Maternal Fetal Medicine: Ensuring A Healthy Pregnancy For You And Your Baby

High-Risk Pregnancies: What Does It Mean?

A high-risk pregnancy means some risks increase the likelihood of complications during pregnancy and/or delivery. This can include pre-existing medical conditions or pregnancy-related complications.

Having a high-risk pregnancy doesn't necessarily mean that something will go wrong, but it does mean that you and your baby require closer monitoring and care to ensure a healthy pregnancy and delivery, said Dr. Kalchbrenner.

“It’s important to know that every pregnant woman is at risk of complications that can affect their health and that of their unborn child,” said Dr. Kalchbrenner.

What Makes A Pregnancy High-Risk?

Some common risk factors can make a pregnancy high-risk. These include:

Preexisting Diabetes

If you have type 1 or type 2 diabetes before pregnancy, a maternal-fetal medicine specialist will continue to closely manage those conditions. Preexisting diabetes puts women and their babies at an increased risk of certain pregnancy complications.

“We perform a detailed anatomic scan at 20 to 22 weeks of gestation to look closely at the details of your baby’s anatomy,” said Dr. Kalchbrenner.

Gestational Diabetes

Gestational diabetes is a type of diabetes that develops during pregnancy. It occurs when the body can’t produce enough insulin to regulate blood sugar levels. High blood sugar can harm both you and your growing baby. Gestational diabetes can affect any pregnant woman, regardless of whether they had diabetes before becoming pregnant.

Preexisting Heart Condition

If you have a preexisting heart condition or structural heart anomaly, your maternal-fetal medicine doctor works closely with your cardiologist to manage your condition and ensure that you and your baby remain healthy. The goal of this collaboration is to fully understand your heart condition related to the pregnancy and determine if or how much the pregnancy could worsen the condition.

Preexisting Kidney Disease

Pregnancy increases your risk for complications if you have a preexisting kidney disease. These can include high blood pressure and preeclampsia, said Dr. Kalchbrenner.

“Regular monitoring and early intervention can help manage these risks and ensure you have a healthy pregnancy,” he said.

Obesity

Being overweight or obese – or having a high body mass index (BMI) – puts pregnant women at increased risk for a variety of health conditions, including:

• Gestational diabetes
• High birth weight or low birth weight
• High blood pressure
• Hypertensive disorders, such as preeclampsia
• Preterm birth
• Stillbirth
• Structural abnormalities, such as neural tube defects

Preeclampsia

Preeclampsia is a condition that affects some women during pregnancy and can be life-threatening if left untreated. Regular prenatal care and monitoring can help detect preeclampsia early and prevent complications.

“There are some preventive measures we can take,” Dr. Kalchbrenner said. “Women at high risk for developing preeclampsia can take a low-dose (81mg) aspirin daily. Doing so reduces their risk by about 40%.”

What Is The Role Of A Maternal-Fetal Medicine Physician? 

Maternal-fetal medicine is a specialized area of obstetrics that focuses on high-risk pregnancies, providing advanced care to women with complex medical conditions. Maternal-fetal medicine specialists work closely with obstetricians and midwives, perinatologists and neonatologists to monitor the health of the mother and baby, diagnose potential problems and develop individualized care plans.

Maternal-Fetal Medicine Services

In some cases, you might see an maternal-fetal medicine specialist only one time. Other women may need to see their maternal-fetal medicine doctor several times during pregnancy. Each person is different, and services vary depending on the individual's care plan. Some of the services offered at Franciscan Health include:

• Amniocentesis: a prenatal diagnostic test used to analyze fetal cells in the amniotic fluid surrounding the developing fetus and determine the baby's health condition.
• Chorionic villus sampling: a diagnostic test used to analyze fetal cells and is typically offered to women at higher risk of having a baby with chromosomal abnormalities, genetic disorders or certain congenital disabilities.
• Fetal blood sampling: a diagnostic test used to analyze fetal blood for genetic and other abnormalities. The test might be offered to pregnant women at higher risk of having a baby with certain conditions such as anemia, blood disorders or infections.
• Fetal transfusion, or intrauterine transfusion: is a medical procedure used to treat certain fetal blood disorders. The most common reason for fetal transfusion is if the mother's immune system produces antibodies that attack the fetal red blood cells, leading to anemia and other serious complications.
• Non-invasive ultrasound doppler exam: is a common diagnostic tool used to create images of the fetal heart and blood vessels to monitor fetal blood flow and detect any potential abnormalities or complications.

From Delivery Room To NICU

Having a high-risk pregnancy can also increase the risk of delivering a baby who needs specialized care in the neonatal intensive care unit (NICU). The NICU is a specialized unit in the hospital that provides advanced medical care for newborns who need extra support.

“A lot of what we do at Franciscan Health is to try to avoid that,” Dr. Kalchbrenner said. “Having a baby in the NICU can be a challenging experience, but it is also a place of hope and healing.”

If your providers think that your baby may be born early or with complications, they will likely recommend that you plan to deliver at a hospital with a Level III NICU on-site. Dr. Kalchbrenner said they try to prepare for such circumstances ahead of time.

“It’s important to have the NICU available. It’s a place where nurses and doctors are dedicated to providing the best possible care,” he said. “Their expertise and compassion can be a source of comfort and reassurance for parents during a difficult time.”