If you've been told you're having a high-risk pregnancy, or a medical complication puts you at risk, our highly skilled team of perinatologists will guide your care. Our team counsels women before birth and provides them ongoing pregnancy care at our clinics in Durham, Raleigh, Cary, and Burlington. We use our years of training and experience and our extensive resources to ensure you and your fetus receive the highest level of personalized care before and during your pregnancy and delivery, for the best possible outcome.
Duke Health perinatal clinics are located in Durham, Raleigh and Burlington.
High-Risk Care Before Pregnancy
Our perinatologists are board-certified obstetricians-gynecologists who complete additional years of fellowship training in maternal-fetal medicine. They provide care for both the mother and fetus before and during high-risk pregnancies and deliveries.
High-Risk Pregnancy Consultations
If you have an existing medical concern that may complicate your pregnancy, our team will perform a high-risk pregnancy consultation. In addition to our perinatologists (also referred to as maternal-fetal medicine specialists), you may meet with our nurse midwives and nurse practitioners, genetic counselors, and other specialists. They work with your doctors to plan for conception and ensure you can achieve a healthy pregnancy.
Existing Medical Concerns
These conditions would be discussed during a high-risk pregnancy consultation:
- An existing condition such as heart disease, diabetes, high blood pressure, lupus, bleeding disorder or a seizure disorder that could affect your pregnancy
- History of complications such as cervical incompetence, miscarriage, preterm delivery, or multiple births
- A genetic disorder that may affect the health of your child
- Maternal conditions such as a pelvic mass that may require surgical intervention
Identifying Fetal Medical Concerns
Advanced Imaging and Screening
If a concern is suspected, advanced imaging may be recommended to help doctors detect and monitor issues that can occur as your baby develops. Imaging options include targeted fetal ultrasound, fetal echocardiography (ultrasound that studies your baby’s heart and blood flow), and MRI. They are performed and interpreted by our specially trained technicians and specialists.
Counseling and Guidance
Our genetic counselors are available to women whose babies may be at risk for certain chromosomal disorders, such as Down syndrome or trisomy 18, or inherited diseases, such as Tay-Sachs disease. We help you make educated decisions about your pregnancy and prepare for your child’s birth. Our goal is to pinpoint the cause of your child’s condition as quickly as possible, then guide the development of your child's treatment plan to possibly prevent, delay, or minimize future complications. Our genetic counselors walk you through your baby’s risk factors and screening options and help you decide whether to undergo one of our advanced screenings. If you receive a positive diagnosis, they offer information on the latest research on these diseases and connect you with support programs and community resources.
We understand that expectant moms may worry about the risk of miscarriage that comes with amniocentesis (less than 0.5 percent) and chorionic villus sampling (0.5 to 1 percent), which test for chromosomal disorders. Because our center performs many of these procedures each year, our high levels of experience and skill can lower your risk for complications.
Care for Medically Complex Pregnancies, Transition to Neonatal Medicine
High-Risk Pregnancy Care
In addition to caring for pregnant women with medical conditions, our perinatologists manage high-risk pregnancies in women carrying multiples (twins, triplets, and more), as well as women with placenta previa or placental implantation defects, conditions that refer to the abnormal placement or attachment of the placenta that can lead to significant complications.
Expertise in Blood Conditions Unique to Women
Our obstetricians work closely with hematologists to coordinate the special care required by women with platelet disorders, clotting disorders, bleeding disorders, and sickle cell disease. We have the expertise and experience to help you manage the increased risks associated with pregnancy and childbirth.
Additional Team Members
High-risk pregnancy care may also be provided by our registered dietitians, clinical social workers, and psychologists.
Level IV NICU - Neonatal Nursery
Babies with congenital defects or who require medical or surgical care after birth are transitioned immediately to our Level IV neonatal intensive care unit (NICU) and cared for by neonatologists and other pediatric specialists.
In addition, Duke University Hospital is proud to be named the best hospital in North Carolina, and nationally ranked in 10 adult and 9 pediatric specialties by U.S. News & World Report for 2019–2020.