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The Birthplace is affiliated with maternal-fetal medicine specialists (perinatologists) from Massachusetts General Hospital who care for women with high-risk pregnancies.
This test is used within the first trimester as a screening tool to identify those babies who are at risk for chromosomal abnormalities. This very thorough ultrasound is used for cases where there is a potential for genetic defect or an in utero complication for your baby.
A pregnancy is considered high-risk if there is a condition present that increases the chances that the woman or the baby may have a health problem. There are a number of conditions or factors that may put you at high risk during a pregnancy.
Maternal age: The risks of pregnancy are higher for women 35 and older but women who will be under 17 when they deliver are also at increased risk.
Medical conditions before pregnancy: Issues like high blood pressure, diabetes, kidney issues, heart problems, or sexually transmitted diseases can make a pregnancy more risky.
Lifestyle: Smoking, drinking alcohol, or using illicit drugs increase the risk level of a pregnancy. Pregnancy history: If you have a history of preterm labor or other pregnancy problems, you may be at higher risk for complications in future pregnancies. Multiples pregnancy: It you are having twins or higher level multiples, you are considered a high risk pregnancy. Complications during pregnancy: Problems with the uterus, cervix, or placenta can place your pregnancy at risk. Once it has been established that you are at high risk, you will typically need to be followed by a team of specialists to manage your condition. Each high-risk pregnancy may not require each part of this care team; it depends on the specific situation. You may still keep your regular appointments with your obstetrician, but you will likely have to visit the perinatologist several times and get several imaging and lab tests during your pregnancy.
Your doctors will want to keep a close eye on you and your baby to make sure things are developing as normally as possible.


Amniocentesis: In this test, the doctor will sample the amniotic fluid - usually around 15 weeks - so that the fluid can be examined. Chorionic villus sampling (CVS): Sometimes, the doctor will take some cells from the placenta itself between weeks 10 and 12. Cordocentesis: This test is also called percutaneous umbilical blood sampling where a sample of blood is removed from the umbilical cord. Biophysical profile: This test uses both fetal ultrasound and fetal heart rate monitoring to check on the baby's status.
Cervical length measurement: Using an ultrasound, your doctor may measure the length of your cervix if there is a concern about preterm labor. Lab tests: You may need a number of lab tests - for example, monitoring your blood sugar levels or measuring your blood count levels - depending on your health condition. Healthy diet: You should eat a healthy diet with more folic acid, iron, calcium, and other nutrients. Weight gain: Gaining the appropriate amount of weight during your pregnancy can help outcomes for you and your baby. Lower stress levels: While a high risk pregnancy is by nature somewhat more stressful than a low-risk pregnancy, you have to try to lower your anxiety levels for the health of your baby. You should work with your care team before you get pregnant again to optimize your future pregnancies. If you receive a high risk diagnosis, this does not necessarily mean you will lose your baby or the baby will be born with health problems. What a high risk pregnancy diagnosis does mean is that it's even more important that you adhere to the advice of your OB provider and stick to a schedule of regular obstetric exams throughout your entire pregnancy. If you understand the reasons for a high-risk pregnancy and what to expect, you can better take care of yourself and your baby.
Too much amniotic fluid, or too little fluid, or Rh compatibility issues can also increase the risks of a pregnancy.
Depending on your health situation, you may still have to follow up with your medical specialists like your kidney doctor if you have kidney disease or your cardiologist if you have a heart problem.


If you have diabetes or other condition that may affect your diet, you should check with your doctor; you may need some help from a nutritionist. Talk to your doctor about stress-relieving methods including mediation, yoga, calming imagery that you can use to lower your stress.
Depending on your condition, you will probably be discouraged from a home birth because of the potential danger to you and the baby.
If you had certain pregnancy-caused issues like placenta previa, you may not be high risk during your next pregnancy if you don't have the same issue.
Through this program most of our high-risk pregnancy patients are able to deliver their babies safely at our Birthplace.
Again, you will have the opportunity to discuss this with your health care team; in most cases, the plans for your baby's birth will be established earlier in your pregnancy. If you have a medical condition like heart disease or diabetes, you will always be high risk.
Your doctor will check you closely during subsequent pregnancies to make the determination of high risk. Patients who require more advanced care can be transitioned seamlessly to Massachusetts General Hospital as needed. High blood pressure or diabetes (gestational diabetes) that may occur in pregnancy are additional challenges.
Your doctor should know about any nutritional supplements that you are taking or that you are thinking about taking during your pregnancy; some therapies may not be helpful and may actually be harmful during pregnancy.



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