High-Risk Pregnancy Care at BIDMC
We work closely with your primary obstetrician, as well as other BIDMC specialists as needed, to provide comprehensive, coordinated care. We also provide second opinions or one-time evaluations as needed.
We perform ultrasounds and consultations in our Prenatal Diagnostic Center. Specialists in endocrinology, anesthesia, genetics, radiology, and perinatal clinical nursing, among others, participate in weekly team conferences to discuss our most challenging obstetrical issues and reach consensus on best practices and next steps.
Comprehensive Maternal-Fetal Medicine Services
Non-Stress Test (NST)/Biophysical Profile (BPP)
- Monitors fetal heartbeat, activity, muscle tone and breathing
- Monitors volume of the amniotic fluid
- Also called a sonogram; uses high-frequency sound waves (not X-rays) to create an image of the developing fetus. Sound waves are safe for the developing baby.
- We offer several types of ultrasound:
- Abdominal (non-invasive)
- Transvaginal, where a small probe is inserted into the vagina
- Doppler, to identify heart or circulation abnormalities in the fetus
- Three-dimensional (3-D), with life-like images
- Four-dimensional (4-D), with photos that move in real time
- Targeted ultrasound, a longer exam that sometimes includes 3-D imaging to investigate fetal abnormalities
- Aneuploidy screening
- Nuchal translucency measurement to determine if fluid is accumulating in the back of the fetal neck, which can be a marker for Down syndrome
- Used to assess fetal health
- Amniocentesis is performed to obtain a sample of the amniotic fluid
- Chorionic Villus Sampling (CVS) is performed to obtain a sample of the placenta
- Cordocentesis (also called percutaneous umbilical blood sampling) is performed to take a blood sample from the umbilical cord
- Cervical cerclage is a surgical procedure to sew the cervix closed in patients with cervical weakening
Complex Fetal Care
A diagnosis of a fetal condition during pregnancy can be overwhelming. Our compassionate maternal-fetal medicine experts are with you every step of the way. Using a holistic and family-centered approach to care, we diagnose and treat fetal anomalies at the Center for Maternal-Fetal Medicine at BIDMC. Foremost in our care philosophy is taking into account your desires and preferences to allow for the best possible outcome for you, your family, and your pregnancy.
New England Center for Placental Disorders
The New England Center for Placental Disorders at BIDMC provides comprehensive, leading-edge care for placenta accreta, placenta previa and other placental abnormalities. Placental disorders are rare, but require treatment from experienced providers and the coordination of many subspecialists.
Prenatal Genetics Program
Our Prenatal Genetics Program provides compassionate genetic counseling for families with concerns about genetic conditions, birth defects and/or cognitive deficits. Our licensed genetic counselors meet individually with you and your family to:
- Provide genetic risk assessments
- Summarize complex genetic information
- Help you decide about additional testing
- Coordinate care with your team of providers
- If needed, we offer ongoing supportive counseling
Specialty Care for Medical Conditions in Pregnancy
Patients with pre-existing medical conditions who are pregnant or planning to become pregnant may require additional obstetrical care and monitoring to ensure a healthy pregnancy and delivery. Our multidisciplinary maternal-fetal medicine clinics offer specialized high-risk pregnancy care for women who have one or more medical conditions such as heart disease, diabetes, inflammatory bowel disease or other gastrointestinal diseases, hematology (blood) disorders, infectious diseases, and mental health or substance use disorders.
Close Collaboration with Social Work
Our maternal-fetal medicine specialists work closely with social work services at BIDMC. Our OBGYN social work staff offers individual counseling, support groups, education and emotional support to you and your family. OBGYN social workers have specialized knowledge pertaining to high-risk pregnancy, pregnancy loss and bereavement, and family and relationship issues.
Neonatal Intensive Care Unit
BIDMC's Klarman Family Neonatal Intensive Care Unit (NICU) provides leading-edge, family-focused care for more than 900 high-risk newborns and their families each year. The NICU team works closely with maternal-fetal medicine to track mothers who are likely to deliver a high-risk newborn, in order to prepare for and coordinate multidisciplinary services.