Spotlight on Health – Maternal Fetal Medicine



when you're faced with an at-risk pregnancy is important to have a structured plan and know what is coming next the reason you enter neonatology I think is because you get to deal with very sick babies but what you do from the beginning is to offer help we have this team of doctors this team of nurses and then all the other things that go up to make up high quality care we have that here even though pregnancy and early preterm labor is not the best way to handle things in preemie babies isn't the way you want things it's not the worst thing in the world and they end up being okay kxly-four HD presents spotlight on health comprehensive care for at-risk moms and newborns brought to you by Providence healthcare for expectant mothers the prospect of having a baby brings excitement and anticipation while most pregnancies proceed smoothly occasionally concerns arise either for the health of the mother or the development of the baby luckily for women in our region Providence Sacred Heart Medical Center and Sacred Heart Children's Hospital offer moms-to-be and their newborns a wide spectrum of highly specialized diagnostic and therapeutic procedures along with the inland northwest most modern and state-of-the-art maternity center and neonatal intensive care unit everything on one site and in one location hello in a given year you can expect more than 2,500 mothers to be to give birth right here at Providence Sacred Heart Medical Center what you can also expect is that a certain percentage of those women for whatever reason will develop some sort of problem that may affect their fetus their pregnancy or possibly their newborn offering a reassuring presence the doctors nurses surgeons and subspecialists who work here bring a team approach in providing expert care from conception to delivery and beyond there's really not a whole lot routine about pregnancy and you know even though you hear about perfectly pregnant outcomes all the time this is what women hear about from their friend their relatives everyone talks about good pregnancies no one often talks about the complications of pregnancy for douglas barber who just recently joined the providence maternal fetal medicine team at Sacred Heart his is a position that requires the overseeing of a multitude of pregnancy issues a maternal fetal medicine physician provides care for any at-risk pregnancy so anything outside of the normal for a woman in pregnancy is when a perinatologist or maternal fetal medicine doctor gets involved realizing a problem exists and then knowing the steps to take in regards to a team approach with other specialists is critical to handling these problem pregnancies usually what will happen is a diagnosis has been made to have a birth defect a woman would come into my office we go ahead we do a full ultrasound evaluation in our office and I speak directly with the patient about the findings how this birth defect occurred and usually the outcomes related to those type of babies depending on the birth defects say for instance if it was a cardiac defect I take it one step further because I have so many resources here and would have that patient then go on to meet with some of our specialists in pediatric cardiology so the patient would then go from my office for a full fetal echo evaluation and a consult with the pediatric cardiologist what fetal echocardiography is is evaluating the heart of the fetus and looking for heart-felt malformations and the fetus and the reason it's important is because there are some heart malformations that are lethal if not taken care of immediately after birth so if we find that type of a heart abnormality then we can prepare the family to be able to be informed before the baby is delivered and then prepare the NICU Nadel intensive care unit to be ready for this baby and prepare the surgical team to be ready for this baby because oftentimes these babies will need heart surgery in the first week of life fetal echocardiography can actually be done fairly compared comprehensively and with a lot of confidence by about 18 to 20 weeks gestation and usually the earlier we do it the better off we are combining the benefits of a number of sub specialists is the fact that dr. barber has the resources of the region's only hospital dedicated especially to children I think we are really in a great situation to have a Children's Hospital available care for complex defects and problems is very very specialized and I think people don't realize what a high level of care they receive when they come to this institution here that coordination of care you just can't get that outside of a setting of having Children's Hospital I have these specialists right here I can call them they're right here the patient gets to see them right at this institution and we can coordinate their care of all together for some women problems with their pregnancies can mean extended bed rest or in some cases a prolonged stay here in Sacred Hearts antepartum unit I've been here since September 30th weeks pregnancy was pretty normal and then that Friday I started having some leaking so I called my doctor and she said come down here and they confirmed that I had ruptured so they admitted me and this is where I stay usually a woman would be admitted to the antepartum unit after I have already evaluated her for a high-risk obstetrics rupture of membranes in pregnancy a woman then has to be monitored for preterm labor and infection in an inpatient unit this is where they would be admitted to the antepartum unit the patient would have a long-term stay with us and I will usually coordinate her care with a team of hospitals physicians the OB hospital is here at Sacred Heart there are five of us so we cover every hour of the day every week of the year there is always one of the OB Hospital is here at the hospital all of us OB hospitalists have been in private practice before so we've seen a gamut of obstetric emergencies Sacred Heart has a wonderful antepartum unit it's new it's beautiful it's very accommodating to people that have to be here long term we oftentimes have patients that are here for one month two months or longer so we try to take the entire patient into perspective keeping your head on straight it's that approach and a specific plan that keeps moms like Rachel focused on the objective you know as hard as it is to be on bedrest it helps me get by day by day just knowing that every day is so important for his development and that when he gets here even though it's early and not the way I planned I know he's gonna be in good hands and that he's gonna end up being fine because of everything that they're they're able to do now so for the patient faced with an at-risk pregnancy you know it's a very stressful time in their lives continuity and continuum of care provides reassurance to the patient they do not have to wonder about what the next step is in their pregnancy or the treatment of their baby we provide that all the way through their pregnancy to the delivery to whatever services are needed after the delivery so most important is that consistent reassurance and delivery on a plan even though pregnancy and early preterm labor and it's not the best way to handle things and preemie babies isn't the way you want things it's not the worst thing in the world and they end up they end up being okay the maternal-fetal program offering complete care for mothers and their babies when we come back we have this team of doctors this team of nurses and then all the other things that go up to make up high quality care we have that here

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