The Five Most Common Reasons for Patients to Need High Risk Services (Maternal Fetal Medicine) During Pregnancy - By Cornelia “Connie” Graves, MD
Pregnancy complications are scary. Some complications may mean you need special care, some can be managed easily and some can be life threatening. But having a high-risk pregnancy doesn’t mean you can’t have a healthy, full-term baby. Here are the top five most common reasons mothers may need high-risk services:
Women who have children at the extreme ages of childbearing age, i.e. less than 17 years of age or greater than 35 years of age, are at increased risk for complications during pregnancy. These complications include preterm labor and delivery, a smaller than normal newborn, the development of high blood pressure and an increased need for cesarean section. Women who are 35 or greater also have an increased risk for having a child with a genetic abnormality, such as Downs syndrome.
Due to medical advances, more women with chronic diseases, such as diabetes, high blood pressure and lupus are able to have children. However, poorly controlled chronic disease during pregnancy can increase the risks of significant maternal and fetal complications. Counseling prior to becoming pregnant is recommended for all women with chronic disease, especially those with diabetes. Poorly controlled diabetes is associated with an increased risk of birth defects. In addition, preconception counseling can make sure that your current medications will be safe if continued during the pregnancy.
Women with a family history of certain genetic diseases, such as cystic fibrosis or sickle cell, may be seen for consultation and testing. The American College recommends that all women be offered certain screening genetic testing. If these tests results indicate the patient is at risk for genetic disorders, the maternal-fetal specialist has special training in counseling and understanding the significance of the results of the testing. This training also allows the provider to offer the patient appropriate counseling regarding the best next steps. In most cases, the maternal-fetal medicine specialist has special training in performing invasive genetic testing, such as amniocentesis
Maternal Fetal specialists have specialty training in reading the ultrasound of the unborn fetus. In some cases, ultrasounds that may be felt to be abnormal may be determined normal after being reviewed by the specialist. If an ultrasound is abnormal, the specialist may provide counseling, genetic testing and other information to assist trying to provide a diagnosis prior to birth. This is very important for infants that have heart defects or other issues which may cause significant problems for the baby at the time of delivery.
Ultrasound may also be used to look for placental complications, especially in patients with a previous cesarean section
Having twins may sound like fun but women who are carrying more than one fetus are at increased risk for early delivery, diabetes and high blood pressure developing in pregnancy, and stillbirth. There is also an increased risk of birth defects. In special cases, such as more than three fetuses, very close observation may need to be performed in a hospital setting.
Dr. Connie Graves is a maternal fetal medicine specialist and Medical Director at Tennessee Maternal Fetal Medicine and the Director of Perinatal Services at Baptist Hospital and Middle Tennessee Medical Center. She is a nationally recognized expert in maternal disease states.
For more information, visit www.tnmfm.com.