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High Risk Pregnancies Require a Dedicated Team Methodology

Richard Pircon, M.D., Maternal-Fetal Medicine, Columbia St. Mary’s

Posted: Jan. 1, 2007

There has been a dedicated effort at Columbia St. Mary’s over the past decade to create an institution which provides mother and baby with the kind of medical attention necessary to create a healthy, positive pregnancy and birthing experience — especially if the pregnancy is deemed “high risk.” The Perinatal Assessment Center (PAC) and Level III Neonatal Intensive Care Unit (NICU), both located at Columbia St. Mary’s Milwaukee campus, are two of the core services which provide this high risk care.

Pregnancy can be categorized as high risk for many reasons relating to the mother, baby or both. If a woman conceives and is diagnosed with diabetes or hypertension, is taking certain medications, is over age 35 or has a family history of genetic disorders, her pregnancy is often considered high risk. Even in perfectly healthy women, early ultrasound tests may detect a possible birth defect or chromosome disorders, which would also place the pregnancy in the high risk group. At this point, the services offered in a perinatal assessment center become necessary.

We opened our PAC in 1994 as a way to monitor and treat women experiencing pregnancy complications. Because our center is located within St. Mary’s hospital, each patient not only has access to obstetric specialists, but to the teams of experts that work throughout the hospital, including the neonatal intensive care unit and labor and delivery areas, both right down the hall. The nurses in our center are also trained and dedicated solely to perinatal issues, working with mothers every day to assess, monitor and treat a variety of pregnancy complications.

Along with the expertise of our team, the center utilizes a full range of diagnostic services, including high-resolution 2-D ultrasound as well as the most recent version of GE’s 3-D/4-D ultrasound system, to assess and treat high risk moms and babies. With the 3-D/4-D ultrasound, families can view 3-D images of their baby moving in real time. Other services at the PAC include biophysical profiles, non-stress testing, amniocentesis, genetic screening and perinatal consultative services.

Once a baby is born, if complications exist, he or she is transferred down the hall to our NICU. Having a Level III NICU means we treat not only basic newborn infections and typical complications associated with premature birth, such as respiratory and feeding issues, but if necessary we can also perform certain types of newborn surgery, care for babies who need ventilators and manage the medical issues of babies born as early as 23 weeks.

Our philosophy in both the PAC and NICU is to involve the family as much as possible in the care of their baby. Studies have shown this method can make a baby stronger and shorten his or her stay in the hospital. It is in that spirit that we have implemented in recent years our family-centered care approach.

With a family-centered approach, for example, we have virtually no restrictions in the NICU on when family members can visit their newborn. Parents are treated as the baby’s primary caregiver, partnering with the doctors and staff as decisions are made and having a voice in how their baby is medically treated. We have found this type of parent partnership almost always benefits mom, baby and the rest of the family both physically and emotionally.

Between the PAC and NICU, perinatologists (specialists in maternal-fetal health) and neonatologists (specialists in high risk newborn situations) work closely on a case by case basis. Within the NICU, babies and families have the benefit of access to a wide range of specialists, including neonatal nurses, physical, occupational, respiratory and speech therapists and a lactation consultant.

As a medical community, our knowledge of babies and how to care for them continues to increase. Products we use everyday such as infant catheters, ventilators and formulas have undergone vast improvements over the years, making infant treatment more effective and more successful than ever, with the vast majority of our babies going home to their families happy and healthy.

Richard Pircon, M.D.
Maternal-Fetal Medicine
Columbia St. Mary’s
(414) 326-1745

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