Services

Our board-certified and board-eligible physicians provide outpatient, office-based, high-risk pregnancy care, inpatient antepartum consultative care, and maternal transfer services.

At North Texas Perinatal Associates, we’re committed to turning high-risk pregnancies into low-risk deliveries.

Amniocentesis

Amniocentesis is a procedure used to sample the amniotic fluid around the baby while in the uterus. This procedure is typically done during or after the fifteenth week of pregnancy. Amniocentesis can be used to determine if the baby may have a problem with too many or too few chromosomes, to determine if the baby may have contracted a viral or bacterial infection, or, later in the pregnancy, to determine if the baby’s lungs are mature enough to deliver the baby.

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Amniocentesis

Amniocentesis is a procedure used to sample the amniotic fluid around the baby while in the uterus. This procedure is typically done during or after the fifteenth week of pregnancy.

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Chorionic Villus Sampling

Chorionic villus sampling (CVS) is a technique for obtaining genetic information about an unborn baby by collecting cells from the placenta. Indications for CVS include an increased risk for a baby with a chromosomal abnormality, a family history of inherited (genetic) diseases, or evidence of fetal abnormalities on a first trimester ultrasound (increased nuchal translucency).

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Fetal Assessment

In high-risk pregnancies, additional testing is often used during the third trimester to evaluate your baby’s health.  Fetal well-being can be assessed in several ways.  In addition to maternal perception of fetal movement (“kick counts”), fetal health can also be evaluated by studying the baby’s heart rate tracing (non-stress test), using ultrasound to observe the baby’s movements and amniotic fluid levels (biophysical profile (BPP)), and viewing the blood flow in the umbilical cord blood and/or your baby’s brain with ultrasound Doppler studies.  The clinical situation will guide when testing should begin and how often it should occur.

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Genetic Screening, Ultrasound and Prenatal Diagnosis

Through genetic screening, parents can discover the likelihood of having a child with a genetic birth defect such as Down syndrome. Ultrasound is also used during pregnancy to screen for birth defects; however, neither procedure provides a formal diagnosis. If genetic screening or ultrasound indicates a baby could have a birth defect, parents may choose to have a prenatal diagnostic test performed to determine whether the baby in fact has a birth defect.

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High Resolution, Targeted Ultrasonography

Your doctor may send you to see a maternal-fetal medicine specialist for “a level II,” a “detailed,” or a “targeted” ultrasound even if they have already looked at your baby with ultrasound in their office.  An ultrasound in one of our offices allows our doctors, who have had several additional years of training in ultrasound compared to general OB/GYNS, to use state-of-the-art equipment to look in more detail at your baby’s body, evaluate your baby’s growth, and assess the placenta and your uterus.  This is not a 3-D or 4-D ultrasound, which are often used for keepsake pictures rather than for diagnostic purposes.

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Percutaneous Umbilical Blood Sampling/Intrauterine Transfusion

Percutaneous umbilical blood sampling (PUBS) and intrauterine transfusion (IUT) are techniques used to sample the baby’s blood to evaluate and to treat specific fetal problems. PUBS involves using ultrasound to direct a needle through the mother’s abdomen and uterus and into the vein in the baby’s umbilical cord to obtain a sample of the baby’s blood. IUT is done when the PUBS shows that the baby has anemia (low blood count) and it involves transfusing blood through the needle in the baby’s umbilical cord to treat the anemia while the baby is still in the uterus.

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Preconception Counseling

Some families will benefit from counseling about pregnancy risks and management options prior to trying to conceive. Our Maternal-Fetal Medicine specialists combine expertise and empathy to equip couples with valuable knowledge prior to conceiving.

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Transabdominal Cerclage

A very small number of women with cervical incompetence treated with a vaginal cerclage may still suffer preterm delivery. There are also a small number of women who have too little cervical length to allow for vaginal cerclage placement. In this subset of women, a transabdominal cerclage (TAC) may provide the support they need to successfully carry a pregnancy. TAC placement requires entering the maternal abdomen through an incision (like a cesarean section incision) or through laparoscopy. The TAC allows a suture for structural support to be placed much higher on the cervix/lower uterus to provide the needed support to carry a pregnancy. Once placed, the TAC remains in place even after delivery. Patients with a TAC require a Cesarean section for delivery of their baby.

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Transvaginal (McDonald or Shirodkar) Cerclage

Women who have had prior pregnancy losses with painless premature opening of the cervix and delivery during their second trimester may be diagnosed with “cervical insufficiency” or “cervical incompetence.” Women who have had prior cervical surgery for dysplasia (such as a LEEP or cone-biopsy) and women with a history of other cervical “trauma” (such as multiple D&Cs or cervical laceration during a prior pregnancy) may be at increased risk for cervical incompetence. Therapy can include supplementation with progesterone and vaginal cerclage. Vaginal cerclage involves placing a suture or “stitch” around the upper cervix in a purse-string fashion to provide additional cervical support and to decrease the risk of preterm birth. A vaginal cerclage is generally a day surgery procedure. The cerclage can be removed in the office around 36-37 weeks of pregnancy, and vaginal delivery can occur after cerclage removal.

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