Gynaecological Services

CONGRATULATIONS!

MATERNITY PACKAGE INFORMATION

We are very pleased to have you choose us as your care providers and we look forward to getting to know you and to meeting your baby!

We expect you to collect this maternity package/ information forms on the day you book your first appointment with us, or alternatively you can download it from our web portal/ site.

Should you have further questions, we would be very grateful if you can present them at the meet and greet (1^st appointment) with the Dr’s assistant and the Dr’s administrator. Medical questions will be answered by the Dr during the antenatal visits or alternatively you may pose them via WhatsApp on the following numbers

Medical Assistant Tariro Sakala 0777 019 485   or

you can send an email to: gyn2.africa@gmail.com.

For your booking appointments, please call or message

Medical Receptionist Michelle Shoniwa 0777019485 ( WhatsApp #)

It is very important to note that in case of an emergency or you should need to see the Doctor after hours (from 5pm and during weekends), please go straight to Borrowdale Trauma, or Avenues Clinic, or Health Point, Casualty Department, and advise that you are a patient of Dr Djordjevic. The Dr will immediately be informed by the casualty doctor and will attend to your issue promptly. Initial diagnosis that would constitute an emergency would be a danger to life such as loss of blood and / or loss of the ability to breathe and /or loss of consciousness, loss of baby’s movements or lower abdominal pain followed by backache.

All administrative or payment issues, will be gladly attended to by administrator Kathlyn Kambarami on 0784 995 762 (Whats up )or via email on gyn2.africa@gmail.com during working hours.

Optionally you can contact the practice manager Win Ives on 0242744582.

Please note that the booking forms for hospital (Borrowdale Trauma, Health Point, and Avenues Clinic) under Dr Djordjevic’s name is issued only upon payment of the deposit for the delivery at around 20weeks.  Should there be any additional procedures an invoice will be issued after delivery and emergency situations will incur extra costs.

N.B: If you decide to change the place or country of delivery, your deposit will be returned in full.

Kind regards

DR D DJORDJEVIC and the MIG team!

1. ANTENATAL PLAN OF VISITS

Pregnancy is a physiological condition which usually lasts 40 weeks and results in the birth of the baby.

This is a suggested schedule for your antenatal and postnatal appointment plan; however, it may not be strictly adhered to, and you should not be worried if it differs slightly.

Doctors, Rumbidzai Majangara, Tsitsi Magure and Nangisai Mutare are active consultants of obstetrics and gynecology at MIG Alexandra Park. You will be seen by one of them during the course of your antenatal/ postnatal care to meet all team members in the eventual case of an emergency when Dr D is not available.

Please be aware that although you will likely have a scan at each visit with, scans themselves are not a compulsory component of your antenatal consultation unless there is a perceived risk factor for the baby.  If you do not have a scan at an appointment or do not wish to have one, this is perfectly fine. Dr D scans to check on baby’s well-being and reassure you on the steady progress and development of your baby. 

When you phone to make an appointment, the Medical Receptionist Michelle Shoniwa will advise you accordingly.  However, below is an outline of what you can expect and the links that the Doctor expects you and your partner to read and make yourselves ready for the next appointments (web portal).  There are only two visits with scans that are covered by medical aid throughout the pregnancy. Those are second and third trimester anomaly scans and Dr D refers to imaging fetal maternal specialists Dr Verenga –0784814611/ 0242708259.

Please note that visits are paid per appointment. 

2. ANTENATAL VISITS FOR LOW-RISK PREGNANCIES
   (HIGH RISK PREGNANCIES WILL BE SEEN AS PER DOCTOR’S ADVISE

    

 8-10 weeks  : this is ideally when you will meet/ greet the Dr and the team and get an invitation to the Dr’s web portal ( scan QR code at the reception )for additional information have your initial consultation.  At this appointment, you can expect a scan to confirm pregnancy and you will be sent for blood tests. Initial blood tests (see attached referral form and links to read). You will be also advised on chromosomal anomaly tests that are performed after ten weeks (NIPT test). Counseling will also be done during this period. It is perfectly acceptable to decline Chromosomal testing, a disclaimer form will be given to the couple to sign during the appointment. Please note that blood is taken for the NIPT test at Medicity laboratories (optional Lancet) and is transported to in Jo Bio Next laboratory in Johannesburg; results are expected in 10-14 days later. Should everything be okay with the results, the doctor will sign them and you will get a soft copy via WhatsApp or email. If there is an issue with results suspected, the Doctor will call you for an appointment to explain the results and suggest further management.

Also note that after the first appointment in between 8 and 12 weeks you will have an initial “meet and greet/ social appointment” with the doctor’s assistant Tariro Sakala for a a introduction to MIG services in the duration of 15 to 20 minutes.

11-13 weeks: Doctor will discuss with you first trimester blood test results , enquire about your quality of life and You will have a scan at this appointment..

14-15 weeks: 12-weeks results discussion.  You will be given a 20-week scan referral form for your next appointment with Dr Verenga, fetal specialist. If you haven’t done a 12-week Chromosomal anomaly test or NIPT, you will be given a form for Medicity or Lancet 2^nd Trimester Chromosomal anomaly test, should you wish to have one.

20 weeks: You will have “ANOMALY SCAN” done by a specialist of fetal medicine.  We routinely refer to Dr Verenga.

N.B* DELIVERY DEPOSIT TO BE PAID IN FULL BY NOW IN ORDER TO BE ISSUED WITH A HOSPITAL BOOKING FORM

22-24 weeks: debriefing from the 20-week anomaly scan with fetal maternal specialist Dr Verenga and further follow-up of development of the baby. GTT test recommendation which is done at Medicity/ Lancet laboratories (optional). There will be discussions about the expectations and care during the second trimester. You will be referred to the second trimester antenatal class with the affiliated midwife Urma Hodgson and further follow-up on the baby’s progress. A referral for a glucometer test at Medicity laboratories will be given. 

26-28 weeks: there will be assessment of the development and growth of the baby.  You will be given a referral for placental growth factor (PLGF) second trimester test. A prescription for anti D antibodies will be issued for Rhesus Negative mothers (you will be given a prescription and bring them for or after the appointment for administration). There will be debriefing after the midwife’s appointment and referral for further 3^rd trimester consecutive classes with the midwife will be issued.

32 weeks:  Antenatal consultation. This is a follow up visit with scan for fetal growth and well-being. You will be issued a referral for a 35-week scan with Dr Verenga.

35 weeks: 3^rd trimester 35 weeks anomaly scan with Dr Verenga. He will check on overall fetal wellbeing in particular cerebral median artery, Doppler, and pulmonary artery velocity index (technical terms).

36-37 weeks: Standard consultation. At this appointment, there will be discussion about expectations and care during labour, (Birth plan) will be discussed. Vaginal examination and genital swab for Streptococcus B screening will be done.  3^rd trimester blood test referral will be issued.

39 weeks:  Antenatal consultation.

40 weeks:  Antenatal consultation, with scan to assess fetal growth and wellbeing.

Please note that if your baby has not come by 10 days after 40 pregnancy weeks, you will be scheduled for an induction of labour/ c-section depending on the situation.

Post-natal day 7visit.  There will be a debriefing on the labour / hospital stay/ breastfeeding/ assessment of the wound (if any). There will be an ultrasound scan to check on the condition of the uterus. There will be a breast check and overall psychological assessment check (Edinburgh postnatal depression questionnaire). It is strongly recommended to see a lactation specialist straight after delivery (should there be an issues).  Please have contact numbers in a visible place. Three additional follow-up visits will be done up to 6 weeks postnatally. Pelvic floor exercises are highly recommended.

6 weeks post-delivery: is your final post-natal visit with your Obstetrician/Gynecologist. A postnatal depression questionnaire will be given to the patient to fill in. A Pap smear should be taken if no Pap smear was not done in the past one year.  Pelvic floor exercises will be gain be reinforced and a pelvic floor physiotherapist will be recommended ( Jane Du Toit/ Gyrid Chitombo are available on the premises).

3. PSYCHOLOGIST

Please note that psychologist Amy Garden is available on the premises she will meet with the couple at 16 weeks, usually on Wednesdays. Amy provides women with psychoeducation on how to actively improve their own wellbeing and happiness as they go through life and throughout their pregnancy. A positive mental wellbeing helps to promote a healthy relationship with mother and child and the family as whole.

4. MIDWIVES AND ANTENATAL CLASSES (INDEPENDENT)

Irma Hodgson +263 772 275 533

Merete Horn (Online Antenatal Classes) +263 772 363 989

As part of Dr Djordjevic’s model of shared maternity care, it is expected that you will have 4-6 prenatal classes with independent midwives for primi-parous (first time mum-to be) and two classes for multi-parous mums (Labour & Birth) and /or (Baby and Breastfeeding).

1. The first class is The Early Pregnancy Introduction Class – which ideally takes place between 10-14 weeks. However, this can be undertaken any time shortly after booking.
2. From 20 weeks – prenatal preparatory classes, either:
3. As a set of 4 group classes that prepare you and your birth partner for the final stages of pregnancy, the normal labour and birth, the assisted or complicated labour and birth as well as breastfeeding and the care for the newborn baby.

Or:

1. b) A choice of 1 or 2 private classes covering 1) Labour and Birth

Below is a list of useful contacts you might need during pregnancy, at birth and in the postpartum period please always keep them on your phone. Thank you.

This is to confirm I fully read and understood the information above

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Patient’s signature                      Doctor’signature

Please kindly read the consent and fill in only those consents that are applicable to your medical condition / treatment

Gynaecology services

Day to day consultations and special services

We provide comprehensive gynaecological care throughout the stages of a woman’s life, beginning in the teenage years with her first pelvic examination, into her childbearing years, menopause, and  utilize the latest medical technology to make your visits as comfortable as possible.

Our gynaecology services include:

• Annual exams and screening tests
• Pap smears
• Endometrial thickness screen
• Ovarian screen
• Vulva screen
• Breast examination
• Ultrasounds abdominal, vaginal including transvaginal 4 D scans when indicated
• STD screening and vaccines, including Gardasil®
• Hormone replacement therapy (HRT) counselling and bio identical HRT counselling
• Peri- and post-menopausal care
• Contraceptive counselling
• Birth control:
  • Birth control pills
  • IUD
  • Mirena®
  • Depo Provera®
  • Nexplanon®
• Treatment for painful periods and abnormal bleeding
• Fertility investigations and treatments
• Abnormal cells on the cervix screen and management
• Endometriosis screen and management
• Urinary stress urge and incontinence assessment
• Pelvic organ prolapse assessment