What to Expect from High-Risk Pregnancy Care

January 01, 2018

Blog If you’re a mother-to-be whose pregnancy isn’t routine – perhaps you’re expecting twins, or you or your baby has developed an unexpected medical condition – your doctor or nurse-midwife may refer you to a maternal-fetal medicine specialist for extra care.

These high-risk pregnancy experts, also called perinatologists, are obstetrician-gynecologists with three to four additional years of advanced education and training in diagnosing, monitoring and treating pregnancy complications in a woman and her fetus. Their focus: keeping mom and baby healthy before, during and after birth.

“A woman may consult with an maternal-fetal medicine specialist before conception, at any time in her pregnancy and after giving birth,” says maternal-fetal medicine specialist Ellie Ragsdale, MD.

Before Pregnancy

Dr. Ragsdale explains some of the most common reasons women see these specialists:

Ellie Ragsdale, MD

Planning a healthy pregnancy: Meeting with an maternal-fetal medicine specialist before you conceive can help you plan a healthy pregnancy. Ongoing health issues, such as asthma, diabetes, a heart condition, high blood pressure and obesity can worsen during your pregnancy. This can affect you and, sometimes, your developing baby. This specialist can also monitor how your pregnancy is affecting chronic health conditions that involve your heart, blood vessels, lungs, kidneys, immune system, digestive system and more. She or he can advise about safe medications and other treatments, and how to stay healthy after delivery.

Helping if you’ve had past pregnancy problems: An maternal-fetal medicine specialist can look for the reasons for multiple miscarriages or early labor and delivery, and find solutions.

During Pregnancy

Diagnosing birth defects, fetal abnormalities, growth restrictions and genetic conditions: maternal-fetal medicine specialists use advanced ultrasound, fetal MRI, fetal echocardiograms, and specialized testing to identify genetic conditions and birth defects. This allows parents to prepare for the birth of a child with special needs. It also helps other specialists, such as pediatric surgeons and neonatologists, develop a plan to treat the baby after, and sometimes before, birth.

“After confirming a fetal diagnosis, it is critical to assemble the right care team for the baby’s unique needs,” Dr. Ragsdale says. “As one of a few facilities in the country with complete obstetric, delivery, newborn, pediatric and adult services and specialists all in one place, our patients truly benefit from the vast expertise we can provide.”

Checking the health of multiples: Twins, triplets and other multiples face a variety of risks and higher odds for early delivery. Maternal-fetal medicine specialists can track their growth and use advanced imaging techniques to look for causes of medical issues they may face, such as slow growth or circulation problems. In some cases, they can even perform procedures to correct issues before birth.

Assessing other problems and risks: Maternal-fetal medicine specialists care for women with pre-existing health problems and conditions that arise during pregnancy, such as diabetes and high blood pressure.

“We provide expert advice and care throughout pregnancy to women with high-risk medical issues to minimize risk for complications, such as preterm birth,” Dr. Ragsdale says.

Labor and Delivery

Depending on the complication or diagnosis, medical or surgical treatment may be required during or immediately after delivery. “If so, it is critical to deliver at a facility equipped to provide the highest level of care to both mom and baby,” Dr. Ragsdale says.

Postpartum

Women who have complications after birth, such as heavy bleeding or infections, may receive care from an MFM along with an intensive care team.