Perinatal Care

The board-certified physicians of St. Luke’s Maternal Fetal Medicine provide high-risk obstetric care, also known as perinatal care. Our practice focuses on:

Pre-conceptual Counseling

The goal of preconception care checkup is to find things that could affect your pregnancy. Identifying these factors before pregnancy allows you to take steps that can increase your chance of having a healthy pregnancy and healthy baby. During this visit, your health care provider will ask about your diet and lifestyle, your medical and family history, medications you take, and any past pregnancies.

Genetic Screening In Pregnancy

In genetic counseling, specially-trained professionals help people learn about genetic conditions, find out their chances of being affected by or having a child or other family member with a genetic condition, and make informed decisions about testing and treatment. During your visit the genetic counselor will complete a family medical history evaluation and discuss the likelihood of being affected by a hereditary condition.

This video will highlight the different screening options available to assess genetic risks during pregnancy. We encourage you to view the video prior to your ultrasound appointment.

You can also view additional information on types of screenings and information for your insurance company by clicking here.

Medical Consultations

The Maternal Fetal Medicine Specialist and Obstetrician work together to diagnose, monitor and treat medical complications during pregnancy. Depending upon the condition and severity, treatment can include medications, modified bed rest, increased physician visits, lab testing, ultrasound studies and possible planning for earlier delivery.

High-resolution ultrasound including Doppler blood flow analysis

High-resolution fetal ultrasonography (also called Level II ultrasound) uses sound waves produced by an ultrasound machine to create an image of the fetus called a sonogram. The ultrasound evaluates the physical growth and development of the fetus. High-resolution ultrasound is typically performed between the 19th and 22nd weeks of gestation. A doppler flow is a type of ultrasound that uses sound waves to check the blood flow and health of the fetus.

3-D Ultrasound

3D and 4D ultrasounds are optional. They’re not standard prenatal tests. Doctors often give them as a courtesy to women who want them. Ask your insurance first if they cover the cost.

Like regular ultrasounds, 3D and 4D ultrasounds use sound waves to create an image of your baby in your womb. What’s different is that 3D ultrasounds create a three-dimensional image of your baby, while 4D ultrasounds create a live video effect, like a movie — you can watch your baby smile or yawn.

Parents often want 3D and 4D ultrasounds. They let you see your baby’s face for the first time. Some doctors like 3D and 4D ultrasounds because they can show certain birth defects, such as cleft palate, that might not show up on a standard ultrasound.

Studies suggest that 3D and 4D ultrasounds are safe. Plus, the images can help doctors spot a problem with your baby and make it easier for them to explain it to you. Talk about the pros and cons with your doctor.

First trimester screening for nuchal translucency

A nuchal translucency ultrasound (commonly called a “nuchal scan”) is an ultrasound performed between 11.5 and 13 weeks 6days gestation. It is usually part of an assessment called combined first trimester screening or non-invasive prenatal screen. This assesses the risk for your baby having certain chromosomal abnormalities (trisomy 13, 18 and 21).

Amniocentesis

Amniocentesis evaluates the presence of neural tube defects,genetic disorders and chromosome abnormalities after 15 and up to 21 weeks gestation. During the procedure a needle collects a sample of amniotic fluid that is analyzed in a laboratory.

Comprehensive fetal monitoring and prenatal diagnosis

Prenatal testing includes both screening tests and diagnostic tests to help diagnosis fetal abnormalities:

• Screening Tests Prenatal screening tests can identify whether your baby is more likely to have certain conditions — but they usually can’t make a definitive diagnosis. Non-invasive prenatal tests (NIPT), such as blood tests and ultrasounds, are routine in most pregnancies. Specific screening tests, such as first and second trimester screening for abnormal chromosomes, also might be offered. Screening tests pose no risks for mother or baby.
• Diagnostic Tests If a screening test indicates a possible problem — or your age,family history or medical history puts you at increased risk of having a baby with a genetic problem — you might consider a more invasive prenatal diagnostic test. A diagnostic test is the only way to be sure of a diagnosis. Some diagnostic tests, such as chorionic villus sampling or amniocentesis, carry a slight risk of miscarriage.

Chorionic Villus Sampling

CVS identifies chromosome abnormalities and other inherited disorders through the removal of chorionic villi cells from the placenta between 10 and 13 weeks of gestation.

Fetal Blood Testing Through Umbilical Cord Blood Vessels

In percutaneous (through the skin) umbilical blood sampling, the doctor first anesthetizes an area of skin over the abdomen. Guided by ultrasonography, the doctor then inserts a needle through the abdominal wall and uterus into the umbilical cord. A sample of the fetus’s blood is withdrawn and analyzed, and the needle is removed. Percutaneous umbilical blood sampling is an invasive procedure. It may cause miscarriage in about 1 in 100 procedures. Currently, percutaneous umbilical blood sampling is occasionally done when doctors suspect that a fetus has anemia. If the fetus has severe anemia, blood can be transfused to the fetus through the needle while it is still inserted in the umbilical cord.

Fetal Therapies-limited Fetal Surgeries

Prenatal surgery (also called fetal surgery or fetal intervention) is most often is done to correct serious problems that can’t wait to be fixed, like certain heart defects, urinary blockages, bowel obstructions, and airway malformations. If your baby requires this type of intervention, consultation with Pediatric specialty surgeon will occur.

Diabetes and Pregnancy Program

We offer a complete management program for pregnant women newly diagnosed with gestational diabetes and for women with pre-existing type 1 or type 2 diabetes. Working in cooperation with your obstetrician, our program includes comprehensive teaching with our certified diabetes educators in addition to ongoing evaluation and management of your diabetes throughout the pregnancy. Evaluations with the Perinatologist, in addition to weekly consultations with our diabetes team provide a customized plan for your healthy pregnancy. In order to provide busy mothers the optimal care, the majority of our weekly blood sugar evaluations can be done via phone, fax or email. As our staff continues to closely monitor your pregnancy with periodic ultrasounds and blood sugar evaluations your plan of care will be adjusted to meet your needs and the needs of your baby. Pre-conception counseling is offered to mothers with pre-existing diabetes.

Fetal Echo-cardiography

This procedure evaluates the baby’s potential heart problems after 17 weeks of gestation. A pediatric cardiologist uses an ultrasound to perform a detailed exam of the baby’s heart.