Reviewed by: Celeste Sheppard, MD, FACOG
Written by: Lauryn Gerard
Many moms-to-be find themselves under an extreme amount of pressure to carry out a “perfect pregnancy,” which is presumed to result in a flawless delivery. Unrealistic pressures from society, social media, and even friends and family can create expectations about pregnancy that cause women to believe any hiccups experienced along the way are somehow associated with personal failure. A woman’s body is under immense strain during pregnancy (cut yourself some slack, you are growing another human after all), and while everyone wants both mom and baby to be healthy and have the best experience possible, unexpected things (things out of your control, mom) can sometimes arise.
Unanticipated complications during your pregnancy, labor, or birth are not necessarily signs that you or your baby will be unable to return home happy, healthy, and ready to tackle irregular sleep schedules and loads of tummy time together. You may, however, need ongoing supportive care from a maternal-fetal medicine specialist to ensure the best possible health outcomes for both you and your baby. Maternal-fetal medicine specialists can help you make informed decisions about your own health as well as the health of your baby so that you can find solace in a time of uncertainty.
Maternal-fetal medicine specialists, also called perinatologists, are obstetrician-gynecologists who have completed an additional three years of education and training to become experts in diagnosing, monitoring and treating women with complex and high-risk pregnancies and their babies. These specialists provide expertise in prenatal care and diagnosis, advanced obstetrical ultrasound, fetal anomalies and genetic disorders, multifetal gestation (e.g., twins, triplets), diabetes management, genetic counseling, preterm labor, preeclampsia, and the management of pre-existing maternal conditions, including heart disease, hypertension, autoimmune disorders, mental health disorders, and blood disorders, to give mothers and their babies the best quality of life. Maternal-fetal medicine specialists are committed to keeping both mom and baby healthy before, during, and after birth.
Celeste Sheppard, MD, FACOG, is a fellowship-trained maternal-fetal medicine specialist in both Women’s Health, a clinical partnership between UT Health Austin and Ascension Seton, and the Comprehensive Fetal Care Center, a clinical partnership between UT Health Austin and Dell Children’s Medical Center. Dr. Sheppard and her team are passionate about providing a high value and extremely high quality of care for patients. The Maternal-Fetal Medicine care team offers specialized complex care to women who have, or have previously had, complications during pregnancy, which includes both pregnant women and those who are planning to conceive.
“Women come to us for several different reasons,” explains Dr. Sheppard. “Most pregnant women undergo several ultrasound examinations to evaluate fetal health and some physicians choose to send their patients directly to us for that care. We do a lot of routine ultrasound, screenings, and follow-up care. This is something we enjoy as we love seeing healthy moms and babies and it helps us to continue to cultivate our expertise. Then, when we do come across something that may be unusual or a sign of a developing problem, we are able to follow up with expert recommendations and treatment options.”
One of the most common reasons pregnant women are referred to maternal-fetal medicine specialists is due to an abnormal finding on a routine pregnancy screening or test that evaluates fetal growth and development or assesses for other abnormalities that could be present. A follow-up ultrasound is performed by a maternal-fetal medicine sonographer who is extremely advanced in their field and will be able to observe the baby in detail using advanced practice techniques. These specialized sonography exams aren’t available everywhere and are something that Dr. Sheppard and her team take pride in having the ability to offer to their patients.
“To perform ultrasound at the MFM, or maternal-fetal medicine, level, which is a more specialized and elite level, you have to be experienced and really good at what you do,” explains Dr. Sheppard. “I am very proud that we have cultivated a team of sonographers who have worked alongside us for a number of years now. They all have expert certifications and really are an integral part of the MFM team. Our sonographers are often the first point of contact with the patient after checking in at the front desk, and they typically perform an initial patient scan, after which we follow up and discuss next steps with that patient.”
“We also make sure to prioritize patients who have a diagnosis of a fetal problem to get them in to see us quickly because we don’t want them waiting for an extended period of time as that often leads to excess worrying. Those patients get a very detailed evaluation, and the care team spends a lot of time speaking with them about next steps,” says Dr. Sheppard.
Other potential reasons a maternal-fetal medicine specialist may become a member of your care team during pregnancy could be the result of an obstetric condition that requires close monitoring, such as a multi-gestation pregnancy (twins, triplets, etc.), a history of a c-section birth, a history of pre-term birth, a history of multiple miscarriages, or a family history of a genetic condition that could be passed down to your baby. If you, yourself, have a medical condition, such as diabetes, high blood pressure, lupus, or other forms of chronic illness, a maternal-fetal medicine specialist can also help you manage your condition throughout your pregnancy to ensure both you and your baby are safe.
“When there are concerns that a maternal condition or illness may affect the health of the mother or the baby, we provide consultations, co-management, and surveillance services in collaboration with the patient’s general ob/gyn doctor and other medical providers,” says Dr. Sheppard.
If in the event you or your baby could have a more serious condition, the Maternal-Fetal Medicine Clinic also offers a full line of prenatal diagnostic procedures, including chorionic villus sampling, which involves taking a biopsy sample of the placenta to test for chromosomal abnormalities and other genetic problems, and amniocentesis, which is a procedure in which a sampling of amniotic fluid is taken to test for developmental abnormalities in the fetus. These are examples of invasive procedures that are performed by maternal-fetal medicine specialists to obtain definitive information about both fetal health and fetal genetic health.
“Part of our role is to identify fetuses who would benefit from a fetal intervention and that’s where our collaboration with the Comprehensive Fetal Care Center falls in,” explains Dr. Sheppard. “If we determine that a fetus has a problem and needs to be treated prenatally or in the immediate newborn period with surgery or some other type of treatment, our responsibility is to identify that baby and make sure that we get the mom integrated into a coordinated system for fetal care.”
The Comprehensive Fetal Care Center offers diagnosis, treatment, and management of complex and rare fetal conditions, including fetal heart anomalies, congenital diaphragmatic hernia, urinary tract abnormalities, twin-to-twin transfusion syndrome, and neural tube defects, such as spina bifida. The Comprehensive Fetal Care Center care team provides families with extensive support and education regarding their child’s condition, development, and post-delivery care. As the first and only fetal care center in Central Texas, the Comprehensive Fetal Care Center enables maternal-fetal medicine specialists and fetal care specialists to work together, offering wrap-around services for mothers and their babies.
While no one likes to admit it, pregnancy isn’t always perfect. In the United States alone, approximately 120,000 babies are born with a defect each year. An abnormal diagnosis can be both extremely upsetting and very stressful. But the health of you and your baby is important, and the care you receive should be nothing short of the best. UT Health Austin maternal-fetal medicine specialists are here to assist you and your family in navigating this process as well as provide you with education surrounding potential outcomes and connect you with the resources you need to ease your uncertainties and help you prepare for the future.