Gynecology

Dr. Novoa’s services range from well-woman, preventive care to diagnosic and treatment of complex gynecological concerns. For your convenience and comfort, he provides a full range of office gynecological procedures in a warm and friendly office environment.

Additionally, he also offers inpatient and outpatient surgery. Please go to the following link for more information: http://www.firstchoicemedicine.com/GYN/services.html

22 responses to “Gynecology

  1. Rachell

    I’m 20 weeks pregnant and I have low lying placenta (not the one covering the cervix) and I want to know if I can have sex or if I need to wait until it move completely? I also want to kmow what kind of light exercises can I do?
    Thank you.

    • Hello Rachell,

      By definition a low lying placenta does not cover the cervix but is not in the ideal place. I allow my patients with low lying placentas to have intercourse and continue with low impact aerobic exercises.

      The best judge would be your OB, and this is a very important question to ask him/her. Until you get an ok from them, I would wait before having intercourse.

      If you are still having intercourse and you experience any bleeding, you need to call your doctor right away.

      Sincerely,

      Dr. Novoa

  2. Rachell

    I’m 21 weeks and I’ve been buying over the counter prenatals vitamins “Brain Strong”. My last doctor never gave me a prescription for prenatals vitamins. I heard that the ones the Dr. recomend are better for the baby’s development it is true?

    • Hello Rachell,

      Most prenatal vitamins have all the necessary balance of ingredients in order to provide the nutritional needs for you and your baby. Most of the difference between brands of vitamins are associated with potential side-effects such as heartburn or bad after taste.

      Prenatal vitamins work best when taken before you know you are pregnant to approximately 15-16 weeks of pregnancy when the neural tube of the spine closes.

      Since doctors are not always aware of the nutriential balance of a patient’s diet, we recommend that all patients continue to take prenatal vitamins throughout their pregnancy and even when they are breast-feeding.

      However, prenatal vitamins are not absolutely necessary following the 15-18 week of pregnancy.

      It is important to remember that prenatal vitamins can also cause gastrointestinal problems such as nausea, vomiting, acid reflux (heartburn) and constipation. This is usually due to the high content of iron in the prenatal vitamin.

      I often compare the different brands of prenatal vitamins to cereals. There are dozens of brands of cereals available at the Supermarket. They are all good. Just find the kind that you like the best, and you should be fine.

      Finally, your doctor should offer you different brands to try following your first appointment. We usually give 4 different brand samples for our patients to try. They are all very good brands, so after trying them all for about a month, I write a script for the brand the patient wants or liked the best. If, however, she has already bought an over the counter brand, I just check to make sure it has folic acid and iron in it and the patient can usually take the over the counter brand which is usually just as good as the prescription type.

      Sincerely,

      Dr. Novoa

  3. Rachell

    I have a question. Supose I want to deliver my bany at 38-39 weeks and I’m not feeling comtractions and my water hasn’t broke, but I don’t want to use pitosin, what can a Dr do in a case like this?

    • Hello Rachell,

      I am not sure where you live, however, in the State of Texas, OBs are no longer allowed to induce a patient at less than 39 weeks unless there is a medical reason. Nor are we allowed to perform an elective C/S at less that 39 weeks.

      However, at 39 weeks, you should discuss your request with your OB in order to see if you are a candidate for induction.

      There are generally three “home” options available to patients who would like to be induced.

      (1) Intercourse. Sex can bring on contractions from both orgasm and from the prostaglandins found in semen.

      (2) Exercise and Walking

      (3) Chamomile or Manzanilla Tea, Mineral Oil, Castor Oil, or Laxatives (NOT RECOMMENDED)

      If requested, your doctor may perform, “Stripping of the Membranes.” This is a technique where your doctor manually separates the amniotic sac from its attachment around the cervical opening. If done correctly, it can induce labor within 72 hours.

      HOWEVER, IT IS IMPORTANT TO REMEMBER THAT ANY ATTEMPT TO INDUCE OR PROVOKE LABOR HAS UP TO A 50% CHANCE OF FAILURE LEADING TO CESAREAN SECTION.

      THEREFORE, IT IS IMPORTANT FOR YOU TO UNDERSTAND THAT WAITING FOR NATURAL LABOR IS ALWAYS BETTER AND WILL ALWAYS BE RECOMMENDED OVER INDUCTION.

      ALSO, ANYTHING THAT YOU DO AT HOME TO PROVOKE OR INDUCE LABOR IS MORE DANGEROUS AS COMPARED TO INDUCTION AT A HOSPITAL WITH EITHER PITOCIN OR CYTOTEC SINCE YOUR LABOR CAN BE CONTINUOUSLY MONITORED IN A HOSPITAL; WHEREAS, AT HOME, YOU CANNOT BE MONITORED.

      Whatever, you choice, this is a discussion that you should have and agree upon with your OB.

      Sincerely,

      Dr. Novoa

  4. Zachary

    I haven’t felt my baby today. I’m 21 weeks. Do I have to worry? If not what can I do to make her move?

    • Hello Zachary,

      At 21 weeks, you generally don’t have to worry. You will begin to feel your baby’s movements again within a few minutes to less than an hour.

      If allowed, try taking a little bit of sugar or a drink, sitting or laying down with your hand on your abdomen. Put a little pressure on your abdomen and wait. Your baby should start to move within a few minutes.

      Anywhere between 5-20 movement per hour is normal.

      However, you should always notify your doctor and get advice regarding this subject. So don’t want and call them right away just to be sure.

      Sincerely,

      Dr. Novoa

  5. Zachary

    Thanks you!! I’m so happy you have this web page to answer and help me with my concerns 🙂

    • You are welcome. But remember to ask your doctor to explain everything so that you can understand the situation. This is key to having a good physician-patient relationship. 🙂

  6. Zachary

    🙂 You are my Doctor 🙂 and I’m so happy I choose you as my OB. I’m using a different name for my privacy 🙂

  7. Zachary

    Lol 😀 I’ll reveal my identity next visit 😀

  8. Rachell

    I’m 22 weeks and I’m feeling like a burning pain in my ribs, near to the middle of the chest. I’t happens when I lay dawn or when I’m sitting for a long time.

    • If it is directly in the center of your chest near the lower area of your ribs, this is usually acid reflux, better known as heart burn.

      Heart burn is more common during pregnancy due to the upward pressure on the stomach from the pregnancy and the relaxation of the sphincters of the stomach cause by hormones of pregnancy.

      The general management is to eat smaller means and use antiacids such as TUMS or ROLAIDS. It is also very common to use acid reflux meds such as Nexium or Prevacid.

      Other potential causes may be gallstones or rib muscular spasms called costochondriasis.

      Your doc can check this out. I would make an appointment as soon as possible. Although generally not dangerous, it can become painful and is easy to treat.

      Sincerely,

      Dr. Novoa.

  9. Rachell

    Hello Dr. Novoa I’m your Pt and I have low lying placenta. I had a sonogram at 19 weeks and my next visit will be the 17th of this month. We haven’t talk about my last ultrasoun because it was after my last visit. My question is: when is my next ultrasound to see if my placenta is moving? That week I’ll be 23 weeks. Thanks.

    • Hi Rachell,

      Ultrasounds are generally not repeated for an evaluation of a low lying placenta, only for marginal, partial or complete placenta previa. The direction of movement of a placenta once it clears the cervix is never back over the cervix, rather, it moves away from the cervix. Therefore, your low lying placenta is expected to continue to migrate away from the cervix and towards the top of your uterus.

      If, however, you would like to have a repeat ultrasound, one can be ordered but it will not be paid by your insurance. We can talk about the cost at your next appointment.

      I don’t believe this to be necessary and you should have piece of mind that things are going in the right direction.

      Sincerely,

      Dr. Novoa

  10. Rachell

    Ok, that’s ok I’m asking about the ultrasound because you told me you wanted to do another one at 24 wks to see how was my placenta, but if you said it will move that’s enough to not worry. Thanks.

  11. Rachell

    Can a pregnant woman eat swordfish at least once in a wile? I’m 23 wks 5 days

    • Yes, it is ok to occasionally eat predator fish such as swordfish. The concern is the higher concentration of mercury as compared to smaller fish. But you should be fine with occasionally consumption.

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