High Risk Pregnancy – Maternal Fetal Medicine

The Maternal Fetal Diagnosis Program brings together the best of  DMC Women’s Services and Children’s Hospital of Michigan physicians and pediatricians. Working together, physicians in the program provide world-class infertility services, prenatal genetic testing, high-risk obstetric care, neonatal intensive care and specialized pediatric surgical services.
  With nationally recognized experts and innovative diagnostic tools and therapies, no hospital in Michigan provides more advanced care for high-risk mothers and babies.

Fetal Echocardiography & Surgery

Fetal echocardiography is a specialized ultrasound test that gives physicians a clear view of the unborn baby’s heart. A limited view of the heart is performed during routine obstetric ultrasound tests, but fetal echocardiography enables the physician to study a baby’s heart in greater detail and is extremely useful in detecting heart defects before the baby is born. Once recognized, our specialists are able to prepare for best treatment plan, including the possibility of surgery in fetuses prior to birth or corrective surgery after the child is born.

Fetal Surgery

DMC Women and Infant Services is one of the few hospitals in the country to perform intrauterine fetal surgery and fetal transfusions. Advanced ultrasound imaging techniques play an important role in performing and identifying patients appropriate for these therapies.
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High-Risk Pregnancy

No woman wants to hear that her pregnancy is “high risk” or that she might experience “complications.” But if she does, she’ll want to know about DMC Women and Infant Services, where physicians throughout Michigan refer their high-risk obstetrics patients.

DMC Women and Infant Services physicians provide expert and compassionate care for mothers with serious medical conditions, multiple-fetus pregnancies and pregnancies in which the fetus has a high risk of problems. In addition, we are home to Michigan’s only Maternal Special Care Unit, a specialized intensive care unit for pregnant women who need advanced care and monitoring during labor and after delivery.

What is a high-risk pregnancy? 

Women with serious medical conditions such as asthma, high blood pressure and diabetes are all considered high-risk, as are women over the age of 35 during pregnancy. Other high-risk patients include very young mothers, women who have had previous miscarriages or pre-term deliveries, and women carrying multiple babies.

Are you at risk of pre-term delivery? 
It’s difficult to predict which expectant mothers will deliver early. However, if you’ve already had a pre-term delivery, you are at a greater risk for pre-term delivery the next time you are pregnant. Even if you’ve never had a pre-term delivery, you should still watch for the following warning signs after the 20th week of pregnancy and contact your doctor with any questions:

  • Regular uterine contractions
  • Menstrual-like cramps (constant or occasional)
  • Low, dull backache
  • Pelvic pressure that feels like the baby is pushing down
  • Abdominal cramping, with or without diarrhea
  • Increase or change in vaginal discharge
  • A feeling like something is not right

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Maternal Special Care Unit    

Pregnancy is a natural part of life. But for women with serious health problems, the stress of childbirth can be life threatening. That’s why DMC Women and Infant Services created the Maternal Special Care Unit — Michigan’s only intensive care unit for pregnant women.
 
The five-bed Maternal Special Care Unit at Hutzel Women’s Hospital is a destination for acutely ill pregnant women. Special care physicians and nurses provide 24-hour-a-day, critical care to pregnant women with serious conditions, including:
  • Pulmonary embolisms
  • Severe pneumonia
  • Severe asthma
  • Stroke
  • Congestive Heart Failure
  • Cardiovascular disease
  • High blood pressure
  • Severe diabetes
  • Hypoxia (low oxygen levels in blood

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Prenatal Genetic Testing

The health of your baby is a priority, and DMC Women and Infant Services Maternal Fetal Diagnostic Program provides extensive prenatal genetic testing to detect fetal abnormalities. Testing includes screening for Tay-Sachs disease, cystic fibrosis, sickle cell anemia, congenital heart defects and spina bifida.
 
In addition, Hutzel Women’s Hospital is one of the only hospitals in Michigan to perform FIRST Trimester Screening, an early screening for Down syndrome and trisomy 18. FIRST stands for First trimester Integrated Risk Screening for Trisomy. The test gives physicians and parents valuable information about the health of the fetus as early as 12 weeks gestation and is performed using a combination of ultrasound and blood tests. Research shows the test detects over 80 percent of pregnancies with Down syndrome and 90 percent of pregnancies with trisomy 18.
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Pregnancy Losses

It’s never easy to lose a pregnancy, but pregnancy losses are not uncommon. An isolated pregnancy loss can happen to almost any woman during pregnancy — often without explanation. But repetitive losses are usually caused by hormonal, structural or genetic issues. Often, these issues can be identified and addressed to prevent future pregnancy losses.

The Maternal Fetal Medicine specialists at DMC Women and Infant Services have extensive experience diagnosing the causes of repetitive pregnancy loss and developing effective strategies to prevent future losses.

Types of Pregnancy Loss
Pregnancy losses can be categorized generally as either miscarriage or intrauterine fetal death (IUFD).

  • Miscarriage tends to occur in the first or second trimester of pregnancy. It may be caused by genetic, structural, hormonal or immune system issues.
  • Intrauterine Fetal Death (IUFD) can occur in the later stages of pregnancy. Causes may include immune system and genetic issues.

Referrals to Community Services
The Maternal Fetal Diagnosis Program can be a valuable resource to families of infants with special needs – providing referrals to appropriate community programs that can help patients and families after their time with DMC Women and Infant Services.
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