For the vast majority of women, pregnancy follows a routine nine-month course and results in the birth of a healthy baby. Some women, however, have medical difficulties and experience what is called a "high-risk" pregnancy. High-risk complications occur in only six to eight percent of all pregnancies. But these complications can be serious and require special care to ensure the best possible outcome.
While some problems are unavoidable, our perinatologists—obstetricians with special training in high-risk pregnancy care—work to minimize complications. Our team coordinates all aspects of care, from diagnosis to delivery and long-term follow-up.
PCI doctors are currently the only perinatologists in central Iowa that offer complete high-risk case management including labor and delivery.
If you have been told you are having more than one baby (twins, triplets or more) you may call our office at (515) 643-6888 or toll-free at (877) 415-7447 to initiate complete obstetric care. We combine extensive experience providing care to pregnant women carrying more than one baby with knowledge of the latest recommendations for these pregnancies.
If you are currently pregnant and have had problems with a previous pregnancy—or have a medical condition which might impact pregnancy—you may also schedule an appointment to review your personal history and determine the need for care by a perinatologist.
Prenatal Ultrasound & Diagnostics
An ultrasound examination uses high-frequency sound waves to create a visual image of fetal structures. Extensive studies to date show no evidence of ill effects or harm to the fetus by these sound waves. Other studies have shown that it is possible to detect many birth defects early in pregnancy that would otherwise go undetected until birth. The ultrasound also allows evaluation of the number of babies, fetal growth, due date confirmation, determination of placental position and other information about the pregnancy that can be useful to you and your doctor.
You do not need to have a full bladder for ultrasounds in our office; however, it is helpful to have your bladder partially full at the beginning of the ultrasound. Obstetrical ultrasounds take approximately 30 minutes to complete. Comprehensive (Level II) scans take approximately one hour.
PCI has a certified, perinatal genetics counselor who discusses risks and benefits of various screening and testing options. PCI can provide counseling for issues such as pregnancy later in life, inherited disorders and abnormal screening results.
During genetic counseling, our counselor will provide information and support to you and your family. She will address concerns about birth defects or inherited disease before or during pregnancy. Our genetic counselor is dedicated to providing you with personalized, focused care.
First, your family and personal health history will be discussed to determine the chance that fetal disorders may occur. Based on this information, appropriate options for prenatal testing in detail — along with the benefits, limitations and risk for each procedure— will be presented. Through the genetic counseling process, individual and family goals will be kept in mind.
Prenatal screening tests have been designed to identify women who are at increased risk of having babies with certain chromosomal abnormalities such as Down syndrome; selected inherited diseases like cystic fibrosis or thalassemia; or physical birth defects like spina bifida.
Tests of proteins in a pregnant woman’s blood and/or ultrasound can be combined in various ways to assess the risk for Down syndrome. Each test has specific benefits, and our genetic counselor will help you decide which test, if any, may be right for your pregnancy. All of these screening tests are non-invasive, with no increased risk for miscarriage.
You may benefit from prenatal testing if:
- You are pregnant and under the age of 35, but would like more accurate screening for Down syndrome.
- You are pregnant and will be 35 years old or older on your due date.
- You are pregnant with an abnormal screening test result
- You have had an ultrasound of your fetus showing a possible birth defect.
- You have already had a child or other close relative with a birth defect or genetic disease.
- You and your partner are carriers of a recessively inherited disease such as Tay-Sachs, sickle cell anemia, cystic fibrosis or thalassemia.
- You are a carrier of an X-linked disease such as Fragile X, hemophilia or muscular dystrophy.
- You have been exposed to medications, X-rays or other agents during your pregnancy that may be harmful to the developing fetus.
First-trimester screening is a test performed between weeks 11 and 14 of pregnancy. It is currently the most reliable screening test for Down syndrome—the most common chromosomal abnormality among babies born today. It also screens for other chromosome abnormalities and birth defects.
The first-trimester screening combines an ultrasound measurement of the skin thickness on the back of the baby’s neck (nuchal transulcency or NT) with a finger-stick blood test performed on the mother. These results are then analyzed and assigned a risk estimate.
What are the benefits of having a first-trimester screening completed?
Because first trimester screening can be done earlier than most other prenatal screening tests, you'll have the results early in your pregnancy. This will give you more time to make decisions about further diagnostic tests, medical treatment and the course of the pregnancy. If your baby is diagnosed with a genetic condition, you'll also have more time to prepare for the possibility of caring for a child who has special needs.
Abnormal First-Trimester Screening Results
Receiving news of a “positive test” can be very alarming, especially when the person relaying the result does not have a thorough understanding of what the results actually mean. PCI offers patients the only certified genetics counselor in central Iowa to assist in this assessment and help you fully understand your results and options for further testing. PCI offers both chorionic villus sampling (CVS)and genetic amniocentesis to patients who opt for these tests.
First-trimester screening without a physician referral
Some women are not able to see their obstetric provider until late in their first trimester, PCI offers first-trimester screening without a physician’s referral.
If you are interested in this screening, you may call our office at (515) 643-6888 or toll-free at (877) 415-7447 to schedule an appointment for this screening.
If problems or concerns arise during pregnancy, you may be referred to the Mercy Women & Infant’s Center Maternity Triage and Treatment (MTT) Unit for evaluation, lab tests, fetal monitoring and/or ultrasound.
Mercy’s MTT staff is specially trained and devoted to caring for women with high-risk and complicated pregnancies. The inpatient area, which features the same amenities as Mercy’s Mother/Baby Unit, is available for those who require additional care. The unit also has an ultrasound room that provides obstetric ultrasounds 24 hours a day for inpatients and Mercy Emergency Room patients. These ultrasounds are performed by PCI sonographers and are read by PCI physicians.
Mercy Medical Center—Des Moines has the only birthing unit with a certified critical care obstetrical team in the state of Iowa. PCI physicians, along with a core group of nurses who have received additional training and education in critical care obstetrics, comprise the Mercy Obstetric Critical Care Unit. Critically ill patients who would otherwise be transferred to an intensive care unit somewhere else in the hospital can remain with the nurses and physicians who know them best and can stay close to their baby once they deliver.
In addition to the Maternity Triage and Treatment Unit, the Mercy Women & Infants’ Center consists of the Variety Neonatal Intensive Care Unit, the Birthing Unit and the Mother/Baby Unit with the well-baby nursery. It is designed to provide state-of-the-art technology to mothers, babies and families throughout the birthing and post-partum experience.
The Mercy Women & Infants’ Center is housed on three floors of Mercy’s East Tower, which is located in downtown Des Moines on Third Street between University Avenue and Laurel Street.