Boerne OB/GYN

Methodist Boerne Medical Center
134 Menger Springs
Suite 1360
Boerne, TX 78006

Phone: 830-816-5222
Fax: 830-816-5223

Hours of Operation

Mon: 8:30am - 5:00pm
Tue: 8:30am - 5:00pm
Wed: 8:30am - 5:00pm
Thu: 8:30am - 5:00pm

Boerne, TX Obstetrics Gynecology Essure

Obstetrician Boerne, TX

Routine and High Risk Obstetrics

Obstetrician Pregnancy Boerne, TXBoerne Ob/Gyn provides prenatal care and postpartum follow-up visits for both routine and high risk pregnancies. From the moment you find out you are pregnant, Dr. Kocay and his staff will be available to answer and address all of the many questions and concerns you will have throughout your pregnancy.

Dr. Kocay has privileges with Methodist Hospital located in the Medical Center in San Antonio, TX. This hospital is one of the premier facilities in all of South Texas, You will be provided with a packet of information about what you can expect when you deliver at Methodist as well as what services are available to you and your family. Dr. Kocay participates in a call group for the rare times he is out of town, but will make every attempt to attend your delivery and be available to you throughout your entire pregnancy.

General Obstetrical Services

New OB Visit

During this visit Dr. Kocay will spend time learning about you and your past medical, surgical and family history. A complete physical examination will take place and an ultrasound is frequently performed to help determine a precise due date. Routine prenatal lab work will also be ordered. Information and educational material regarding your pregnancy will also be provided as well as information about Methodist Hospital where you will deliver.

Routine Visits

Appointments after the initial visit generally will occur every 4 weeks in a low risk pregnancy and every 2 weeks if the pregnancy is determined to be high risk. Visits are usually every 2 weeks from 28 to 36 weeks. At 36 weeks of pregnancy, Dr. Kocay will begin scheduling appointments on a weekly basis until delivery. Every attempt to keep scheduled appointments is vital as many important tests are performed at specific times throughout pregnancy.

Ultrasounds

There are two different kinds of ultrasound typically performed during pregnancy. Transvaginal is used during the first trimester when the fetus is very small and involves placing a small probe inside the vagina to visualize the pregnancy. This is a very accurate way to establish a due date and is frequently performed by Dr. Kocay during the initial visit. An abdominal ultrasound is usually performed around 20 weeks for an anatomical survey of the baby. Gender determination can be attempted as well at this time if you desire. Dr. Kocay may also perform a 3-D ultrasound per request, but please note it is usually not covered by insurance.

Fetal Monitoring

At certain times throughout pregnancy, Dr. Kocay may order a non-stress test. This can be done in the office or in the hospital. This involves monitoring the fetal heart tones and contraction pattern over time. It typically takes 20-30 minutes and is a non-invasive way to establish fetal well-being.

Genetic Testing

Certain lab tests are performed at specific times throughout pregnancy and can help determine if the fetus is healthy and growing normally. These tests help to screen for certain abnormalities such as Down Syndrome and Spina Bifida. While these are very rare conditions, it is the choice of the patient whether to have these tests performed.

Vaginal Delivery

Vaginal birth is the natural delivery of a baby through the birth canal and vagina. It occurs when the cervix has dilated 10 centimeters. Dr. Kocay will work with each patient to formulate a mutually agreed upon birth plan. Assisted vaginal delivery means special instruments such as forceps or vacuum extractor are used to help deliver the baby. While Dr. Kocay is experienced in utilizing these instruments, he does not routinely use them and only does so when medically indicated.

Cesarean Delivery (C-Section)

Cesarean delivery is performed by Dr. Kocay only when a vaginal delivery is not possible (i.e. breech presentation, placenta previa, etc…) or when there is concern for the well-being of the mother and/or baby. In most cases, once a cesarean has been performed in the past, a repeat cesarean will be scheduled. Dr. Kocay will discuss the safest time to schedule your surgery for your baby.

VBAC (Vaginal Birth After Cesarean)

Vaginal birth after cesarean is offered to pregnant patients only in select cases. The decision to attempt a trial of labor will be made by Dr. Kocay only after discussing the risk factors with the patient and obtaining a full history and physical with specific attention devoted to the type of previous cesarean. There will be time to discuss this option throughout your pregnancy.

High Risk Obstetrical Services

Amniocentesis

This is a test performed between 15-17 weeks gestation. It helps to provide information about fetal chromosomal abnormalities or other genetic diseases. It requires the insertion of a very small needle into the amniotic sac and with the aid of ultrasound guidance, a small sample of amniotic fluid is extracted and tested. It is relatively painless, but there is some risk associated with the procedure.

Gestational Diabetes

Also called GDM, this condition occurs in approx. 3-10% of pregnancies and causes high blood glucose levels during pregnancy. All patients are tested around 26 weeks gestation. It involves drinking a very sweet glucose drink. After 1 hour a small blood sample is drawn to test the level of blood glucose. Babies born to mother with GDM are at increased risk for problems such as macrosomnia (large birth weight), low blood sugar and jaundice. Fortunately, it is a treatable condition, with diet and sometimes insulin. Dr. Kocay will develop a treatment plan and monitor the patient closely throughout the pregnancy.

Gestational Hypertension

This is a condition that involves the development of high blood pressure in a pregnant woman after 20 weeks gestation. Also called Pregnancy Induced Hypertension or pre-eclampsia, this condition can be very serious for both mother and baby. Blood pressure and urine protein will be checked at each prenatal visit to observe for any elevation or abnormality. If this condition is diagnosed, Dr. Kocay has extensive experience in treating and managing this disease.

Premature Labor

This is described as labor that occurs 3 or more weeks before the due date. While some causes of PML are known, such as infection or incompetent cervix, it is often not understood why a woman delivers prematurely. Signs and symptoms are regular contractions or cramping, premature rupture of membranes and/or vaginal bleeding. If any of these symptoms occur, please phone Dr. Kocay’s office immediately or go into the hospital for evaluation. There are tests and exams that can determine whether a patient is at high risk for a premature delivery.

Incompetent Cervix

This is a medical condition in which a pregnant woman’s cervix dilates painlessly prematurely. It often leads to miscarriage or premature delivery. Although it is a rare condition (1-2% of pregnancies), it can have catastrophic results. If a patient has a history of incompetent cervix, Dr. Kocay will discuss treatment options to help prevent miscarriage or premature delivery in future pregnancies.

Multiple Gestation

A diagnosis of multiple gestation (twin, triplets, etc…) automatically puts a woman at high risk. Dr. Kocay has experience managing multiple gestations and will monitor this condition on a more regular basis due to the increased risk of premature delivery.