Services for Mother and Child

PERINATOLOGY
A maternal-fetal specialist/perinatologist is an obstetrician who has completed two or three years of additional training in Maternal-Fetal Medicine. Perinatologists are board-certified in Obstetrics and Gynecology as well as Perinatology and have expertise in dealing with all aspects of high-risk pregnancies. Our perinatologists are usually consulted to evaluate pregnant women with high-risk conditions or women who need specialized testing in their pregnancy. Perinatologists routinely perform detailed ultrasound examinations and prenatal diagnosis such as CVS, amniocentesis, and fetal blood sampling.

SONOGRAPHY
Our sonographers are certified by the American Registry for Diagnostic Medical Sonography and have specialized expertise in high-risk obstetrics. They perform ultrasound examinations in collaboration with our perinatologists. ROC is accredited by the American Institute of Ultrasound in Medicine and has received certification through the Society for Maternal-Fetal Medicine to perform nuchal translucency measurements. This measurement is used for first trimester screening for Down syndrome and Trisomy 18. Our staff includes ten diagnostic medical sonographers who are all registered in OB/GYN ultrasound. They have attained accreditation with the American Institute of Ultrasound in Medicine, as well as certification in Nuchal Translucency for first trimester screening.

ULTRASOUND
What is ultrasound? Ultrasound is like ordinary sound except it has a frequency (or pitch) higher than people can hear. Ultrasound is sent into the body from a scanning instrument (transducer) placed on your skin. The sound is reflected off structures inside your body and is analyzed by a computer to make an image of these structures on a monitor, which is similar to a television screen. The moving pictures can be recorded on film. Diagnostic ultrasound is commonly called sonography or ultrasonography.

Why do patients have a targeted obstetric ultrasound examination?
 The most common reason for having a targeted ultrasound examination is to help your doctor determine when your baby is due, to make sure your baby is growing appropriately, and to look for structural abnormalities. Your doctor may also want an ultrasound examination to determine the baby's position or to see if you are carrying more than one baby. With an ultrasound examination, the amount of fluid around your baby can also be seen.  Are there any special preparations needed for the ultrasound examination? In most cases, no special preparation is needed for the examination. In some cases, your doctor may recommend an endovaginal ultrasound study, which involves the use of a special transducer in your vagina, to improve visualization of your baby or your cervix.

Who will perform the examination? One of our Registered Diagnostic Medical Sonographers will perform your ultrasound. The images captured during the procedure will be reviewed and read by the doctor immediately following your ultrasound.

Will the ultrasound hurt? There is no pain from an ultrasound examination. Patients may feel some pressure from an endovaginal ultrasound examination in which a probe is inserted into the patient's vagina; the probe is the size of a tampon and is smaller than a speculum. The ultrasound examination does not affect your pregnancy. During the scanning procedure, a gel-like material is put on the patient's abdomen and a transducer is placed on the skin. The gel makes it possible for the ultrasound system to see through your skin into your body. The gel wipes off easily and does not usually stain clothing, but it is a good idea to wear clothes that are machine washable. Can I see my baby move? Your baby's heartbeat and movement of his or her body, arms and legs can be seen using ultrasound, depending on the age of the baby. Your baby can be seen moving during an ultrasound examination many weeks before you can feel movement.

Will I learn the sex of my baby? Sometimes it is possible to see the sex of the baby and sometimes it is not. If your baby is lying in an inconvenient position the baby's sex may not be determined.

Does an ultrasound examination guarantee a normal baby? No, an ultrasound examination does not guarantee a normal baby. The ability to detect fetal abnormalities depends on many things. For instance, the size and position of your baby may not allow certain abnormalities to be seen. Some types of abnormalities cannot be seen because they are too small or not visible by ultrasound.

What is Doppler ultrasound? Doppler ultrasound is a special form of ultrasound. This type of ultrasound is useful in evaluating blood flow to the pelvic organs and fetal vessels. The doctor or sonographer performing the scan can display this information in several ways. An audible sound may be used, or the blood flow may be shown as a graphic or color display. It is not painful. The decision to use Doppler ultrasound is often not made by the doctor until the time of the exam; for example, for further evaluation of the heart of the fetus. It is not considered harmful to the fetus. 

Is ultrasound safe?
 The AIUM has a Bioeffects Committee that meets regularly to consider safety issues and evaluate reports dealing with bioeffects and the safety of ultrasound. The AIUM has adopted the following official statement: "There are no known harmful effects associated with the medical use of sonography. Widespread clinical use of diagnostic ultrasound for many years has not revealed any harmful effects. Studies in humans have revealed no direct link between the use of diagnostic ultrasound and any adverse outcome. Although the possibility exists that biological effects may be identified in the future, current information indicates that the benefits to patients far outweigh the risks, if any.

Patient Support Services

Genetic Counseling
Genetic Counselors are board-certified in genetic counseling. Genetic counseling is an important part of the decision-making process for prenatal testing. Our Genetic Counselor evaluates the medical and family histories of patients to find out if there is an increased chance of birth defects or other problems. The counselor explains testing options, benefits and risks of testing and reasons why patients choose or decline to have testing. The genetic counselor provides follow-up for patients to discuss their individual test results.
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Diabetes Education
Diabetic Educators are certified by the National Certification Board for Diabetes Educators. They help patients deal with the challenge of diabetes before and during pregnancy and provide ongoing support.
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Prenatal Diagnostics
CVS and amniocentesis are diagnostic tests and enable the unborn baby's chromosomes to be studied to detect Down syndrome or other chromosomal abnormalities. The chromosomal analysis has greater than 99% accuracy. Other genetic testing can be performed by CVS or amniocentesis as indicated. CVS is performed between 10 and 12 weeks gestation. Amniocentesis is typically performed between 15 and 18 weeks gestation but can be performed later. Fetal blood sampling, or cordocentesis, is only used for a limited number of high risk situations such as the need for a fetal blood transfusion. All diagnostic tests have a small risk of complications.
Prenatal Screening Tests
Unlike a diagnostic test, a screening test does not give a definite result. However, it can indicate if there is an increased or decreased risk for a particular problem in the developing baby. Screening has the advantage that there is no risk to the pregnancy. All screening has the chance of false positives or false negatives.
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