cause loss of fluids and lead to dehydration and problems during pregnancy.
• If it has been some time since you have exercised, start slowly.  Begin with five minutes per day and add five minutes each week until you can stay active for 30 minutes a day.
• Avoid brisk exercise in hot, humid weather or when you have a fever.
• Drink plenty of water to prevent overheating and dehydration.

​Warning signs – Stop exercising if you have any of the following:

• Vaginal bleeding
• Dizziness or feeling faint
• Increased shortness of breath
• Chest pain
• Muscle weakness
• Calf pain or swelling
• Uterine contractions

How will you know when you are in labor?

Labor is different for every woman. Here are some general rules that may help you know when you are in labor:

Your uterus will tighten and relax – this is a contraction. Contractions may begin in your lower back and move around both sides to your lower abdomen.

When you notice that contractions are coming regularly (every five to ten minutes) or you are unable to talk, walk, or sleep through the contractions because they are painful, notify us.

What happens if your bag of water breaks?

When your bag of water breaks, there may be a sudden gush of fluid from your vagina or you may have uncontrollable leaking of fluid. Notify us immediately if this happens. You will need to come to the office or to the hospital for evaluation.

You may pass your mucus plug up to one to two weeks before you go into labor – this is thick and not watery. Sometimes it is blood tinged. This is OK. It in not necessary to call us; however, if there is any question, please contact us.

What should you call for?

• Regular, painful contractions
• Uncontrollable leakage of fluid or a gush of fluid
• Vaginal bleeding (other than after a cervical exam in the office)
• Headache that does not resolve with Tylenol
• Visual changes
• Severe abdominal pain
• Fever
• ANY other unlisted concerns

Who and how do you contact us?

If you have an emergency or an urgent question, call Dr. Dullye’s office number – 214.369.2400. Follow instructions for an urgent message. Dr. Dullye should return your call within 5 to 15 minutes. If you do not receive a return phone call, you may leave another message and/or notify Labor & Delivery – 214.345.2652.

If you have a nonurgent message/question, feel free to call Dr. Dullye’s office. You can leave a message for Tracy (the nurse) by pressing 4 or Robyn (the front office manager) by pressing 3 anytime.

These messages are checked only during regular office hours. All attempts will be made to return calls within 24 hours.

Regular office hours are: Monday, Tuesday, Wednesday, and Friday, 8 AM to 4 PM. Dr. Dullye’s office is closed on Thursday.

Often nausea and vomiting occur during the early months of pregnancy. Although it is frequently referred to as “morning sickness,” it can occur any time of the day or night. Nausea and vomiting typically peak during the ninth week. Usually, it disappears after approximately the third month (the twelfth week) but may continue or be intermittent until 20 weeks.

FOR PREVENTION of morning sickness, try the following suggestions until you find one that works for you:

• Eat a piece of bread or a few crackers before you get out of bed in the morning (put them close to your bed the night before), or when you feel nauseated.
• Get out of bed slowly. Avoid sudden movements.
• Eat several small meals during the day so your stomach doesn’t remain empty for long periods of time.
• Drink soups and other liquids between meals instead of with meals.
• Increase protein intake and decrease carbohydrates and fat.
• Avoid greasy or fried foods, because they are hard to digest.
• Avoid spicy, heavily seasoned foods.
• Avoid iron supplements during the first trimester.

TO REMEDY morning sickness, try these suggestions:

• Sip soda water (carbonated water) when you begin to feel nauseated.
• Take Vitamin B6, 25 milligrams three times daily
• Take ginger supplements, 125-250 milligrams every six hours.
• Take Unisom SleepTabs (doxylamine), 12.5 or 25 milligrams at bedtime, 12.5 milligrams in the morning and/or afternoon.

If vomiting persists or it becomes difficult to retain food and liquids, please call the office to discuss prescription medications: Diclegis, Phenergan, and/or Zofran.

Clinical Pediatrics:

• Colleen Edge, MD
• Lorin Levin, MD
• Pat Hieber, MD
• Ernesto Fernandez, MD

8355 Walnut Hill Lane, Suite 105
Dallas, TX 75231
214.368.3659
www.clinicalpediatrics.com

Pediatric Associates:

• Christina Bourland, MD
• Michael Brown, MD
• Early Denison, MD
• Maribel Diaz-Esquivel, MD
• Bich Do, MD
• Christopher Dreiling, MD
• John Foster, MD
• Lauren Gore, MD
• Lisa Grysen, MD
• Arthi Krishnan, MD
• Karen McClard, MD
• Muzzian Rani Siddiqi, MD
• Melissa Waters, MD
• Kathryn Wray, MD

8355 Walnut Hill Lane, Suite 200
Dallas, TX 75231
214.369.7661
www.paddallas.com

Pediatricians of Dallas:

• Somer Curtis, M.D.
• Karen Halsell, M.D.
• Joe Neely, M.D.
• James Watkins, M.D.
• Matthew Yeager, M.D.
• Hillary Lewis, M.D.

8325 Walnut Hill Lane, Suite 225
Dallas, TX 75231
214.691.3535
www.pediatriciansofdallas.com

Richardson Pediatric Associates:

• Norah Randles, MD
• Sarah Troendle, MD
• Abbie Smith, MD
• Natalie Pounds, MD
• Chelsea Duffy, MD

1112 N. Floyd Road
Suite 6
Richardson, TX 75080
972.952.0280
www.richardsonpediatricassociates.com

• Reese Mathieu, M.D.

3601 North Star
Richardson, TX 75082
972.235.0385 (Mathieu)
972.231.9421 (Daniel)

Inwood Village Pediatrics:

• Tina Deuber, MD
• Janie Hamner, MD
• Julie Linderman, MD
• Grace Khouri, MD
• Susan Hubbard, MD
• Celia Browning, MD

5470 W. Lovers Lane, Suite 330
Dallas, TX 75209
214.956.7337
www.inwoodvillagepediatrics.com

• Dynal London, M.D. (patient referral)

6900 Scenic Drive, Suite 103
Rowlett, TX 75088
972.412.1034

• Seth Kapland, M.D. (patient referral)

3401 Preston Road
Frisco, TX 75034
214.618.6272

• William Kessinger, M.D. (patient referral)

3701 Eldorado Parkway, Suite A
McKinney, TX 75070
972.548.7888

Forest Lane Pediatrics:

7777 Forest Lane
Building B, Suite 445
Dallas, TX 75230
972.284.7770
www.forestlanepediatrics.com

• Kim Mehendale, M.D.

5490 Communications Parkway
Plano, TX 75093
972.403.9355

What is Down Syndrome?

Down syndrome is one of many chromosome disorders. Chromosomes are the genetic blueprints that determine how a baby will develop. Chromosome disorders occur by chance when a baby receives too few or too many chromosomes at conception. Down syndrome occurs when a baby receives an extra chromosome 21. This disrupts development and causes birth defects and mental retardation. These disorders are not typically inherited. Instead, they are usually caused by a random error during formation of the egg or sperm, or during the earliest stages of development.

What is fetal genetic testing?

Screening tests are blood and or ultrasound tests that estimate the likelihood for the fetus to have certain types of birth defects, including Down syndrome, Trisomy 18, Trisomy 13, Sex chromosome abnormalities (that is, Turner, Klinefelter, Jacobs, and Triple X syndromes), and certain microdeletion syndromes. A normal result does not guarantee a normal/healthy baby, as these tests are not diagnostic tests and only screen for certain conditions.

Who should have fetal genetic screening?

Screening is offered to all pregnant women who are at least 10 weeks pregnant. Because women over age 34 or with a family history of chromosome abnormalities are at a higher risk of having a baby with chromosome abnormalities, the American College of Obstetricians and Gynecologists recommends that all be offered chorionic villi sampling or an amniocentesis for chromosome testing. These tests detect 99.9% of all chromosome abnormalities. However, these diagnostic tests are invasive and carry a small risk of miscarriage.

How and when is genetic screening done?

There are several ways to do genetic testing/screening. If you choose to undergo genetic screening, you will need to have only one of these tests performed:

• NIPT (Non-invasive prenatal test) – Verify or Panorama: These tests require only a blood draw and are safe for mother and baby. This screens for the most common chromosomal abnormalities (Down syndrome, Edwards syndrome, Patau syndrome, Turner syndrome, Klinefelter syndrome, Jacobs syndrome, and Triple X syndrome). This test can also tell you the gender of your baby if you want to know. This test can be done anytime after 10 weeks and results are available in about 7-10 days.

• First-trimester ultrascreen: This test is done between 11 and 13 weeks and consists of 1) a special sonogram to measure the nuchal translucency (NT), and 2) blood testing to measure protein levels (B-HCG and PAPP-A). These measurements are used to calculate the risk of the most common chromosome abnormalities (Down syndrome, Trisomy 18, and Trisomy 13).

Am I required to have genetic testing?

No. The decision whether to have the screening tests performed is your personal decision.

Baby blues and postpartum depression are extremely common following delivery. Baby blues can occur in 80% of women in the postpartum period. It usually starts within one week after giving birth. Symptoms include drastic mood swings, elation, and joy followed by sadness, crankiness, and crying spells. If you experience these symptoms, be sure to get plenty of rest and eat well. Be sure to ask family and friends for support and help with the baby and your house.

Postpartum depression occurs in one out of ten women in the postpartum period. It can begin any time after birth and may appear for up to a year after delivery. Symptoms include feelings of despair, extreme weight loss/gain due to appetite changes, difficulty sleeping or sleeping more than usual, crying spells, withdrawal, and attempts to avoid the baby. Women with postpartum depression often feel like they don’t want to get out of bed in the morning, like everything is hopeless like they are staring into a big, black hole, and/or like they don’t want to deal with anyone and wish everyone would “leave me alone.” If you experience any of these symptoms, please contact our office.

Postpartum psychosis is a rare disorder that occurs in one in 1000 women in the postpartum period. It usually occurs within two to three weeks after childbirth. Symptoms include hallucinations (seeing objects that aren’t really there), delusions, severe insomnia, no interest in eating, extreme anxiety and agitation, suicidal or homicidal thoughts or gestures, and lack of attention to personal hygiene. If you experience any of these symptoms, please contact us or proceed to the emergency room as soon as possible. Postpartum psychosis is a severe medical emergency and requires immediate medical attention. When left untreated, this disorder can have tragic results for both the mother and her child.

As stated above, if you are concerned that you may be suffering from postpartum depression or postpartum psychosis, please contact us. Other resources that you may contact include:

Postpartum Support International – Texas (Multi-lingual)
811 Nueces
Austin, TX 78701
1.800.944.4773 – toll-free
www.postpartum.net

Mental Health Association of Greater Dallas
624 N. Good-Latimer, Ste. 200
Dallas, TX 75204
214.871.2420
www.mhadallas.org

Mental Health Association of Tarrant County
3136 W. 4th Street
Fort Worth, TX 76107
817.335.5405
www.mhatc.org

Texas Department of Health Family Health Services, Information & Referral Line
1.800.422.2956

2-1-1 Texas
2-1-1 Texas, formerly First Call for Help, is a service for the entire community. 2-1-1 is the new abbreviated dialing code for free, bilingual information and referrals to health and human services and community organizations.

Travel, either by car or plane, will not cause problems with pregnancy. However, if a pregnancy complication arises, it is important to have access to medical care. The best time to travel is mid-pregnancy (14 to 24 weeks).

Prior to 14 weeks, nausea, vomiting, and fatigue are common. Also, the risk of miscarriage is highest prior to 14 weeks.

After 24 weeks, your baby is “viable.” This means that in the rare chance your baby is delivered early, it has the potential to survive. Some of this potential depends upon what type of medical care the baby receives. You and your baby may not be able to receive the same medical care in your travel destination (especially if you are traveling outside the United States) as you will receive at THR Presbyterian Dallas Hospital.

Please note:

• Most airlines do not allow pregnant women to travel after 36 weeks
• Many cruise lines do not allow pregnant women to travel with them at any gestational age

If you plan to travel after 24 weeks, please notify us. We may recommend (depending on your gestational age and your destination) an examination, sonogram, or other testing prior to your departure.

ZIKA VIRUS

• Zika virus is primarily transmitted through the bite of an infected mosquito.  However, it can be spread through sexual transmission and blood transfusions.
• Most cases of Zika in Texas are related to travel abroad.
• It is possible for a pregnant mother infected with Zika to pass the virus to her baby.  The virus has been linked to birth defects.
• There is currently no vaccine or treatment for Zika.
• Symptoms:
  • Fever
  • Rash
  • Joint pain
  • Conjunctivitis (red eyes)
  • About four out of five people won’t even know they have it.
  • Please inform us if you have experienced these symptoms, especially if you have traveled to a high-risk area.
• Prevent Zika while traveling:
  • Pregnant women and their partners should delay travel to areas where Zika is spreading – a list of areas to avoid can be found at www.texaszika.org/travelers.htm
  • Protect yourself from mosquito bites: Wear long sleeves and pants when outdoors, wear an EPA-approved insect repellant with DEET when outdoors, stay indoors or in screened-in areas.
  • Pregnant women with sex partners who live in or have traveled to a high-risk area should abstain from sex (vaginal, anal, or oral) for the duration of the pregnancy.
  • For couples not yet pregnant, but have had a confirmed Zika virus infection or illness consistent with Zika virus disease: Men should abstain from sex or use condoms for at least six months after onset of illness. Women should abstain for at least eight weeks after onset of illness.

DAILY FOOD GUIDE DURING PREGNANCY

The average amount of weight gain during pregnancy is 25 to 45 pounds. Pregnancy is not a time to diet or lose weight.

• Include protein (egg, chicken, fish), carbohydrate (fruit, vegetables, cereal), and healthy fat (olive oil, tree nuts, avocado) to stay energized.
• While awake, try to eat every three hours.
• Enjoy healthy foods first and plan for an occasional treat.
• Drink plenty of water (6 to 8 cups daily).  Limit soda, coffee, juice drinks and other sweetened beverages.
• No more than 100 mg of caffeine daily (for example, one cup of coffee).
• Eat enough for a healthy weight gain, but you do not need to “eat for two.”

Food groups:

Healthy Protein:

• Chicken, turkey, fish, low-fat dairy products, eggs, beans, nuts, almond butter, lean meat, tofu
• Fish – Eat about 12 ounces, 2 average meals, per week of low-mercury seafood (shrimp, canned light tuna, salmon, pollock, catfish). If you are unable to eat fish, other sources of DocosaHexaenoic Acid (DHA) include walnuts, wheat germ, flaxseed oil, or a DHA supplement.

Healthy Fats:

• Olive and canola oil, fatty fish (salmon, herring, sardines), avocados, nut butter, salad dressings, nuts and seeds
• Avoid trans fat or foods with hydrogenated or partially hydrogenated fat (packaged and processed foods, fried foods, fast foods).
• Limit saturated fat (butter, lard, whole-milk dairy, sausage, and bacon).

Healthy Carbohydrates:

• Fruits and vegetables are healthy sources of carbohydrates. Eat them throughout the day. Try for five to nine servings per day. Choose whole fruit rather than juice whenever possible.
• Limited amounts of whole-grain products, including whole-wheat bread, oatmeal, brown rice, whole-grain pasta, seeded rye, barley, quinoa, wheat berries, bulgur, millet, and kasha.  Limit refined carbohydrates (cookies, soda, instant rice, instant oatmeal).

Food Safety and Preparation:

When you’re pregnant, you’re at an increased risk for foodborne illness due to a weakened immune system.

Remember to:

• Wash your hands before and after food preparation.
• Cook well and properly handle meat, fish, eggs, and poultry. Eggs should be cooked until firm.
• Wash fruits and vegetables well.

Avoid:

• Shark, swordfish, king mackerel, tilefish, and solid white albacore tuna (due to mercury)**
• Unpasteurized brie, feta, camembert, blue cheese and all other unpasteurized soft cheeses
• Unpasteurized milk and juice
• Cold cuts and hot dogs (unless reheated to steaming hot)
• Cooked foods and foods requiring refrigeration that have been left unrefrigerated for more than two hours
• Salads prepared outside of home (for example, chicken salad, egg salad, tuna salad, seafood salad)

**www.nutrition.gov offers additional information on mercury and fish

If your blood type is Rh Negative (O negative, A negative, B negative, or AB negative), you will need to receive a gamma globulin injection at the following times:

• Anytime you have bleeding during your pregnancy
• Approximately 28 weeks gestation

Within 72 hours after delivery IF your baby’s blood type is found to be RH positive
This injection is given to prevent an immune reaction in case some of your baby’s blood cells enter your bloodstream. The baby’s Rh-positive cells entering your bloodstream could cause your body’s defense system to create antibodies to attack the different invading Rh positive cells. A Rhogam injection will prevent this from happening.

These injections are not necessary if the father of the baby is also Rh Negative. However, he must have bloodwork ordered through our office or an outside lab confirming that his blood type is Rh Negative (O negative, A negative, B negative, or AB negative).

If your blood type is Rh Negative, contact us immediately if you have any vaginal bleeding so that we can determine whether or not you need to receive a Rhogam injection.

As a general rule, no drug should be taken during pregnancy unless the benefit of that medication is significant. The first 12 weeks of a pregnancy are the most crucial time for development of the baby. Therefore, no medications (other than prenatal vitamins) should be taken unless the benefit outweighs the risks.

MEDICATIONS SAFE TO TAKE DURING PREGNANCY:

MULTIVITAMINS, MINERAL SUPPLEMENTS, AND LOW-DOSE ASPIRIN:

• Take a prenatal vitamin that includes at least 400 micrograms (mcg) of folic acid, 200-400 IU of Vitamin D, and 220 mcg of iodine.
• Take one low-dose (81 mg) aspirin daily – begin by 12 weeks gestation. This will decrease the risk of pre-eclampsia.
• If you do not consume two to three servings of dairy daily, take a calcium supplement (1200 mg).
• Choline – can promote fetal brain development. This is found in eggs, beef liver, and chicken liver.

SKINCARE PRODUCTS:

The following are minimally absorbed into the bloodstream following topical use, so are likely safe to use during pregnancy:

• Benzoyl peroxide
• Clindamycin
• Erythromycin
• Salicylic acid (if applied to intact skin)
• Sunscreens (oxybenzone, octocrylene, octisalate)
• Self-tanning
• Hair color/Highlights – as long as you are in a well-ventilated area while color is being applied.

Avoid the following skincare products:

• Tretinoin
• Retinoids
• Hydroquinone

ALSO AVOID:

• Oil-based paint fumes
• Insecticides  (OK to use Deet-containing insect repellant)
• Artificial sweeteners
• Exhaust fumes
• Large doses of vitamins
• Unusual herbs (Saint John’s Wort, Don Quai, Ginseng, Yarrow, Pennyroyal, Ephedra, Licorice Root)
• Cat feces (due to toxoplasmosis)

Gestational diabetes is a condition of pregnancy in which the mother’s body acts diabetic only during her pregnancy. Identifying the disease will reduce the risk to both mother and child. Please take this

A blood screening test has been developed to help identify those patients who have developed gestational diabetes. The test will be performed at approximately 24-28 weeks gestation on all pregnant patients. Having a screening test prevents all patients from completing a three-hour glucose tolerance test, which is both more expensive and time-consuming. Those patients whose screening test comes back abnormally high will then require more definitive testing.

Please click here to view the full glucose screening test instructions.

CPL Laboratory hours:

8:00 AM to 5:00 PM, Monday through Friday
8:00 AM to Noon on Saturday

CPL location:

Suite #111, Margot Perot Building

Results:

Will be emailed to you within the week following your blood draw. If you do not receive an email within the week, please contact Dr. Dullye’s office.

As long as you and your baby are healthy and your job presents no special hazards, you should be able to work as long as you want. In certain situations, you may need to give up certain tasks or transfer to another position until after the baby is born.

Most women are, physically, able to return to work six weeks after a vaginal delivery and eight weeks following a cesarean section. In the rare event that you experience a pregnancy, delivery, or postpartum complication, this may need to be extended.

According to the Family & Medical Leave Act (FMLA), “eligible” employees are able to take off up to 12 workweeks in any 12-month period for the birth or adoption of a child, to care for a family member, or if the employees themselves have a serious health condition. However, the employer is not required to pay the employee for this time off. This includes prenatal and postpartum care.

Most pregnancies are not disabling. For some women, pregnancy could become a disability if problems arise. There are two types of pregnancy-related disability:

• Disability caused by the pregnancy itself: some symptoms of pregnancy may cause short-term or partial disability. Giving birth also causes short-term disability (six weeks for vaginal delivery, eight weeks for cesarean section).
• Disability caused by pregnancy complications: more severe problems or conditions you had before getting pregnant may worsen during pregnancy and cause longer disability.

We are happy to complete any FMLA and/or disability forms that are required by your employer. We ask that you mail, fax, or bring the forms with you to your appointment. The forms will be completed by your next scheduled appointment.

With regard to disability, we will complete the forms as follows:

• Uncomplicated vaginal delivery: six weeks
• Uncomplicated cesarean section: eight weeks

Unless documented complicating factors occur, we are unable to extend the disability any longer than stated above. If complications occur during the pregnancy or postpartum period, we will alter the time of disability as necessary.

What Is Group B Strep?

Group B Streptococcus (GBS) is a bacteria frequently and normally found in the vagina of women. In fact, one-third of all healthy women are found to have GBS in the vagina. Although this bacteria does not typically cause symptoms or problems for the woman, it can occasionally cause severe and life-threatening infections in newborns. GBS is NOT a sexually transmitted disease. GBS is not the same as Group A Strep, which causes “Strep throat.”

How Is GBS Transmitted to the Baby?

GBS is passed to the baby through the birth canal during labor or delivery when the baby comes into contact with the bacteria carried by the mother. Although up to 35% of women carry GBS, in untreated women, only 1% of babies become ill due to the bacteria. It is not known why some exposed infants become ill while others never have a problem.

How Do We Test for and Treat GBS?

A vaginal culture will be done when you are approximately 36 weeks pregnant. Your results will be emailed to you within one week. If the culture is positive, you will be treated with intravenous antibiotics (Penicillin, unless you are allergic) during your labor and delivery. You will NOT need to take antibiotics prior to the labor, as treatment with oral antibiotics will only decrease the amount of GBS for a short time, but will not eliminate it.

What if You Go into Labor Before Your GBS Test is Done?

You will be treated with antibiotics while you are in labor.

• In 30-60 minutes the anesthesia will wear off, and your baby may be fussy. Cuddle and hold him.
• For the first three days, you may give Tylenol Infant Drops (or similar liquid medicine used for fever or pain in babies). Do not use these more than three times in 24 hours or for more than three days.
• Your baby should pee (urinate) normally.
• The penis will look red, swollen, and bruised. This will go away after a few days. You may see spots of bleeding as the penis heals.  If you see small scabs or areas of bleeding, apply a small amount of Vaseline to prevent diapers sticking to the healing area.
• For the first few days, your baby’s urine may look pink. This is normal.
• Your baby will probably be more comfortable if he lies on his back or side.
• Do not put diapers on tightly. Hold your baby so that you do not put pressure on his penis.
• Sometimes, a yellow or yellow-green crust will form for several days. This is a normal part of healing.
• If your baby was given local anesthesia by injection, you may see bruising on the penis where the injections were given.
• Usually, one to two weeks after the circumcision is done, the penis is healed.
• Once the penis is healed, be sure to push the extra foreskin back and clean with a q-tip or baby wipe once daily. This will help to prevent adhesions (scar tissue).
• Every baby’s foreskin and penis is different. Do not compare your baby to others.
• If there is any blistering or if the penis is still red and swollen after two days, call Dr. Dullye or your pediatrician.

How should I clean the baby’s penis?

• Wash your hands first.
• Carefully clean the circumcision site by gently blotting or pressing with a damp washcloth. Never use alcohol.
• Wash your hands again when you are through.

Call Dr. Dullye’s office or your pediatrician if you notice:

• A lot of bleeding.
• A bad smell or drainage from the penis.
• The skin of the penis not healing well in seven to ten days.

After the Plastibell ring falls off and the penis is healed: It is very important to push the remaining foreskin back and clean underneath daily. This will help to prevent adhesions (scar tissue) from forming.

At 28 weeks gestation during pregnancy, please visit cordblood.com/education. This informational site explains the value of cord blood stem cells, why cord blood is the focus of new medical research and provides your options for saving your baby’s cord blood. Once you have reviewed this information, please share your cord blood banking decision with Dr. Dullye during your next office visit. If you have any questions, please call 1.888.536.9826.

The Cord Blood Education Center is an educational resource from Cord Blood Registry (CBR). Alternatively, you may choose any other cord blood bank you wish to use.

Tracy Shaw, BSN, RN, of Dr. Dullye’s staff periodically offers a childbirth preparation class based on the Lamaze philosophy. The class helps prepare you for labor, birth and early days with your baby.

The following topics will be discussed during the class:

• Stages of labor and birth
• Pain Management
• Labor Rehearsal
• Postpartum
• Breastfeeding

Location and time: This is a one-night class held from 6 p.m. to 9 p.m. outside of Dr. Dullye’s office in the Margot Perot facility. Call Tracy Shaw at 214.369.2400 or 214.995.3885 (cell phone) for dates when the course will be offered. The class also includes a brief tour of the Margot Perot Labor and Delivery area and also the postpartum floor.

Class Fee: $100 per couple, cash or check, due at the time of registration. Note: for cancellations, registrants must cancel a minimum of two weeks prior to the class to receive a full refund. In the case of a medical complication, a full refund will be given with a doctor’s note.

After you download this form by clicking here, you can complete it on your computer or by hand (once you print it out). Once you have completed the form, please mail or deliver it with your check to Tracy Shaw at Dr. Dullye’s office at 8160 Walnut Hill Lane, Suite 219, Dallas, TX 75231.