SoCal Flipbooks

8 | Health Matters: Providence Cedars-Sinai Tarzana Medical Center P regnancy can be complicated. There are many reasons women may be referred to a maternal- fetal specialist—also called perinatology or high-risk obstetrics. For many, it's not because they 're high-risk. It's because their doctor wants them to get a higher level of screening or additional information about their pregnancy. If they are higher-risk, it means they may need closer surveillance and intervention if their health status changes. At Providence Cedars- Sinai Tarzana Medical Center, we help our patients feel supported throughout their pregnancies. Health Matters asked Tania Esakoff, MD, an OB-GYN and maternal-fetal medicine doctor at Providence Cedars- Sinai Tarzana, to explain what patients need to know. What is maternal-fetal medicine? For expectant moms who are being managed for high-risk conditions or complications with their pregnancies, there is maternal-fetal care that begins in pregnancy and ends with the baby 's birth. These medical conditions vary, as do complications the baby might experience before it's time for delivery. What makes a patient higher-risk? Some women have diabetes, hypertension or autoimmune diseases such as lupus. Or maybe they had an organ transplant in the past or were born with a congenital heart defect that was repaired. We also follow patients because of their fetal complications: For example, if you are having multiple babies, it automatically makes you a little bit higher-risk. What are the other reasons people visit a maternal-fetal medicine specialist? We may see patients in their first trimester for their nuchal translucency (an ultrasound that measures the fluid behind a baby 's neck to screen for potential abnormalities). In the second trimester, it might be for the fetal anatomic survey, to make sure the pregnancy is developing normally, and, if women desire, more diagnostic procedures. How do you determine if a woman should be an outpatient or inpatient? Most women are outpatients, as long as their maternal status is stable and their fetus is doing well. If a woman's disease worsens, or there are any signs she's developing a new condition—such as preeclampsia—depending on the severity and how far along the woman is in her pregnancy, she may require admission to the hospital. The same is true for the fetus: If there are issues with the fetal heart rate, the placenta or amniotic fluid volume, that might prompt hospitalization well before it's time to deliver. What are important questions for patients to ask? One of the most important things to find out is whether the pregnancy is healthy and if there are single or multiple babies. It's important to ask what sort of testing an expecting mother might consider. Every person is different. Some people want to do less, but I think being educated about the options is important for everybody. Helping Mom and Baby Our maternal- fetal medicine program focuses on helping people feel supported—whether they're high-risk moms or not. S P E C I A L M A T E R N I T Y S E C T I O N

• Cover