Maternal-Fetal Medicine

For most expectant mothers, pregnancy goes smoothly. For others, pregnancy-related health concerns may develop. In these cases, your OB/GYN may suggest you consult with a maternal-fetal medicine physician (perinatologist) – an obstetrician trained in minimizing complications arising from a high-risk pregnancy.

Our maternal-fetal medicine services are internationally recognized and provided through Miami Valley Hospital’s Maternal-Fetal Medicine, Ultrasound, and Genetics Department. Miami Valley Hospital offers the Dayton area’s only high-risk maternity center.

Maternal Fetal Medicine Ultrasound and Genetics has received accreditation from the AIUM Ultrasound Practice Counsel.

What does this mean for our patients?

Maternal-Fetal Medicine Ultrasound and Genetics practice accreditation is a voluntary peer review process that allows practices to demonstrate that they meet or exceed nationally recognized standards in the performance and interpretation of diagnostic ultrasound examinations.

Practices accredited by the American Institute of Ultrasound in Medicine (AIUM) have demonstrated competency in every aspect of their operation, including:

Personnel Education, Training, and Experience
Document Storage and Record Keeping
Policies and Procedures Safeguarding Patients, Ultrasound Personnel, and Equipment
Instrumentation
Quality Assurance
Case Studies

High-Level Care For High-Risk Pregnancy

Premier Health board-certified maternal-fetal medicine physicians specialize in the diagnosis, treatment, and ongoing care of expectant mothers and their babies — or women planning to become pregnant — who may be at higher risk for health problems during pregnancy. They’ve completed two to three additional years of fellowship training in medical and surgical solutions to pregnancy complications. They work collaboratively with your OB/GYN to co-manage your high-risk pregnancy care.

Our physicians are joined by other skilled professionals dedicated to helping you and your baby begin a healthy life together. Together, we provide expansive prenatal testing services, genetic counseling, high-risk pregnancy management, in-utero therapy, and diabetes education.

Our team includes:

Board-certified maternal-fetal medicine physicians available 24/7
Nurses who specialize in high-risk obstetrics and diabetes in pregnancy
Registered and accredited perinatal sonographers (ultrasound technicians)
Board-certified genetic counselors
Administrative and support staff committed to serving the needs of high-risk pregnancy patients

Types Of High-Risk Pregnancies

Fortunately, very few women face the potential of having a high-risk pregnancy. The most common reasons for needing high-risk pregnancy care are high blood pressure and diabetes. We’re here to help in these cases with consults and a co-management program that allows you to remain with your primary OB/GYN while visiting our program for high-risk pregnancy care.

Conditions that can contribute to a high-risk pregnancy include:

High blood pressure (hypertension)
Preeclampsia
Diabetes or other endocrine disorder
Lupus or other autoimmune disease
Thyroid problems
Clotting disorders, including antiphospholipid syndrome (APA)
Multiple births (twins, triplets or more)
Early labor

If your baby has birth defects or growth problems, we can monitor your baby throughout your pregnancy and even begin some treatments before you give birth.

Specialty Services And Programs

Diabetes in Pregnancy Program – This multidisciplinary program provides comprehensive care for moms with diabetes prior to pregnancy, as well as moms who develop diabetes as a result of pregnancy ( gestational diabetes). Early, intensive management of your diabetes during pregnancy can help decrease the risk of pregnancy complications and birth defects.

Our Diabetes in Pregnancy team provides the following to help keep you and your baby healthy:

Individualized meal planning
Blood glucose monitoring
Medications
Follow up and support to enable each woman to adequately manage her blood sugars

Fetal to Newborn Care Center – Miami Valley Hospital and Dayton Children’s Hospital have come together to form the Fetal to Newborn Care Center, which provides a seamless continuum of care to women facing a high-risk pregnancy.

Center patients have access to expertise at both hospitals, depending on the unique needs of each pregnancy. This includes full access to a dedicated team of maternal-fetal care specialists, high-risk obstetricians, neonatologists, neonatal surgeons, and pediatric subspecialists. Our nurse navigator guides patients from diagnosis to delivery and beyond, explaining next steps along the way.

Genetic Counseling – If you’re concerned about the possibility of your baby having a physical or intellectual abnormality, genetic counseling can help. Genetic counselors are health professionals with specialized experience in medical genetics and counseling. They provide information and support to families at risk for having a child with a birth defect, intellectual disability, or a genetic disorder.

Genetic counselors:

Identify risks
Investigate possible conditions
Analyze inheritance patterns
Determine recurrence risks
Review available options with you and your family
Act as advocates for you and your family

Reasons your physician may refer you to our genetic counselors include:

Advanced maternal age (35 or older)
Abnormal maternal serum screen
Family history or previous child with a birth defect, intellectual disability, or genetic syndrome
Recurrent pregnancy loss
Abnormal ultrasound
Abnormal amniocentesis
Ethnicity screening
Positive cystic fibrosis, sickle cell, or thalassemia screen

Multiple Miracles Program specifically addresses the needs and risks of mothers carrying more than one fetus. It combines evidence-based best practices with the experience of our maternal-fetal medicine team into a comprehensive clinic that offers services, testing, treatment, and advice.

Preeclampsia Screening – Preeclampsia is a condition that affects 2 to 8 percent of all pregnancies and can lead to serious health problems for both you and your baby. The condition usually occurs after 20 weeks of gestation, is marked by high blood pressure and protein in the urine, and can cause premature birth and poor fetal growth. The good news is that screening early in pregnancy helps us detect most women who are at risk. Prevention, or at least delaying the onset of preeclampsia, is our goal. Early diagnosis is important for managing preeclampsia.

Ultrasound Testing And Screening

An ultrasound is a diagnostic test to help physicians manage your care. Our ultrasound services stay current with advanced technologies to help us monitor your pregnancy and detect problems or potential issues. A registered and accredited perinatal sonographer and an experienced maternal-fetal medicine specialist perform each ultrasound.

First Trimester Fetal Ultrasound – A first trimester fetal ultrasound is used to confirm fetal heartbeat, your estimated due date, and that your pregnancy is in the right location. The first trimester is also an excellent time to assess risk for a chromosomal abnormality such as Down syndrome. Other conditions and abnormalities may also be detected in the first trimester through ultrasound screening. Premier Health’s Maternal-Fetal Medicine Program is internationally recognized for first trimester ultrasound screening, having contributed to the science of ultrasound markers for Down syndrome through the leadership of Jiri Sonek, MD.

Second Trimester Fetal Ultrasound – After your first trimester ultrasound(s), you may need to be re-evaluated during your second trimester. While no test can identify all birth defects or conditions, an ultrasound in the second trimester can typically help detect birth defects of the heart, brain, digestive system, skeletal system, and spinal cord. By identifying these fetal conditions before birth, we can work with you to determine the best care plan for you and your baby.

Gynecologic Ultrasound — Information obtained from a manual pelvic exam may prompt further evaluation such as a pelvic ultrasound. With a pelvic ultrasound, your uterus and ovaries are evaluated. Common indications for a pelvic ultrasound include pelvic pain, abnormal vaginal bleeding and suspicion of an abnormality on a manual gynecologic exam.

Other Tests And Procedures

Chorionic Villi Sampling (CVS), Amniocentesis – There are two procedures commonly performed to test fetal chromosomes. The first is CVS (chorionic villus sampling), a biopsy of the placenta typically performed from 10 to 13 weeks. The second is amniocentesis, a prenatal test in which a small sample of the amniotic fluid surrounding the fetus is removed and examined. It’s usually performed in the second trimester after 15 weeks. Some indications for having one of these tests performed are:

Maternal age
Previous child with a birth defect
Abnormal screening results
Other family history

Fetal Monitoring/Non-Stress Test – A non-stress test (NST) is a safe, painless way to check on your baby's well-being. Two small monitors are placed on your abdomen and held in place using elastic belts. One of these monitors records contractions, and the other records your baby's heart rate. The test normally takes about 20 to 40 minutes and is done in the comfort of our private rooms.