High-risk pregnancies tend to fall into two categories: those that are considered high risk due to a maternal factor, and those that are high risk due to a suspected problem with the fetus. We see both types of high-risk pregnancies at the Maternal Fetal Care Center and Fetal Concerns Center.
Common high-risk pregnancy factors include:
- Women with diabetes, heart disease, kidney disease and other chronic conditions
- Adult congenital heart disease survivors
- Cancer survivors
- Women of advanced maternal age
- Women with sickle cell disease
- Women pregnant with multiples
- Suspected chromosomal, genetic or birth defects
Specialized Maternal Care for Clotting Disorders
If you have a known blood clotting disorder, have a history of blood clots or have a history of prior pregnancy complications (including miscarriage), you may benefit from risk assessment and screening at the country’s only Pregnancy Coagulation Clinic directed by a dedicated hematologist and maternal fetal medicine specialist.
High-Risk Pregnancy Centers
Our Maternal Fetal Care Center and Fetal Concerns Center utilize a high-tech, high-touch approach to addressing complications and concerns of pregnancy and newborns. Unlike many health centers, we provide a complete array of maternal care services to our high-risk patients. Many maternal/fetal medicine doctors see patients by referral only; they typically see patients only a few times during the patient’s pregnancy and leave the bulk of care to the patient’s obstetrician. Our dedicated high-risk OB clinic provides a full scope of prenatal care. We don’t just manage the high-risk aspects of your pregnancy; we also talk to you about labor, birth, infant-feeding options and contraception.
We listen to your concerns, and provide you with information and support. We don’t shy away from high-tech interventions, but we don’t allow high-tech to overshadow your pregnancy and birth. We provide access to first trimester screening and genetic counseling. Our team includes perinatologists (obstetricians who have received specialized training in the care and management of high-risk pregnancies), a nurse midwife and ultrasonographers who specialize in pregnancy and fetal ultrasounds. Each week, the maternal/fetal team comes together to discuss cases and collaborates to develop the best possible treatment plan and alternatives. Our patients benefit from our clinicians’ combined knowledge.
High-Risk Pregnancy Services
Our Reproductive Medicine Center offers complete evaluation and treatment services for men and women dealing with fertility issues.
Cell-Free DNA Testing
Cell-free DNA testing is a screening test used to help detect Down syndrome (trisomy 21), Edward’s syndrome (trisomy 18), trisomy 13 and some common fetal heart defects. The test is non-invasive; it’s performed on a sample of the mother’s blood. The test gathers information about the fetus by analyzing fractions of fetal DNA found in the mother’s blood. Cell-free DNA testing is considered a screening test because it does not detect all cases of Down syndrome or other disorders. If cell-free DNA testing indicates a high probability of an abnormality, chorionic villus sampling (CVS) and amniocentesis may be performed to confirm a diagnosis.
Your doctor or nurse midwife can help you weigh the risks and benefits of cell-free DNA testing. Cell-free DNA testing is not required; some parents opt for cell-free DNA testing while others decline the test.
Cell-free DNA testing can be performed throughout pregnancy. Insurance coverage varies.
Quad Screening Blood Testing
The quad screen is a blood test that can be used to determine the likelihood that the baby has chromosomal abnormalities including Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), a neural tube defect (such as spina bifida) or another chromosomal condition.
Quad screening uses a sample of maternal blood. It’s called a quad screen because it examines four specific substances found in the blood: alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), estriol and inhibin-A. The quad screen is an advanced version of AFP testing and the triple screen, which were both previously used to assess fetal risk of chromosomal abnormality or neural tube defects.
Quad screening is an optional screening test that can be performed between weeks 16 and 18 of pregnancy. Your doctor or nurse midwife will discuss the pros and cons of the test with you so you can decide if you want the test or not. It’s important to remember that quad screening is a screening test; it cannot tell you for sure whether or not your baby has a problem. If the screening suggests a high probability of an abnormality, CVS and amniocentesis may be performed to confirm a diagnosis.