High-Risk Obstetrics

Your OB/GYN may decide that your pregnancy is “high risk” if you develop complications or if you have a greater chance of developing certain complications. Common high risk conditions include:

• You are either under 17 or over 35 years old.
• You have a chronic medical condition such as diabetes or hypertension.
• You develop diabetes (gestational diabetes) during the pregnancy.
• Your pregnancy involves more than one baby.
• You have had a previous miscarriage.
• You have given birth prematurely in the past.
• Prenatal testing indicates a suspected birth defect.
• You have a history of fibroids or other gynecologic problems.

If your obstetrician determines that you have a “high risk” pregnancy, he may refer you to another doctor who specializes in Maternal-Fetal Medicine at the Center for High Risk Pregnancy. Maternal-Fetal Medicine specialists are OB/GYNs who have additional education and training in pregnancy complications that may occur before conception or during pregnancy and delivery. Maternal-Fetal Medicine doctors work closely with your obstetrician to carefully monitor your pregnancy and provide testing, diagnosis, and treatment for both you and your baby.

Our doctors are known not only for their expertise in Maternal-Fetal Medicine but also for the compassionate care they provide to patients. They understand both the anxiety and the joy of pregnancy because they are parents themselves. Their first concern is to ensure the health of you and your baby. Moreover, they are up-to-date on the latest research and treatments. They all serve on the faculty of the University of Tennessee Health Science Center College of Medicine. Maternal-fetal medicine and genetics specialists offer a comprehensive service for women who have pregnancy complications or who are at increased risk for complications. The Center for High Risk Pregnancies in east Memphis offers a full range of diagnostics and treatment for women with pregnancy complications that may occur prior to conception, during pregnancy, and at delivery.

Whether the pregnancy is complicated by either medical or obstetrical factors, our physicians and staff are dedicated to helping mothers and their babies obtain the best possible outcome. Our state-of-the-art technology and the medical expertise of our team enable the Center for High Risk Pregnancies to provide a highly advanced level of care that is unique in the Mid-South.

Fetal transfusion and surgery is performed by Dr. Giancarlo Mari and is the only one of its kind in the area and one of less than 20 in the nation. Dr. Mari, who also serves as Director of the Maternal-Fetal Medicine Institute as well as Chair of the OB/GYN Department, is known for his expertise in fetal ultrasound and has pioneered therapies for conditions such as twin-twin transfusion syndrome and fetal anemia.

In some cases, your doctor may recommend that you see a Maternal-Fetal Medicine specialist before you become pregnant. For instance, if you have a medical condition such as epilepsy or a family history of a certain disease, you may benefit from pre-conception counseling and/or genetic testing. The doctors at the Center for High Risk Pregnancies know that it can be upsetting to think that your unborn child may have a medical problem. They take great care to answer all of your questions, explain any tests that need to be performed, and counsel you on the results.

Inpatient consultation Services provided to care for your high risk pregnancy due to medical, surgical or obstetrical factors:

• Special care of medical conditions complicating pregnancy
• Ultrasound for routine and high risk pregnancies
• Advanced ultrasound to evaluate fetal problems and anomalies. We use 3D/4D, tomographic imaging and advanced volume rendering.
• Fetal echocardiography for heart studies
• Fetal transfusion and surgery when needed through the Fetal Therapy Center at Le Bonheur Children’s Hospital
• Technically-advanced equipment and facilities help us diagnose your baby’s risks for genetic, growth and structural differences.
• Some babies can be treated with medications or through surgery while still in your uterus.
• First trimester genetic screening, which has a detection rate of 91% of Down syndrome pregnancies at a 5% false positive rate, and a detection rate of 98% of Trisomy 18 pregnancies at a 1% false positive rate
• Genetic counseling
• Care of diabetes during pregnancy
• Perinatal outreach program
• Prenatal diagnostic procedures
• Preconception counseling

We manage medical conditions, including:

• Care of diabetes during pregnancy
• Fetal growth restriction
• Heart disease
• Hypertension
• Infectious diseases
• Kidney or gastrointestinal disease
• Multiple gestation
• Pre-eclampsia (toxemia)
• Preterm labor
• Recurrent pregnancy loss

Our diagnostic tools include:

• Amniocentesis
• Biophysical profiles
• CVS (chorionic villus sampling)
• Doppler velocimetry
• Fetal echocardiography for heart studies
• First trimester genetic screening
• Genetic ultrasound
• Nonstress testing
• Prenatal diagnostic procedures