Florida Perinatal Associates, part of Pediatrix Medical Group

Women who become pregnant after age 35 are more likely to have pre-existing health problems that can complicate pregnancy and are at greater risk for complications like high blood pressure, abnormal fetal growth and diabetes in pregnancy. There is also an increased risk for certain fetal genetic abnormalities, specifically trisomies (where the fetus has an extra chromosome).

Pregnant women carrying multiples (twins, triplets, quadruplets, etc.) are at an increased risk of experiencing complications such as preterm delivery, low birth weight and preeclampsia. A maternal-fetal medicine specialist specializes in the care of women experiencing a high-risk pregnancy, such as multiples, and has the additional training and experience required to treat any complications experienced during a pregnancy.

A diagnostic test to screen for chromosome abnormalities and inherited disorders. A sample of amniotic fluid is collected through an ultrasound guided needle inserted into the amniotic sac. The amniotic fluid is sent to a laboratory for analysis.

Antenatal or prenatal diagnostic screening, refers to a variety of testing options available to determine if a fetus has certain abnormalities. Many of the tests are conducted by an obstetrician (OB) as routine prenatal screening, including ultrasound, nuchal translucency screening and testing of a pregnant woman's blood to help estimate the risk of certain abnormalities. When a test indicates a higher risk, additional tests are available to further analyze the fetus. These additional tests, such as amniocentesis and chronic villus sampling, are often more invasive and have additional risks to the fetus and should be conducted by a maternal-fetal medicine (MFM) specialist.

CVS is a diagnostic test to screen for chromosome abnormalities and inherited disorders by analyzing the chorionic villi cells from the placenta. The placenta cells are collected either transcervically, using an ultrasound guided catheter inserted through the cervix to gently suction the cells, or transabdominally, through a long thin needle inserted into the placenta through the abdomen.

A non-invasive exam using ultrasound technology to generate pictures of a baby's heart. A maternal-fetal medicine (MFM) specialist or pediatric cardiologist will review the images to identify any congenital fetal heart anomalies.

An extra level of care available to women at risk of experiencing problems during or after their pregnancy. A variety of risk factors can make a pregnancy high-risk, including advanced maternal age, chronic health conditions, problems with a previous pregnancy and problems that develop during pregnancy. A high-risk pregnancy means the baby is at a higher risk of having health problems during pregnancy, birth or after delivery. Women having a high-risk pregnancy should be seen more frequently for close monitoring by a maternal-fetal medicine specialist, a physician specially trained to treat high-risk pregnancies.

Maternal-fetal medicine specialists are available to provide additional monitoring and comprehensive care to women with high-risk pregnancies who are hospitalized prior to delivery.

Our maternal-fetal medicine doctors have special training and certification to perform types of ultrasound that may not be available from a radiology service or a general obstetrician. These exams are performed in special situations, not in every pregnancy. Special exams include: Biophysical profile (A focused check of fetal movements and amniotic fluid (the liquid surrounding the fetus) to check on fetal well-being), Cervix length (If the cervix is short, there is a risk of preterm birth and special treatment might be needed), Doppler (Measurement of blood flow through certain blood vessels (umbilical cord, arteries in fetal brain, other blood vessels) to check on fetal well-being), Fetal echocardiogram (A detailed exam of the fetal heart to look for heart defects), 3-D Ultrasound (still pictures that appear 3-dimensional. These are used to get details for certain types of birth defects), 4-D ultrasound (Videos that appear 3-dimensional. These are used to get details of certain types of birth defects).

Ultrasound is a method to get pictures or videos of the fetus (unborn baby). It can be used to help determine the due date, to find out whether there is only one fetus or multiples (twins, triplets, etc), to check on whether the fetus is growing normally, and to look for birth defects or other problems. The method uses sound waves to make the images, not x-rays or radiation. Ultrasound is painless and safe for both mother and fetus.

Pregnant women have access to a variety of tests to determine a baby's risk of Down syndrome, Trisomy 18 and open neural tube defects. Some newer testing methods involve only a blood test and an ultrasound, which can be done safely early in the pregnancy. These screenings are minimally invasive and do not pose any identifiable risk to the fetus. However, while they predict the likelihood that a particular condition is present, they do not provide definitive answers. For example, a "positive result" would not necessarily mean that a baby has a health problem, but it shows that the baby is at increased risk. Similarly, a "negative" result would not guarantee that no health problem is present. Other testing methods can provide a more definitive answer for the specific condition being investigated. However, these tests may pose a greater risk to the mother and fetus because often they are more invasive.

Support provided by a genetic professional or qualified physician to the patient and the doctor by identifying genetic risk, discussing family history, explaining available testing options and implications of test results, as well as providing patient education. Genetic counselors or qualified physicians, act as patient advocates translating medical and scientific knowledge into practical information. In addition, resources are available to provide support to anyone who may be at risk for a variety of inherited conditions or birth defects, such as cystic fibrosis or disorders common to a particular race or ethnic group. This information is provided in a non-directive, unbiased manner and allows the patient to make their own decisions regarding testing options.

Women diagnosed with diabetes before or during pregnancy have difficulties producing the appropriate amount of insulin to process glucose, or sugar, in their bodies. Improper management of diabetes during pregnancy can lead to serious health problems for both the mother and baby. A maternal-fetal medicine (MFM) specialist is specially trained to treat women with diabetes during pregnancy. Through frequent prenatal visits, an MFM specialist can monitor and provide recommendations to help manage blood glucose levels through a combination of healthy eating, exercise and medications.

Maternal-fetal medicine (MFM) specialist and OB/GYN health care providers are available to coordinate in the management of women who became pregnant through assisted reproductive technology, including in vitro fertilization (IVF) and intrauterine insemination (IUI). An MFM specialist is able to provide an extra level of care through additional monitoring and screening.

A term used to describe infants born before the 37th week of pregnancy. Infants born prematurely may experience motor, language, cognitive or other developmental delays, sensory losses such as hearing or visual impairment or feeding difficulties.

Pregnancy places extra stress on a woman's heart and circulatory system, causing the heart to work harder. The labor and delivery experience also adds to the heart's workload.

Hypertension or high blood pressure, can be present before pregnancy (chronic hypertension) or develop during pregnancy (gestational hypertension). Pregnant women with hypertension are at risk of developing preeclampsia, experiencing both high blood pressure and protein in the urine, which can lead to serious complications for both the mother and baby.

While women with very mild kidney disease (stages 1-2), who are otherwise healthy, can expect to have a healthy pregnancy, those with moderate to severe kidney disease (stages 3-5) experience a much higher rate of complications.

Obesity during pregnancy puts both the mother and baby at serious risk of developing serious health problems, including gestational diabetes, preeclampsia, birth defects, preterm birth and pregnancy loss.