Wellstar Maternal-Fetal Medicine
Maternal-fetal medicine, or perinatology, helps women with high-risk pregnancies keep their babies and their bodies as healthy as possible.
Understanding Maternal-Fetal Medicine
Maternal-fetal medicine specialists are physicians with medical, surgical, obstetrical, fetal and genetic expertise. Also known as perinatologists and high-risk pregnancy doctors, their focus is on keeping women and their developing babies as healthy as possible.
These specialists not only treat the mother, but they have extensive experience with diagnosing problems, performing ultrasounds, running genetic screenings and monitoring the baby in utero. Treatments before birth can include blood transfusions and surgery to support the fetus.
Wellstar perinatologists collaborate with women’s health doctors on patient care required during labor and delivery, attending complex births when necessary.
High-Risk Pregnancies
High-risk obstetrics describes the conditions in which a mother, the developing fetus or both face higher-than-normal risks for complications during or after pregnancy and birth. Factors that can affect a pregnancy can be divided into maternal and fetal.
Maternal factors affecting pregnancy include age (younger than age 15, older than age 35); weight (pre-pregnancy weight under 100 pounds or obesity); history of complications during previous pregnancies, stillbirth, multiple births, pre-term labor/delivery, complications from high blood pressure; history of disease or chronic infections.
Wellstar’s birthing centers are equipped to handle the most extreme of high-risk pregnancies and provide care for the smallest of babies. The Maternal-Fetal Medicine team treats women with high-risk factors such as heart disease, diabetes, high blood pressure, infectious diseases and kidney or gastrointestinal problems; multiple births; recurrent pregnancy loss; and recurrent pre-term labor and delivery. New procedures and technologies have been developed in high-risk obstetrics, and WellStar’s birthing centers provide care and services benefitting from such advancements.
Wellstar’s Maternal-Fetal team also promotes pre-term birth prevention, encouraging mothers with high-risk pregnancies to seek regular prenatal care, maintain healthy diet and exercise, manage chronic and stressful conditions and avoid risky substances, such as alcohol, nicotine and non-prescribed drugs.
What We Treat
Our doctors care for expectant mothers with:
- High-risk pregnancy
- Pregnancy with hypertension (high blood pressure)
- Pregnancy with diabetes
- Pregnancy with autoimmune diseases
- Pregnancy with blood clotting disorders
- Pregnancy with seizure disorders
- Pregnancy with obesity
- Pregnancy with HIV
- Pregnancy with twins
- Maternal bleeding
- Fetal complications
- Fetus with defects
- Preterm birth
- Fetal surgery
- Fetal blood transfusion
- Overview
- Ultrasound
- Fetal Surveillance
- Chorionic Villus
- Genetic Screening
- Blood Sampling
- Fetal Evaluation
Overview
During your pregnancy, your Wellstar obstetrician may prescribe a number of tests and procedures to ensure your health and the health of your unborn child or children. You may also be referred to a perinatologist, an obstetrician specializing in high-risk pregnancies who will likely perform the test or procedures.
Obstetrical Ultrasound
Wellstar’s Maternal-Fetal Team employs state-of-the-art ultrasound machines operated by registered ultrasonographers who specialize in all specialties of obstetrics, including high-risk. Ultrasound services include first trimester scans, fetal growth scans and multiple-gestation scans.
These tests do not require any special preparation and are completed within a regular obstetric visit. Results are often available and reviewed during the visit by your Wellstar physician.
Antepartum Fetal Surveillance Tests
These routine tests are designed to assess the risk of fetal death in high-risk pregnancies and allow your Wellstar obstetrician or perinatologist to intervene before further complications develop. These non-invasive tests—often conducted with ultrasound—include a fetal movement assessment; a non-stress test (NST), a measure of fetal heart activity; a contraction stress test (CST), a measure comparing the fetal heart rate with uterine contractions; an umbilical artery Doppler velocimetry, a special ultrasound that measures the effectiveness of blood flow in fetal circulatory systems, the placenta and the umbilical cord; and a biophysical profile (BPP), an overall assessment of fetal health.
The biophysical profile combines information from a non-stress test (NST) with ultrasound observations of the fetus’s breathing movements, limb movements and muscle tone as well as the volume of amniotic fluid.
These tests, which can be administered during routine obstetric visits at Wellstar, may be conducted several times throughout your pregnancy.
Chorionic Villus Sampling
Chorionic Villus Sampling (CVS) involves the removal of a small sample of placenta tissue (chorionic villi) from the uterus during early pregnancy to test the baby for genetic defects, such as Down’s Syndrome.
Your Wellstar obstetrician or perinatologist may offer this procedure for expectant mothers older than 35, with a family history of a genetic or metabolic disorder or as a follow-up to abnormal screening tests or ultrasounds. Before performing the procedure, your physician will counsel you in detail about the risks of CVS, what you may expect during and after the test and alternatives, such as amniocentesis.
During the procedure, your Wellstar obstetrician or perinatologist obtains a sample of placental tissue by passing a needle through your abdomen or a small tube (catheter) through the cervix, both with the use of ultrasound for guidance. Some women feel no discomfort during the procedure, while others describe some cramping sensations and pressure. The sample is sent to a Wellstar laboratory with results available in about seven to 10 days.
The entire out-patient procedure takes about 45 minutes.
After the procedure, you should refrain from excessive exertion such as work, heavy lifting or sexual activity for 48 hours. You may feel cramping and mild pain for several hours. If pain and cramping persists for more than 24 hours or if there is fever, vaginal bleeding or leaking amniotic fluid from the vagina, you should call your Wellstar physician immediately.
Amniocentesis (Genetic Screening)
Amniocentesis involves the removal of a small sample of amniotic fluid from the sac surrounding the baby to test for genetic defects such as Down’s Syndrome or cystic fibrosis or neural tube defects such as spina bifida, assess lung maturity or blood type incompatibility (Rh disease).
Your Wellstar obstetrician or perinatologist may recommend this procedure for expectant mothers older than 35, with a family history of a genetic or metabolic disorder or as a follow-up to abnormal screening tests or ultrasounds. Before performing the procedure, your physician will counsel you in detail about the risks of an amniocentesis and what you may expect during and after the test.
An amniocentesis is most often performed between the 14th and 20th week of pregnancy. During the procedure, your Wellstar obstetrician or perinatologist obtains a sample of amniotic fluid by passing a needle through your abdomen (not the navel) with the use of ultrasound for guidance. The mother may experience a sharp pain as the needle passes through the abdomen and again as it passes into the uterus. The sample is sent to a Wellstar laboratory with results available in about seven to 10 days.
The out-patient procedure takes about 45 minutes, although the actual extraction of amniotic fluid takes about five minutes.
After the procedure, you should refrain from excessive exertion such as work, heavy lifting or sexual activity for 48 hours. You may feel cramping and mild pain for several hours. If pain and cramping persists for more than 24 hours or if there is fever, vaginal bleeding or leaking amniotic fluid from the vagina, you should call your Wellstar physician immediately.
Fetal Blood Sampling
Fetal blood sampling, or cordocentesis, describes the collection of fetal blood directly from the umbilical cord or fetus to test for signs of anemia or other blood problems. Your Wellstar obstetrician or perinatologist may prescribe this test if earlier ultrasounds or an amniocentesis reveals moderate or severe anemia. Before performing the procedure, your physician will counsel you in detail about the risks and what you may expect during and after the test.
A fetal blood sampling may be performed as early as the 17th week of pregnancy.
During the procedure, your Wellstar obstetrician or perinatologist obtains a sample of blood by passing a needle through the mother’s abdomen with the use of ultrasound for guidance. The mother may experience a sharp pain as the needle passes through the abdomen and again as it passes into the uterus. A sedative may also be administered to the fetus to temporarily restrict movement. The sample is sent to a Wellstar laboratory with results available in about seven to 10 days.
The out-patient procedure takes about 45 minutes, although the actual extraction of fetal blood may take about five minutes.
After the procedure, you should refrain from excessive exertion such as work, heavy lifting or sexual activity for 48 hours. You may feel cramping and mild pain for several hours. If pain and cramping persists for more than 24 hours or if there is fever, vaginal or abdominal bleeding or leaking amniotic fluid from the vagina, you should call your Wellstar physician immediately.
Fetal Diagnostic/Evaluation
Although ultrasound remains the standard imaging tool in obstetrics, your Wellstar obstetrician may order fetal magnetic resonance imaging (MRI) to exact more detail of your baby. A fetal MRI, which uses magnetic and radiofrequency waves, is especially effective in providing more precise imaging by freezing fetal movement and providing soft tissue detail, especially of the brain.
An MRI is most often prescribed after your Wellstar obstetrician finds an abnormality or concern on an ultrasound. Although there are no known risks to the fetus from the strong magnetic fields of an MRI, these tests are not used until the second or third trimester of a pregnancy.
This procedure does not require any special preparations, but it can take as long as an hour.
Fetal Echocardiography
A fetal echocardiogram, like an ultrasound, uses sound waves but provides greater detail of the baby’s developing heart. Your Wellstar obstetrician may prescribe a fetal echocardiogram if a previous ultrasound suggests that the baby may have a heart defect or if there is a history of heart problems in the family. There are no risks to the mother or baby during this outpatient procedure.
