High Risk Pregnancy

with Richard Pircon, M.D., Obstetrician/Gynecologist, Columbia St. Mary’s

Posted: Jan. 1, 2004

In a perfect world, nine months from the time a woman becomes pregnant, she delivers the most beautiful seven-to-10-pound human being she and her family have ever seen. They admire the long fingers and rosebud mouth, stroke downy hair and argue over whether the newest family member favors Mom’s side or Dad’s.

The parents-to-be Dr. Richard Pircon sees are those for whom pre-existing conditions or the discovery of unexpected complications may require specialized care in the quest to achieve that perfect outcome. Most come from the metro Milwaukee area, but the Prenatal Assessment Center at St. Mary’s Hospital draws mothers from as far away as Beloit, Sheboygan and Kenosha.

Richard Pircon, M.D., Obstetrician/Gynecologist, Columbia St. Mary's "The maternal death rate as recently as 80 years ago was greater than 1 in 200 live births. Now it's less than 1 in 10,000 live births."

Dr. Pircon, director of the Prenatal Assessment Center, is an obstetrician/gynecologist who specializes in high-risk pregnancy care.

“My practice is referral-only,” he explained. “A patient cannot make an appointment here unless they have a referral. We offer tools to doctors to help assess a baby and a mom. We then make recommendations for appropriate therapies.”

“Our goal when a doctor has identified complicating factors is to further define them and institute the appropriate therapy so patients can have healthy babies. We can’t guarantee it,” he said, “but we can do things to help parents reach that goal.”

Women are referred to the Center for any number of reasons. An extreme example is a multiple birth. He’s helped care for two sets of quintuplets, but most of the complications he treats are more common.

“Sometimes it’s a pregnancy-related complication – pre-eclampsia or gestational diabetes,” he said. “Sometimes it’s a pre-existing medical condition that can complicate a pregnancy, such as lupus or diabetes. If a mom has a seizure disorder, it’s not uncommon that we’ll see her.”

What to expect
When a mother-to-be is referred to the Center, her medical history is taken by a nurse or a physician, who also makes sure that Center staff is aware of all parental concerns. From that history, the health care team determines which medical tests are the most appropriate in assessing the situation.

“One of the most common things would be an ultrasound examination for the baby,” Dr. Pircon said. “Amniocentesis may also be done, for multiple reasons.”

Those reasons include determining whether their lungs are functioning well enough to survive outside the womb, whether the baby has anemia that would require an in-utero transfusion, or whether there are genetic factors that might need to be taken into consideration.

Maternal tests include physical examinations, blood pressure readings, and blood tests that may explain abnormal findings which have been discovered.

Specialized care
One of the most important things that goes on at the Center is helping patients to understand what’s happening in their particular situations, and teaching them how best to help ensure the most positive outcome for themselves and their children-to-be.

Toward that end, the Center has multiple specialized health-care providers in-house or on call.

“Our nurses are specialized in high-risk pregnancies,” Dr. Pircon said, “and in advising patients about what they need to know about their diagnoses, be they medical complications or pregnancy complications.”

For instance, he said, a totally healthy mother can end up with toxemia, and she needs to know about the condition. Staff helps inform patients on-site, and can send them home with reading material. The Center has literature on pre-eclampsia, diabetes, hypertension and pre-term labor. In addition, there’s a neonatologist (a pediatrician who specializes in the care of premature babies and sick newborns) to counsel patients and alleviate fears.

Other specialists can be called in as needed.

“We might consult a medical specialist if a maternal medical problem is identified,” said Dr. Pircon. “If there’s a mother with kidney problems, we can have an adult nephrologist talk to the patient and further evaluate her condition, and the same goes for a pulmonologist, cardiologist or other specialist.”

The bottom line, Dr. Pircon said, is to minimize anxiety and ensure maximum health for mother and child, something that’s literally 50 to 100 times more achievable than it was three generations ago.

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