High-Risk Pregnancy Care
(Maternal-Fetal Medicine)

Get to know more about our maternal-fetal medicine miracle workers.

Jackson Health System is Miami’s specialist in high-risk maternity care, which is available throughout our system, at our doctors’ offices, outpatient centers, and hospitals.

Delivering World-Class Care To Patients

Pregnancy is nothing short of a miracle. But, sometimes, you or your baby might require extra care.

In these cases, your doctor may refer you to a maternal-fetal medicine specialist. These specialized physicians are experts in diagnosing and treating medical conditions that could put the health of a patient or her child at risk.

The UHealth Jackson Maternal-Fetal Medicine team helps thousands of women each year by providing comprehensive services before, during, and after pregnancy. Led by the academic research from the University of Miami Miller School of Medicine, our team of board-certified obstetricians can help manage even the most complex cases.

Delivering World-Class Care To Patients

Pregnancy is nothing short of a miracle. But, sometimes, you or your baby might require extra care.

In these cases, your doctor may refer you to a maternal-fetal medicine specialist. These specialized physicians are experts in diagnosing and treating medical conditions that could put the health of a patient or her child at risk.

The UHealth Jackson Maternal-Fetal Medicine team helps thousands of women each year by providing comprehensive services before, during, and after pregnancy. Led by the academic research from the University of Miami Miller School of Medicine, our team of board-certified obstetricians can help manage even the most complex cases.

Physicians: Our team will work with you throughout the entire process, so you can refer with confidence.

What To Expect On Your First Visit

On their first visit, new patients can expect to receive evaluations, tests, and consultations based on their individual needs. If you have a pre-existing medical condition or face challenges at any time throughout pregnancy, you can trust in the experts at UHealth Jackson Maternal-Fetal Medicine to keep you and your baby healthy and safe.

What To Expect On Your First Visit

On their first visit, new patients can expect to receive evaluations, tests, and consultations based on their individual needs. If you have a pre-existing medical condition or face challenges at any time throughout pregnancy, you can trust in the experts at UHealth Jackson Maternal-Fetal Medicine to keep you and your baby healthy and safe.

Our Maternal-Fetal Medicine Services

We offer consultation services to determine the right course of treatment for your unique needs. Our specialists are available for you every step of the way, using advanced technology and years of experience to help give you the best chances for a smooth, healthy delivery.

Jackson Health System is staffed with experts in prenatal diagnosis and the treatment of complex fetal conditions. Most often, fetal care is indicated because the fetus’ life is at risk. Generally, the earlier the prenatal diagnosis, the better the survival rate and outcome.

What helps Jackson excel in this is our network of care: all our pediatric specialists have the ability to collaborate with our obstetrics and high-risk pregnancy teams when a prenatal fetal diagnosis is made.

We specialize in a wide range of services, including:

  • High-resolution ultrasound: Checks on aspects of the baby’s well-being, growth, and development
  • Chorionic villus sampling and amniocentesis: Tests to evaluate the genetic makeup of the baby
  • Nuchal translucency testing: Identifies risks for chromosome and anatomic abnormalities
  • Doppler studies: Evaluates the baby’s blood flow
  • Percutaneous umbilical cord sampling/cordocentesis: Uses umbilical cord blood to test for chromosome abnormalities or blood disorders
  • Non-invasive genetic screening, including: Biochemical screening and cell-free fetal DNA testing (NIPT), which screens a sample of the mother’s blood for possible genetic conditions in the child
  • Genetic testing for inherited conditions
  • Pre-conception and pregnancy counseling regarding any medical condition affecting the patient

Description

Our Maternal-Fetal Medicine Services

We offer consultation services to determine the right course of treatment for your unique needs. Our specialists are available for you every step of the way, using advanced technology and years of experience to help give you the best chances for a smooth, healthy delivery.

Jackson Health System is staffed with experts in prenatal diagnosis and the treatment of complex fetal conditions. Most often, fetal care is indicated because the fetus’ life is at risk. Generally, the earlier the prenatal diagnosis, the better the survival rate and outcome.

What helps Jackson excel in this is our network of care: all our pediatric specialists have the ability to collaborate with our obstetrics and high-risk pregnancy teams when a prenatal fetal diagnosis is made.

We specialize in a wide range of services, including:

  • High-resolution ultrasound: Checks on aspects of the baby’s well-being, growth, and development
  • Chorionic villus sampling and amniocentesis: Tests to evaluate the genetic makeup of the baby
  • Nuchal translucency testing: Identifies risks for chromosome and anatomic abnormalities
  • Doppler studies: Evaluates the baby’s blood flow
  • Percutaneous umbilical cord sampling/cordocentesis: Uses umbilical cord blood to test for chromosome abnormalities or blood disorders
  • Non-invasive genetic screening, including: Biochemical screening and cell-free fetal DNA testing (NIPT), which screens a sample of the mother’s blood for possible genetic conditions in the child
  • Genetic testing for inherited conditions
  • Pre-conception and pregnancy counseling regarding any medical condition affecting the patient

Who Needs High-Risk Pregnancy Care?

If you already have an obstetrician, she or he may have let you know that your pregnancy could be “high-risk.” Our team of specialists provides state-of-the-art clinical management in high-risk obstetrics. Women whose pregnancies are considered high-risk may include those:

  • ​Over the age of 35 or under the age of 18
  • With a history of pre-term (early) labor or miscarriages
  • Carrying twins or multiple babies
  • Diabetes and other endocrine conditions
  • Heart disease, congenital or acquired heart disease
  • High blood pressure, preeclampsia or kidney disease
  • Infectious disease, including HIV/AIDS
  • Infertility, reproductive issues or difficulty conceiving
  • Fetal cardiac anomaly or any fetal genetic condition identified during pregnancy
  • Placenta Accreta Spectrum (PAS)
  • Placental disease, amniotic fluid disorders or other conditions affecting the pregnancy​
  • And many others

For women whose pregnancies require hospitalization prior to delivery, such as those with high-risk pregnancies or facing high-risk deliveries, The Women’s Hospital at Jackson Memorial offers beautiful suites in the dedicated High-Rsk Antepartum Unit.

Description

Who Needs High-Risk Pregnancy Care?

If you already have an obstetrician, she or he may have let you know that your pregnancy could be “high-risk.” Our team of specialists provides state-of-the-art clinical management in high-risk obstetrics. Women whose pregnancies are considered high-risk may include those:

  • ​Over the age of 35 or under the age of 18
  • With a history of pre-term (early) labor or miscarriages
  • Carrying twins or multiple babies
  • Diabetes and other endocrine conditions
  • Heart disease, congenital or acquired heart disease
  • High blood pressure, preeclampsia or kidney disease
  • Infectious disease, including HIV/AIDS
  • Infertility, reproductive issues or difficulty conceiving
  • Fetal cardiac anomaly or any fetal genetic condition identified during pregnancy
  • Placenta Accreta Spectrum (PAS)
  • Placental disease, amniotic fluid disorders or other conditions affecting the pregnancy​
  • And many others

For women whose pregnancies require hospitalization prior to delivery, such as those with high-risk pregnancies or facing high-risk deliveries, The Women’s Hospital at Jackson Memorial offers beautiful suites in the dedicated High-Rsk Antepartum Unit.

For Patients Considering Vaginal Birth After Previous Cesarean Section (VBAC)

Jackson Health System fully supports VBAC deliveries. If you have a history of Cesarean delivery, it may be possible to experience natural childbirth with your next baby.

Each Jackson maternity program supports VBAC as a safe choice in accordance with American College of Obstetricians and Gynecologists’ practice guidelines.

Request an appointment with one of our maternal-fetal medicine specialists to find out if a VBAC procedure is right for you.

Request an Appointment

Description

For Patients Considering Vaginal Birth After Previous Cesarean Section (VBAC)

Jackson Health System fully supports VBAC deliveries. If you have a history of Cesarean delivery, it may be possible to experience natural childbirth with your next baby.

Each Jackson maternity program supports VBAC as a safe choice in accordance with American College of Obstetricians and Gynecologists’ practice guidelines.

Request an appointment with one of our maternal-fetal medicine specialists to find out if a VBAC procedure is right for you.

Request an Appointment

Meet our Maternal-Fetal Medicine Specialists

Our physicians, who are board-certified in maternal-fetal medicine, as well as obstetrics and gynecology, help thousands of women every year as they plan for and manage high-risk pregnancies.

What is Placenta Accreta?

Placenta made simple

The placenta, commonly known as the afterbirth, is an organ that develops in your uterus during pregnancy. This structure provides oxygen and nutrients to your growing baby and removes waste products from your baby’s blood. The placenta attaches to the wall of your uterus, and your baby’s umbilical cord arises from it.

During the last stage of labor, the placenta will separate from the wall of the uterus, and contractions will help push it out of the birth canal after childbirth.

What can go wrong?

Sometimes, the placenta is attached deep into the uterus, and it doesn’t completely separate from the uterus during delivery, which can cause dangerous bleeding. This is referred to as Placenta Accreta Spectrum (PAS) also known as placenta accreta, placenta increta or placenta percreta depending on how deep it is attached.

Why does it happen?

Research has yet to prove why a placenta accreta will occur; however, it often happens in women who have had a prior cesarean section or surgery on the uterus, such as removal of fibroids or multiple dilation and curettage.

The layer behind the lining of the uterus called endometrium is injured during a cesarean section and it doesn’t heal back completely, leaving a space for the placenta to attach to directly and grow deeper into the muscle of the uterus.

How can I know if I have it?

Historically, placenta accreta was diagnosed at the time of delivery and attempts to remove the placenta would lead to profuse hemorrhaging, requiring emergent hysterectomy to preserve the mother’s life. Now, placenta accreta can be diagnosed with an ultrasound during pregnancy.

With early diagnosis, lifesaving plans can be put in place to minimize the risks to you and your baby throughout your pregnancy and delivery.

Can it be treated?

No treatment is available during the pregnancy, but several treatment options are available during delivery.

Our team at the Placenta Accreta Spectrum (PAS) Center can help to devise a plan of management that will best suit your case and be the safest for you and your baby.

What is the treatment for placenta accreta?

Once you are diagnosed with placenta accreta, you will meet with all the team members and understand the step-by-step process until your delivery, as well as have contingency plans for any emergency delivery.

Our multidisciplinary team of experts includes your maternal-fetal medicine specialist, gynecological oncologist, anesthesiologist, urologist, radiologist/interventional radiologist, critical care, Ryder Trauma team, neonatologists, transfusion medicine specialist, and Center for Bloodless Surgery. The team has extensive experience with placenta accreta spectrum and have treated many patients that have cases similar to yours. The multidisciplinary team at UHealth/Jackson has been working together for several years and has extensive experience in cesarean hysterectomy and uterine preservation surgery – a procedure in which the placenta is left inside the uterus (“in situ”) and your uterus is saved.

At UHealth/Jackson we have an established Placenta Accreta Spectrum (PAS) program with standardized protocols and proven outcomes. Our patients deliver at a state-of-the-art facility with access to critical support resources, including 24/7 blood bank and transfusion services. In addition, at UHealth/Jackson a placenta accreta laboratory is in place with extensive translational innovative research in the field.

What is the recovery time after treating a placenta accreta?

Most often the recovery is similar to a cesarean section. You’ll most likely stay in the hospital for three to five nights after delivery. Very rarely, some women will need to stay in the intensive care unit for a day or two to help them recover from blood loss.

What are the risks to the mother and baby from placenta accreta?

The risks of placenta accreta can be serious and can expand beyond the mother to the newborn. If an emergency C-section is required during the pregnancy, the baby might be delivered prematurely and require care in the neonatal intensive care unit (NICU) at Holtz Children’s Hospital. Risks for the mother can include:

  • Damage to the uterus and surrounding organs
  • Loss of fertility due to the need of a hysterectomy (removal of uterus)
  • Excessive bleeding that requires a blood transfusion
  • Death

What is delayed interval hysterectomy?

Delayed interval hysterectomy is a treatment plan that involves delivering the baby and leaving placenta inside the uterus (“in situ”) with expectation to perform hysterectomy at a later time, when the risk of blood loss and tissue damage may be decreased. While still considered investigational, this approach can be a strategy for placenta accreta cases with severe invasions.

Are there uterus preserving treatment options?

We will do our best to preserve the uterus, however, most cases of accreta require hysterectomy. In rare and individualized cases, conservative and expectant management may be considered. Conservative management is when a portion of the placenta is removed, expectant management is when the placenta is left inside the uterus. According to the American College of Obstetricians & Gynecologists (ACOG) and the Society of Maternal Fetal Medicine (SMFM): conservative management or expectant management should be considered only for carefully selected cases of placenta accreta spectrum after detailed counseling about the risks, uncertain benefits, and efficacy and should be considered investigational.

Will I still be able to breastfeed if i had a hysterectomy?

Yes, most women are able to produce breast milk after an accreta delivery, even if it involved a hysterectomy. Our lactation consultant can assist you in this process. Keep in mind that placenta accreta moms often have many factors that can make breastfeeding more challenging (premature baby, blood loss at delivery, etc.), so be kind to yourself and know that we are here to help you in any way possible.

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