High Risk OB Services

Doctors use the term “high risk” to describe a pregnancy in which the mother or the baby may experience medical complications due to a newly developed or pre-existing disorder. This includes conditions or situations that could threaten the well being of the mother or child such as:

• Diabetes
• High blood pressure
• Heart problems
• The expectation of twins, triplets or more
• History of miscarriage
• Symptoms of premature labor

As many as 10 percent of pregnancies are considered high risk, but with expert care, 95 percent of these special cases result in the birth of healthy babies. UC Irvine Medical Center is the only facility in Orange County offering specialized care in one location for high-risk expectant mothers and their babies.

Select a perinatologist (high risk obstetrician) »

Pre-pregnancy planning

At UC Irvine Medical Center, women with chronic diseases or a history of premature delivery are able to plan their pregnancy with the help of perinatologists and other high-risk maternal-fetal experts. An important part of this process is adjusting medications and treatments before a woman becomes pregnant to protect the fetus during a future pregnancy. Once she conceives, the patient and fetus are carefully monitored to ensure a healthy outcome.

Multidisciplinary care

Our high-risk obstetrics team offers a comprehensive program of services to protect both mother and child during pregnancy and immediately after birth. This well-coordinated continuum of care from pregnancy through neonatal care and beyond has earned UC Irvine Medical Center some of the best outcomes in the nation for the management of complicated pregnancies. Features of the program include:

• Multidisciplinary approach. Our in-house physician specialists include obstetricians, perinatologists (experts in high-risk pregnancy), geneticists, endocrinologists (specialists in the endocrine system and hormones, including diabetes), radiologists, cardiologists and neonatologists (experts in the care of high-risk newborns).
• Highly coordinated care. Our high-risk maternal-fetal team works together, providing consistent, comprehensive care throughout pregnancy and childbirth.
• Access to subspecialists. As a university-based medical center, we are able to offer the services of many specialists, if needed, including more than 55 types of pediatric subspecialists.
• Combined perinatal-neonatal program. Continuity of care is extremely important for high-risk women. If fetal testing indicates a baby has a congenital problem, UC Irvine Medical Center maternal-fetal specialists make plans to treat it immediately. Additionally, if premature labor is likely, neonatologists and perinatologists can work together to delay the birth. Every extra day in the womb gives the baby’s lungs and other vital organs more time to develop.
• Neonatal intensive care unit (NICU). Our NICU is one of only two neonatal intensive care nurseries in Orange County accredited to care for the smallest and sickest newborns. Because we are experts in this field, many expectant mothers in premature labor are transported to UCI from other hospitals to receive specialized care. So are hundreds of high-risk infants who are born at other facilities. Our neonatologists are now saving babies born up to 23 weeks prematurely, and weighing a little less than a pound.

Fetal testing

Thanks to ongoing research breakthroughs and new technologies, sophisticated testing can reveal an enormous amount of information about the health of the fetus and the likelihood of premature labor. Among the tests available are:

• Combined First-Trimester Screening (CFTS). This noninvasive test to assess a fetus’s risk for Down syndrome and trisomy consists of a blood sample and specialized ultrasound test. Conducted in the eleventh week of pregnancy, CFTS can be performed earlier than amniocentesis, an invasive test used to determine the presence of genetic abnormalities.
• Ultrasound. Using sound waves to provide a window into the womb, this multifunctional test can reveal physical abnormalities and track blood flow patterns in the fetus, as well as monitor the amount of amniotic fluid in the birth sac.
• Premature labor tests. To determine if there’s an increased risk for premature labor, the maternal-fetal team uses two tests pioneered by UCI researchers. The first test screens for the presence of fetal fibronectin—a protein that’s a red flag for preterm labor. The second test—high-resolution ultrasound—measures the length of the cervix. The shorter the cervix, the more likely premature labor will occur.

Genetic counseling

For information about genetic risks to the developing fetus, UC Irvine Medical Center high-risk maternity patients can turn to our Center for Fetal Evaluation. Our genetic counselors help women understand the risks, benefits, and limitations of prenatal tests they’re considering, as well as the results of tests they’ve already taken. Screenings such as the multiple marker screening, nuchal fold scan, combined first-trimester screening, amniocentesis and chorionic villus sampling can determine a woman’s risk of having a child with genetic problems.

Maternal treatment options

Our goal with high-risk pregnancies is to prevent premature labor throughout the full term of the pregnancy—or to keep delivery as close to term as possible. To achieve this goal, we employ a number of strategies to prevent premature labor, beginning with low-tech remedies such as bed rest and the administration of intravenous fluids. We also have the option of using medications called tocolytics that relax the uterus and help to stop labor.

Fetal therapy

Advances in medical and surgical technology have provided almost miraculous opportunities to treat ailing fetuses while still in the womb. Treatments include:

• Corticosteroid medications to speed the development of an unborn child’s lungs and other organs so that, if premature birth occurs, the baby can enter the world with a better chance for survival.
• Percutaneous umbilical blood sampling (PUBS) for fetuses with severe anemia. Guided by high-resolution ultrasound, doctors insert a hair-thin, hollow needle directly into the fetus’s umbilical cord to retrieve a single drop of blood. The sample is immediately analyzed. If necessary, doctors can perform a blood transfusion through the needle that’s still in place.
• Surgery to correct fetal abnormalities while the baby is still in the womb. While many fetal disorders can be diagnosed with genetic and imaging techniques, it was only recently that anything could be done about them before birth. UC Irvine Medical Center specialists are now able to correct abnormalities such as heart defects, spina bifida and other serious anomalies while a baby is still in the womb. Our physicians helped set the standards worldwide for fetal surgery.

Research

We are a world-renowned, university-based medical center known for our outstanding patient care, advanced research and leading-edge technology.

UC Irvine Medical Center was the first health care facility in the nation to use OxiFirst™ to monitor newborns’ oxygen saturation level while still in the birth canal. This practice helps to reduce the number of Caesarean sections. UC Irvine Medical Center has also been the site of many other medical breakthroughs, including the use of nitric oxide therapy to treat life-threatening breathing problems in infants.