Duke University Hospital's maternal-fetal medicine specialists (also called perinatologists) follow your pregnancy closely while focusing on personalized care based on your risk factors, lifestyle considerations, and specific health needs.
Expert care for your high risk pregnancy
If you’ve been told you have a “high-risk” pregnancy, you and your baby need extra medical support to ensure you both stay as healthy as possible. Our maternal-fetal experts follow you closely throughout your pregnancy and delivery. We believe that every woman is different, and so is her pregnancy.
We care for women who are carrying multiples (twins, triplets and more), who have a history of pregnancy complications (such as miscarriage, preterm delivery and cervical incompetence) or have an existing medical condition that could affect pregnancy, such as heart disease, diabetes, lupus, or seizure disorder.
Choose Duke for your maternal-fetal medicine care because we offer:
- A team approach. Our maternal-fetal medicine specialists, genetic counselors, specialized ultrasonographers, midwives and nurse practitioners work together to make sure you have the best pregnancy outcome possible. We also work closely with the pediatric specialists in our Level III neonatal intensive care nursery (NICU). They offer specialized medical and surgical care for babies born with birth defects diagnosed in the womb that need immediate care after delivery.
- Advanced ultrasound. We offer a wide range of advanced imaging options including targeted fetal ultrasound, fetal echocardiography (ultrasound that studies your baby’s heart and blood flow), and MRI. Our ultrasonographers and Maternal-Fetal Medicine specialists are specifically trained to interpret these tests in order to detect and monitor developmental issues that can occur with your baby.
- Latest genetic testing. We offer all aspects of genetic screening including noninvasive and invasive testing. Our genetic counselors work one-on-one with you to identify your baby’s risk factors for fetal diseases and chromosomal abnormalities and help you decide whether to undergo one of our advanced screening options, which range from blood tests to minimally invasive procedures, including amniocentesis and chorionic villus sampling, which test for chromosomal abnormalities. If an issue is found, your family may be eligible to participate in our research, which uses advanced genetic technologies available at only a handful major medical centers across the country. 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.
- Fetal diagnostic expertise. Many expectant moms worry about the risk of miscarriage that comes with amniocentesis (less than 0.5 percent) and chorionic villus sampling (0.5 to 1 percent) – the two standard tests used today to diagnose certain chromosomal disorders. We perform a high volume of these procedures. Our experience and skill lowers your risk of complications. We also have significant experience with other invasive procedures that are performed on the baby inside the womb if they become necessary.
- Personalized pregnancy support - We believe that every woman is different, and so is her pregnancy. Our Maternal-Fetal Medicine specialists provide both comprehensive consultation as well as complete obstetric care for high-risk patients. If you have an existing medical condition, we will work with you before you conceive to help you plan for the healthiest pregnancy and delivery possible. Our on-site nutritionist provides support for our patients who have weight or diet related issues.
MATERNAL FETAL MEDICINE
Our certified genetic counselors are available to any women who believe their baby may be at risk for certain chromosomal disorders (such as Down syndrome or Trisomy 18) or inherited diseases (such as Tay Sachs disease). They walk you through your baby’s risk factors and screening options. 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 help women with pre-existing medical conditions plan for conception and monitor them throughout pregnancy. Our maternal-fetal specialists understand the special needs and potential risks of expectant moms with conditions such as heart disease or Lupus. We also work closely with women who have a history of risk factors or complications, such as miscarriage, cervical incompetence and preterm delivery, as well as women who develop problems during pregnancy, including partial and complete placenta previa. Your obstetrician will typically refer you to us in these cases.
Measures your baby’s heart rate in your womb to detect any heart abnormalities and to check the baby’s well being. Fetal heart rate can change in response to certain complications, changes in the uterus or decreased oxygen.
We provide the full spectrum of advanced screening and diagnostic testing, performed by skilled ultrasonographers with experience detecting problems and monitoring high-risk patients, including chorionic villus sampling. We also offer routine and detailed ultrasound services.
MATERNAL FETAL MEDICINE
Provides detailed measures of your baby and helps determine whether he or she is developing properly.
Combines the results of ultrasound measurements with maternal blood sampling to determine your baby’s chance of having Down syndrome, Trisomy 18 and Trisomy 13.
Also called the AFP screen, triple screen, or quad screen, it measures several proteins in your blood to assess your baby’s risk for Down syndrome, Trisomy 18 and spina bifida.
Ultrasound imaging guides a thin needle through the mother’s abdomen and uterus to collect a small amount of amniotic fluid. It is an option for pregnant women with certain risk factors, such as advanced age, family history of birth defects. The test is more than 99 percent accurate in diagnosing chromosomal abnormalities. Additional testing of the fluid can diagnose more than 98 percent of neural tube defects, an opening in the spinal cord or brain.
Chorionic villus sampling uses ultrasound guidance to sample placental tissue from the cervix or abdomen, depending on the position of the placenta. CVS is performed between 10 to 12 weeks of pregnancy, and can diagnose chromosomal abnormalities earlier than amniocentesis.