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Pregnancy can be a stressful and emotionally challenging time for many families. We have the expertise and resources to help, whether you have an underlying medical condition, problems with poor pregnancy outcomes, or a suspected or known problem with your baby (fetus).
Our high-risk pregnancy-related services include preconception planning, pregnancy management (primary or consultative) and delivery.
You may be a candidate for our services if you:
Cleveland Clinic's unique team-based approach gives women who seek care for pregnancy-related complications many advantages. Patients will have immediate access to experts in the care of newborns, including neonatologists and pediatric surgeons and subspecialists.
For example, if a baby has been found to have a heart defect, our team consists of pediatric cardiologists and cardiac surgeons, who will help further counsel the family and prepare them for the child’s care after birth.
Our team in maternal-fetal medicine consists of:
If patients have a preexisting condition or develop a medical complication during pregnancy, they will have the resources of one America’s top hospitals immediately available them.
Cleveland Clinic offers options for women who are interested in determining the risk for chromosome abnormalities and certain birth defects in their baby during a pregnancy. These tests allow patients the opportunity early in pregnancy to find out if their baby has one of these conditions.
While the risk for having a baby with a chromosome abnormality increases with a women’s age at the time of delivery, the majority of these babies are born to younger women. Thus, screening is an option for everyone. Having this testing performed is optional and should only be done after a thorough discussion of available tests. In some instances, your provider may refer you for genetic counseling to see which, if any, test is best for you.
Download the brochure
The sequential screen combines ultrasound and blood tests to determine the risk for chromosome abnormalities, including Down syndrome (Trisomy 21) and Trisomy 18. It also determines the risk for a group of birth defects known as open neural tube defects (ONTD’s), which include spina bifida. Ultrasound examination is performed in the first trimester between 11 and 13 6/7 – weeks’ gestational age and involves measuring the nuchal translucency. The nuchal translucency is a fluid filled space behind the neck, which is typically increased in size in fetuses with Down syndrome, other chromosome abnormalities, and birth defects. Blood tests, which measure the levels of certain hormones in the mother, are drawn at the time of the nuchal translucency measurement and later in the second trimester between 15 and 21 weeks’ gestational age.
This is a new test that is now available for women with risk factors for having a baby with chromosomal abnormalities. NIPT evaluates DNA from the baby, which is found in the mother’s blood, to determine risks for chromosome abnormalities such as Down syndrome, Trisomy 18, and Trisomy 13. Again, this is a blood test for the mother and poses no risk to the pregnancy. NIPT can be performed any time after 10 weeks’ gestational age. At the present time, NIPT is not recommended for routine screening or in patients with multiple gestations (twins, triplets, etc.)
Prenatal, or intrauterine, diagnosis is a process that can identify some birth defects and genetic disorders in your child before birth.
Cleveland Clinic's Center for Personalized Genetic Healthcare uses several different testing and evaluation techniques to perform prenatal diagnosis. Depending on your age, family health history and other risk factors, you may undergo a blood draw, an ultrasound examination of your pregnancy, or more invasive forms of testing such as chorionic villus sampling or amniocentesis.
Center for Personalized Genetic Healthcare Desk NE50 Cleveland Clinic 9500 Euclid Avenue Cleveland, OH 44195
Phone: 216.445.5686 or 800.998.4785 (toll-free) Fax: 216.445.6935
More than 300 disorders can be detected in unborn infants. Some of the birth defects and genetic disorders for which Medical Genetics provides testing include:
These disorders can have different forms of inheritance, and a genetic counselor may be able to give you a better idea of the chance that your baby will be affected. The first step in the process is to obtain a detailed family history to determine the conditions for which your baby is at risk. Then, information from blood testing and/or ultrasound can be used to provide an assessment of risk, and you may have to make a decision regarding a more invasive procedure for diagnosis. For example, a baby's sex can be determined before birth with ultrasound. This is important in assessing the risk for certain diseases such as muscular dystrophy or hemophilia, which are typically passed from unaffected mothers (carriers) to their sons. For a mother who is known to be a carrier for one of these conditions, there is a 50 percent chance that male offspring will be affected by the disorder.
Not all disorders present at birth can be detected through the tests that are currently available, and some babies who have normal test results are born with birth defects or genetic disorders. A normal ultrasound, maternal blood test, amniocentesis or chorionic villus sample does not guarantee that a baby will not have a problem, but normal test results usually indicate that chances for having a baby without genetic disorders are high.
The decision to undergo prenatal testing and diagnosis is a personal one. Your doctor can make recommendations, but you must make the decision. Prenatal testing can lead to early detection of certain birth defects or other problems that may require special care. This testing offers parents the opportunity to learn about these conditions and make decisions and plans long before the baby is delivered. Prenatal testing helps parents and doctors work together for the best management of a pregnancy known to be at risk.
Your obstetrician may recommend prenatal testing and diagnosis if you have a higher-than-normal risk of giving birth to a baby with a birth defect or genetic disorder. Women who meet any of the follow criteria have an increased risk and should consider prenatal testing:
The prenatal diagnosis process begins with a meeting with one of our genetic counselors. Your genetic counselor is the person who will guide you through the entire process, explain the various tests available and the risks associated with each, interpret the results and discuss your options at each step. At your first meeting, the counselor will ask you about your family's health history, as well as your personal medical history and that of the baby's father. You should feel comfortable in raising any questions or concerns that you might have with your counselor.
Cleveland Clinic maternal-fetal medicine specialists or perinatologists primarily provide consultative services to obstetricians throughout Northeast Ohio. We work in close collaboration with them to manage a wide variety of problems that can arise during pregnancy.
Understanding the importance of the bond between patients and their physicians, our perinatal team strives to keep in close contact with the referring physician by communicating regularly over the course of the pregnancy. In certain situations, depending on the severity of either the mother's or the fetus's condition, the patient’s care can be transferred to our practice at Cleveland Clinic.
For patients with significant medical problems and/or history of serious pregnancy complications, the decision to carry a pregnancy must not be taken lightly. Careful planning and taking appropriate measures prior to pregnancy can help prevent or significantly decrease the risk for adverse outcomes in future pregnancies.
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Location(s): Strongsville Family Health Center, Independence Family Health Center, Hillcrest Hospital, Lakewood Medical Building, Wooster Family Health Center, Beachwood Family Health Center
Department: Obstetrics and Gynecology
Diabetes, Gestational, Hypertension In Pregnancy, Labor and Delivery, Medical and Obstetrical Complications of Pregnancy, Medical Disorders In Pregnancy, Medical Problems in Pregnancy, Menstrual Disorders
Treats: Adults Only
Saint Louis University School of Medicine
Location(s): Hillcrest Hospital
High Risk Pregnancy Care, OB/GYN Ultrasound, Section of Maternal-Fetal Medicine
University of Cincinnati College of Medicine
Location(s): Hillcrest Hospital, Strongsville Family Health Center
High Risk Pregnancy Care, Section of Maternal-Fetal Medicine
Case Western Reserve University School of Medicine
Location(s): Westlake Medical Campus Building A
Birth Defects, Cardio-pulmonary Problems in Pregnancy, Hypertension In Pregnancy, Medical Disorders In Pregnancy, Multiple Pregnancy, Pregnancy Complications, Recurrent Pregnancy Loss
University of Natal-Faculty of Medicine
Location(s): Beachwood Family Health Center
High Risk Pregnancy Care, Fetal Echocardiogram, Transvaginal Ultrasonography, Ultrasonography, Section of Maternal-Fetal Medicine
Boston University School of Medicine
( † Disclaimer: This search is powered by PubMed, a service of the U.S. National Library of Medicine. PubMed is a third-party website with no affiliation with Cleveland Clinic.)
Cleveland Clinic has established the Fetal Care Center to help mothers achieve the best possible outcome when a pregnancy is complicated by a maternal, fetal or obstetric disorder. Staff view the fetus as a patient, while respecting the health and well-being of the mother, which always remains the primary objective. We serve Cleveland Clinic obstetric patients from Hillcrest Hospital, Marymount Hospital, Fairview Hospital and our Family Health and Surgery Centers, as well as mothers referred by obstetric providers outside the healthcare system. When fetal anomalies (birth defects) are detected, we offer interdisciplinary diagnosis, counseling and treatment options at our children’s hospital.
Download the Fetal Care Center physician guide
Our program affords tremendous flexibility for the referring physician and expectant mother. For more straightforward problems, our center can provide definitive diagnosis and, in some instances, in utero intervention. The patient can then be referred back to her primary obstetrician for prenatal follow-up and delivery. For more complex problems, we offer longitudinal, coordinated care provided by a core team of maternal-fetal medicine specialists, neonatologists, pediatric surgeons, pediatric radiologists, pediatric cardiologists and a Fetal Care Nurse Coordinator. If needed, our program streamlines access to virtually any maternal or pediatric subspecialist who may be required, such as pediatric anesthesiologists and pediatric congenital heart surgeons. Similarly, when there is a maternal health concern, we work closely with specialists throughout our healthcare system to optimize outcomes for both the mother and her fetus.
Cleveland Clinic Children’s has opened a Special Delivery Unit on our main campus for patients whose pregnancies are complicated by serious maternal or fetal conditions. The unit adjoins a new Pediatric Cardiac Catheterization Laboratory and is in close proximity to a state-of-the-art pediatric surgical suite and Level III Neonatal Intensive Care Unit.
We offer convenience and efficiency that is unmatched in Northeast Ohio by providing services in a variety of settings and at numerous locations throughout the region. Our goal is to get patients in to be seen in a timely manner, while keeping them close to home.
Ashtabula County Medical Center 2420 Lake Ave. Ashtabula, Ohio 44004 Phone: 440.997.2262
Avon - Richard E. Jacobs Health Center 33100 Cleveland Clinic Blvd. Avon, Ohio 44011 Phone: 440.695.4000 Toll-free: 800.599.7771
Beachwood Family Health & Surgery Center 26900 Cedar Rd., Suite 220 South Beachwood, Ohio 44122 Phone: 216.836.3100
Elyria Family Health and Surgery Center 303 Chestnut Commons Dr. Elyria, Ohio 44035 Phone: 440.366.9444 Phone: 440.204.7400
Fairview Medical Office Building 18099 Lorain Ave. Cleveland, Ohio 44111 Phone: 216.476.7912
Hillcrest Medical Building Atrium 6770 Mayfield Rd. Mayfield Heights, Ohio 44124 Phone: 440.312.2229
Independence Family Health Center 5001 Rockside Rd. Crown Centre II Independence, Ohio 44131 Phone: 216.986.4130
Lakewood Medical Building 1450 Belle Ave. Lakewood, Ohio 44107 Phone: 216.529.2913
Medina Hospital 1000 E. Washington St. Medina, Ohio 44256 Phone: 330.725.5282
Mentor Medical Office Building 7060 Wayside Dr. Mentor, Ohio 44060 Phone: 440.357.2770
Stephanie Tubbs Jones Health Center 13944 Euclid Ave. East Cleveland, Ohio 44112 Phone: 216.767.4242
Strongsville Family Health & Surgery Center 16761 South Park Center Strongsville, Ohio 44136 Phone: 440.878.2500 Toll-free: 800.239.1098
Twinsburg Family Health & Surgery Center 8701 Darrow Rd. Twinsburg, Ohio 44087 330.888.4000
Westlake Medical Campus Building A 850 Columbia Rd. Westlake, Ohio 44145 Phone: 440.835.3883
Wooster Family Health Center 1740 Cleveland Rd. Wooster, Ohio 44691 Phone: 330.287.4500 Toll-free: 800.451.9870
Screening for Chromosome Abnormalities
Cleveland Clinic offers new options for women who want to determine a baby’s risk for chromosome abnormalities and other birth defects early in pregnancy. We invite you to view the video to the right for more information on screening options.
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