Women & Infants creates fully integrated center for high-risk pregnancy

Every pregnancy deserves special treatment. But when a woman with a normal pregnancy has a complication or a woman with a medical issue becomes pregnant, she needs highly specialized care.

With this in mind, Women & Infants Hospital of Rhode Island has created New England's only fully integrated center for the care of women with high-risk pregnancies and their developing fetuses. A collaboration of the previously separate divisions of Maternal-Fetal Medicine and Obstetric and Consultative Medicine at Women & Infants Hospital and The Warren Alpert Medical School of Brown University, the Integrated Program for High-Risk Pregnancy brings together the expertise of a wide range of clinical specialists with extensive experience in the care of high-risk pregnancies to help ensure the best possible outcomes for mothers and babies.

"This unique constellation of services offers unparalleled assurance that patients and their doctors can receive the state-of-the-art, interdisciplinary guidance that these special women and these tiniest patients so deserve," said Raymond O. Powrie, MD, co-director of the Integrated Program for High-Risk Pregnancy, interim chair of the Department of Medicine, and senior vice president of Quality and Clinical Effectiveness at Women & Infants Hospital.

The program works collaboratively with community obstetricians, medical providers, and nurse midwives to address medical, obstetric, fetal and genetic issues prior to, during and after pregnancy.

Katharine D. Wenstrom, MA, MD, co-director of the Program and director of the Division of Maternal-Fetal Medicine, said, "Our goal is to work with community-based obstetric providers to offer the highest level of care. The integration of multiple high-risk pregnancy specialists in one program means that the best minds are working together for the best outcomes."

The team of providers includes specialists in maternal-fetal medicine, obstetric internal medicine, internal medicine, obstetric anesthesiology, cardiology, pulmonology, hematology, gastroenterology, rheumatology, endocrinology, infectious disease, clinical genetics, laboratory medicine, radiology, nursing, pharmacy, and respiratory therapy.

Women & Infants' Integrated Program for High-Risk Pregnancy also includes a number of other services.

For outpatients, the Prenatal Diagnosis Center offers sophisticated diagnostic evaluation for pregnant women and their fetuses. Diagnostic services, including ultrasound exams, genetic amniocentesis, and chorionic villus sampling, are provided by the Division of Maternal-Fetal Medicine, and consultations can be arranged through a patient's private physician as needed.

The Division of Maternal-Fetal Medicine faculty are also an integral part of the multidisciplinary perinatology team at Women & Infants and the Fetal Treatment Program, a joint venture of Women & Infants and Hasbro Children's/Rhode Island hospital, and Tufts Medical Center in Boston. The Fetal Treatment Program provides state-of-the-art treatment for several life threatening fetal conditions.

Genetic testing and counseling are also available as both pre-conception and high-risk resources. Patients may be referred for genetic services if they are older, have a family or personal history of a genetic disease, or after other routine tests indicate a potential problem. Most genetic test results are reassuring, but if a problem with a pregnancy is detected, counseling is offered to explain the problem and provide prenatal therapy whenever possible. The team includes genetic counselors and two specialists who are fellowship trained in both genetics and maternal-fetal medicine, a level of expertise offered at few other programs in the nation.

The Diabetes in Pregnancy Program provides a wide variety of services for pregnant women with type 1 or type 2 diabetes as well as those who develop diabetes during pregnancy (gestational diabetes). Our staff has extensive experience in diabetes as it relates to pregnancy and provides a variety of services including pre-pregnancy counseling, diabetes education, and individualized management including insulin therapy.

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