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
Obstetrical Ultrasound
- 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
Ultrasound-Guided Procedures
- 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
- 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.
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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.
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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.
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Perinatal Comfort Care
Perinatal Comfort Care Team: Supporting Families During and After Pregnancy
The multidisciplinary, perinatal comfort care team provides compassionate, family-centered care to parents who are expecting a child with a life-limiting condition. The team works to support and honor the family’s goals for the pregnancy and for their child.
We believe that welcoming a pregnancy and a child with a life-limiting condition is an important and family-defining life event. Our experienced team is here to support you every step of the way — through pregnancy, birth, and postpartum care of your family and your child.
Information for Families
We understand that this is not where you may have expected to be and we are sorry for this. Navigating the options can be challenging, and we hope to partner with you to develop a collaborative plan of care that puts your wishes and goals first.
Our team consists of experts across multiple fields including OBGYN, social work, neonatology, spiritual care, pediatric palliative care, nursing, and other subspecialists. Not all specialists may be needed for all families and we will work with you to create a unique team for your needs.
Working with your family, our team’s goals are to:
- Provide support and education
- Empower parents to share their wishes during pregnancy
- Help develop an individualized birth plan including care of your baby
- Advocate for patient and family-centered care
- Facilitate communication among health care providers
- Welcome and celebrate the birth of your child
- Coordinate community support and referrals for end-of-life care
Family Resources
Referrals
For more information or to arrange a consultation, please contact the Center for Maternal-Fetal Medicine at 617-667-CMFM (2636) or send us an email.
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
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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.
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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.
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