High-risk pregnancy

A pregnancy is considered high risk when the mother or fetus's life is threatened because of a situational circumstance, pregestational condition or conditions occurring because of the pregnancy. Some pregnancies are classified as high risk from the beginning. For others, a condition develops during the gestational period that makes the pregnancy high risk.

Pregnancies may require help for complex issues arising from disorders and conditions such as:

• Birth abnormalities
• Ectopic pregnancies (a fertilized egg implants and grows outside the main cavity of the uterus)
• Endometriosis (tissue that normally lines the uterus grows outside the uterus)
• High blood pressure or preeclampsia
• Hormone disorders
• Ovarian cysts (solid or fluid-filled sacs or pockets in or on the surface of an ovary)
• Ovulation disorders
• Pelvic inflammatory disease (infection of the reproductive organs)
• Polycystic ovarian syndrome (a hormonal disorder causing enlarged ovaries with small cysts)
• Previous surgeries

Patients who fall into one of the following categories may have a higher risk of complications during pregnancy:

• Patients who are 35 years old or older
• Patients with very high or very low levels of body fat/obesity
• Patients who exercise excessively
• Patients with chronic diseases, such as diabetes, arthritis and asthma
• Patients who smoke or drink
• Patients who consume caffeine
• Patients exposed to occupational hazards, such as high temperatures, toxic substances, radiation and high stress
• Patients who have experienced reproductive system disorders
• Patients taking certain medications
  

Perinatologists, or maternal-fetal medicine specialists, are physicians experienced in treating a range of maternal-fetal conditions and issues related to complications unique to pregnancy. They partner with your obstetrician (OB) to monitor the health of both mother and baby throughout your pregnancy, focusing on:

• Critical care obstetrics
• Genetic counseling, including ultrasound evaluation and amniocentesis (testing of amniotic fluid)
• Maternal diabetes patient management
• Prenatal screenings and diagnosis
• Testing and treatment for placental and umbilical cord issues
• State-of-the-art imaging services

If a child is born in a hospital that does not have a NICU and needs neonatal intensive care, our dedicated neonatal transport team, in conjunction with AMR and Med-Trans, can safely transfer the baby to any of our four high-level NICUs from any hospital within an approximate 350-mile radius. We can also transport mothers so they can be cared for near their babies. When a baby's condition improves and no longer requires specialized care, we can safely transfer them to a location that may be closer to home.

For answers to your questions about our transport services, please call us at (84)-GoBabyGo or (844) 622-2946.

Whether you're pregnant with twins (or more!) or need guidance on navigating a complex pregnancy, the MFM specialists at HCA Midwest Health are with you every step of the way.

We have an experienced team of obstetricians, perinatologists, maternal-fetal medicine specialists, neonatologists and pediatric specialists to provide the extra attention and care needed for a mother giving birth to multiples. To help these patients, we also tailor the following services to meet their unique needs:

• Birthing classes designed for women expecting multiples
• Board-certified lactation consultants (specialists who provide breastfeeding support for mothers with more than one baby) and a free breastfeeding support group
• Maternity navigator services (labor and delivery nurses who work one-on-one with patients)

Part of Overland Park Regional Medical Center's Fetal Health Center, the Antepartum Unit offers inpatient care for women who need to be hospitalized before giving birth, also known as being on "bed rest." We provide highly specialized care and monitoring for pregnant women with a variety of medical conditions, including:

• An increased risk for preterm birth
• Diabetes, including gestational diabetes
• High blood pressure or cardiac complications
• Multiple pregnancies
• Placenta abnormalities, such as placenta previa or placenta accreta

Babies born prematurely and/or with serious health conditions can receive specialized neonatal intensive care in our high-level NICUs. HCA Midwest Health offers four expert neonatal intensive care units including a Level III NICU at Overland Park Regional Medical Center that includes a Small Baby Unit for babies born under 29 weeks.

Overland Park Regional Medical Center is also home to a dedicated Placenta Accreta Center of Excellence. In a pregnancy complicated by placenta accreta disorders, blood vessels and other parts of the placenta invade the uterus' wall and become inseparable. It typically causes no issues during pregnancy but can cause complications at the time of delivery.

Our maternal-fetal specialists routinely care for patients diagnosed with placenta accreta disorders. We offer a cohesive, multidisciplinary approach to care for women and their families, which delivers the best possible maternal and neonatal outcomes. We are also prepared, equipped and highly coordinated to mobilize resources within minutes should emergencies arise.

Fetal surgery covers a wide range of interventions—including minimally invasive robot-assisted techniques—to treat issues affecting unborn children and complications arising during pregnancy. Conditions requiring fetal surgery include:

• Bladder obstruction
• Fluid in the lungs
• Spina bifida
• Tumors causing heart failure for the baby
• Twin-to-twin transfusion syndrome (TTTS)

What is twin-to-twin transfusion (TTTS)?

TTTS is a condition where twins sharing a single placenta (monochorionic) are prone to complications related to how well they share the placenta. TTTS arises in 10% of monochorionic twin pregnancies and occurs when the twins are transfusing their blood from one twin (donor) to the other (recipient). As a result, one twin has little to no fluid around it (oligohydramnios), and the other twin has too much fluid around it (polyhydramnios).

In some cases, TTTS can be observed with frequent checks. However, when it progresses to more advanced stages and either of the twins shows signs of heart failure, TTTS can be fatal for both. To treat TTTS, we offer minimally invasive procedures that can be performed with little risk to the mom and markedly improved survival rates for the twins.

We know receiving information about a baby's medical condition can be an emotional experience. That's why we offer a dedicated, highly educated and compassionate support team to help guide families during the process. Our clinical nurse navigators and genetic counselors are here to answer all questions and address any concerns expecting parents may have.