Risky Pregnancies Aided by Specialized OB Care
Jennifer Peterson of Petaluma knew from the beginning that pregnancy would be a hard road. Diagnosed years ago with polycystic ovary syndrome, a hormone disorder that can affect fertility, Jennifer had trouble getting pregnant and her first pregnancy ended in a miscarriage.
Even after Jennifer became pregnant a second time with the help of infertility treatments, she recognized that her chronic high blood pressure made the pregnancy more difficult. The medical knowledge she had gained in her profession as a nurse practitioner only made her worry more.
“I was a mess from the moment I was pregnant until I heard my baby cry – and everything in between,” Jennifer recalls.
While every pregnancy can trigger a certain degree of nail-biting, high-risk pregnancies in particular throw families into a tailspin as they face medical issues and complications that may change from one day to the next. In light of this, Sutter Health has developed a network of services and professionals to walk families across the tightrope of high-risk pregnancy and birth. Their common goal? A happy ending for both mother and child.
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What Constitutes High Risk?
A pregnancy can be labeled “high risk” for maternal or fetal reasons. Sometimes the mother has pre-existing medical problems like diabetes, chronic hypertension or lupus that can become problematic during pregnancy. Some women develop complications during their third trimester, such as gestational diabetes. Or the fetus may be in danger due to a major birth defect or a problem with the placenta.
“One of the most common reasons a woman is high risk is that she has a history of preterm birth in the past; she gave birth before 37 weeks,” says Regina Arvon, M.D., a perinatologist at California Pacific Medical Center. “After that, every future pregnancy is considered high-risk. “The rate of high-risk pregnancies has increased in recent years due primarily to infertility treatments, which lead to more multiple births like twins or triplets. According to the Centers for Disease Control, the rate of multiple births through assisted reproductive technology (ART) has increased by 300 percent since 1986, leading to a drastic increase in preterm births.
But a similar burgeoning of knowledge and technology in the field of high-risk obstetrics means Dr. Arvon and her colleagues at Sutter Health now have more tools than ever to keep high-risk women and babies healthy.
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Exams Track Fetal Health
When a woman in a high-risk pregnancy is referred to a perinatologist like Dr. Arvon, she typically goes through prenatal diagnostic tests designed to check the health of the baby and detect any birth defects. A chorionic villus sampling (CVS) is used to check for genetic problems with the fetus, and a Level 2 ultrasound or anatomical survey measures fetal development and can detect any lethal or non-lethal birth defects like spina bifida or congenital heart defects.
Sutter Health now offers non-invasive prenatal testing, a blood test to uncover chromosomal abnormalities. Currently, the test is available only to a subset of women who qualify: those over age 35, those whose infants have a birth defect as revealed on an ultrasound, or those who’ve tested positive in a screening test for Down Syndrome.
Another set of procedures, known as antepartum testing, checks the health of the fetus during the last trimester of pregnancy. Examples include a non-stress test to monitor the baby’s heartbeat and a biophysical profile, a specialized ultrasound that determines fetal well-being.
Finally, women with a history of premature labor undergo cervical length measurements starting in the second trimester. If the cervix appears too short, making the woman at high risk for premature labor, the doctor can perform a cerclage, a surgical procedure that prevents the cervix from dilating prematurely, or prescribe a drug called 17-hydroxyprogesterone that can help prevent preterm birth.
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Doctors with You Every Step
Perhaps the most important help medical professionals can offer women facing high-risk pregnancies is the availability to answer questions, offer advice and intervene with immediate care if necessary.
“We always felt Dr. (Natasha) Kahl was in control of our care,” recalls Jennifer of her Santa Rosa-based Sutter obstetrician. “Whenever I emailed her, she always emailed me right back. We had absolute concierge service the entire way, from the front desk to the advice nurse."
In other cases, physicians and their staffs offer high-risk patients the “tough love” they need to accept their situation and follow the necessary medical protocol. That was the case for Faye Scott of Daly City, a patient of Dr. Arvon, who had a hard time putting the brakes on her busy schedule during a pregnancy marked by dangerously high blood pressure. “I didn’t want to stop working. I thought I was superwoman. But Dr. Arvon had a great bedside manner and kept telling me, ‘Come on, we have to do this. It’s all for the baby,’” says Faye.
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Equipped for a Safe Delivery
Faye gave birth to her son Mateo prematurely at CPMC on March 23, a harrowing delivery that required an emergency C-section and other life-saving measures on both Faye and the baby. Jennifer, on the other hand, was able to carry her daughter Maggie Mae to full term and deliver via C-section on January 20 at Sutter Medical Center of Santa Rosa. No matter the type of delivery, Sutter Health has technology and staff available to provide the most advanced services to high-risk mothers and their infants, including local state-of-the-art, Level III Neonatal Intensive Care Units.
No one wishes for a high-risk pregnancy, but with supportive, comprehensive medical care, the happy ending can make all the hardship worthwhile. “Everything in my life has changed for the better since having our baby,” says Jennifer. “All I care about now is making sure she’s happy and healthy."
Visit babies.sutterhealth.org to learn about Sutter Health’s pregnancy-related services or call 1-888-637-2762 to find an OB/GYN or perinatologist near you.
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