Maternal-Fetal Medicine
Expert Care to Smooth a Bumpy Road to Parenthood
You have your mother’s eyes, her animated personality and her curly brown hair. But you also may have inherited her health—for good and bad. And when you’re looking for similarities, it’s important to think whole-body, especially if your mother had difficulties during her pregnancy.
Pregnancy is billed as a beautiful experience punctuated by simple joys like feeling the baby’s first kick or picking colors for the nursery. But complications can sometimes create stress for soon-to-be parents. Cleveland Clinic experts offer state-of-the-art care and emotional support to families facing underlying medical conditions, difficulties with poor pregnancy outcomes or suspected or known problems with mother or baby.
“When a problem occurs with a pregnancy, family members can experience tremendous anxiety and confusion,” says Jeffrey Chapa, MD, Head of Maternal-Fetal Medicine. “When you take the time to relieve their fears or to help them understand what is going on, they are extremely grateful. The special relationship that develops is what makes this field so rewarding.”
High-risk pregnancy-related services include preconception planning, early screening, pregnancy management (primary or consultative) and delivery.
The following checklist can help you determine if you could have
a high-risk pregnancy:
- Women over 35 years old can talk to their provider with concerns about increased risk of giving birth to a child with a chromosomal anomaly
- Women under 17 are at increased risk of experiencing intrauterine growth restriction
- Women carrying more than one baby at a time are at risk of experiencing a number of pregnancy-related complications, including preterm labor
- Women with chronic health conditions such as diabetes, heart problems or a blood-clotting disorder
- Women with a history of gynecological problems such as pelvic inflammatory disease (PID), endometriosis or large symptomatic fibroids
- Women with a history of pregnancy loss (miscarriage, ectopic pregnancy, preeclampsia or stillbirth) or premature birth
- Women with an STD, including HIV, that could be transmitted to the baby during pregnancy or at the time of birth
- Women who have had two or more second-trimester abortions
- Women who have conceived while using an IUD Women who have a child with a genetic disorder or are a carrier
Any pregnancy can become high risk. You should call your caregiver immediately if you experience vaginal bleeding, a leakage of fluid, pain in the abdomen or shoulder or painful, urgent urination.
If you are expecting, regardless of whether or not you are high risk, here are some tips for a healthy pregnancy:
- Take 400 micrograms of folic acid daily. This B vitamin prevents spinal and brain birth defects.
- Get 1,000 milligrams of calcium daily. Take a supplement or eat dairy and leafy greens, because it isn’t included in most prenatal vitamins.
- Eat only pasteurized cheeses and fully cooked meats. Bacteria can lead to premature delivery or miscarriage.
- Avoid raw fish and shellfish. They may contain a parasite that can cause infant blindness or brain damage.
- Follow a low-fat, high-fiber diet, broken into several small meals a day to help prevent nausea.
- Don’t smoke or drink. Both can cause birth defects, and smoking can lead to premature birth or infant death.
- Don’t change cat litter. Parasites are found here, too.
- Sleep on your side to reduce pressure on your back from your belly weight.
- Use a seat belt correctly. Place the lap strap under your belly and the chest strap off to the side of your belly (never directly over it) and between your breasts.
- Lastly, exercise to improve circulation, mood and energy.
Women who have significant medical problems and/or a history of serious pregnancy complications benefit from careful planning and appropriate treatment prior to pregnancy to prevent or significantly decrease the risk for problems. Women carrying babies with known or potential health issues have immediate access to experts in the care of newborns, including neonatologists, pediatric surgeons and subspecialists, who can ensure the best possible outcome.