Maternal & Fetal Medicine
Perinatology and High Risk Pregnancy Care
Pediatric perinatologists provide care for mother and child in high risk pregnancies. The conditions they treat include mother's pre-existing conditions, pre-term labor, hypertension, birth defect risks, complications, and other pregnancy concerns.
You may benefit from perinatal services if you have:
- Medical problems including diabetes, asthma, lupus, heart disease, kidney disease or hypertension
- A current pregnancy due to infertility treatment
- A multiple pregnancy (twins, triplets or quadruplets)
- A history of pregnancy complications
- Concerns that your baby will have a birth defect or abnormalities
You usually do not need to be referred to a perinatologist. At your appointment, the doctor will complete a consultation about your pregnancy and symptoms.
Prenatal Diagnostic and Screening Services
A small number of babies are born with birth defects caused by genetic or environmental factors. Diagnostic tests will tell you if your baby will be born with a birth defect. This is different from a screening test, which will tell you if there is a risk for a birth defect.
The major categories of birth defects are:
- Chromosomal conditions
- Gene mutations
- Structural birth defects unrelated to a gene or chromosomes
- Defects related to maternal infections or environmental factors
Your doctor can look directly at your chromosomes to find a chromosome defect, like those found in children with Down syndrome. They will look at your DNA through chorionic villus sampling (CVS) or amniocentesis. CVS involves obtaining a small part of the placenta. In an amniocentesis, your doctor will take a small amount of amniotic fluid from around the baby. They will analyze the samples for genetic, chromosomal and birth defect conditions.
Perinatologists work with genetic counselors to determine if your baby is at higher risk for a birth defect. They will collect information about your personal, pregnancy and family histories.
Women who seek genetic counseling usually:
- Are over 35 and are pregnant or plan to become pregnant
- Are at an increased risk of having a baby with a birth defect, chromosome condition or genetic condition
- Have been told her unborn baby has a birth defect, chromosome condition or genetic condition
- Are concerned about recessive genetic diseases they may carry
- Have a family history of a known genetic disease
- Have had a child with a birth defect
- Have recently had a miscarriage
If you have diabetes or develop diabetes during pregnancy, your perinatologist can create a plan for you to manage the disease. They encourage a healthy lifestyle during pregnancy and hope to maintain the best blood glucose levels for you and your baby.
When you meet with a diabetes counselor, you will discuss:
- Your pregnancy
- Importance of blood glucose control
- Education about blood glucose monitoring
- Nutritional counseling
- Medication management
Perinatologists perform ultrasounds throughout pregnancy to check the location of your baby, assess the due date and growth and evaluate your baby for abnormalities. An ultrasound uses sound waves to take pictures of your baby, uterus, placenta and cervix. Many perinatologists offer high resolution ultrasounds for increased visibility and better analysis.