How to choose a fetal care center during high-risk pregnancy

How to choose a fetal care center during high-risk pregnancyFetal medicine has made huge strides in recent years, to the point where procedures can be done to help the baby while still in the womb. For women who are experiencing a high-risk pregnancy, or have an unborn baby diagnosed with a potential birth defect, it’s important to know where to turn.

A highly skilled and experienced fetal care team can make all the difference in helping you and your baby through this difficult time.

Pay attention to these things

When looking for the right fetal care center, focus on centers that offer the services and benefits below. You can research this information in a variety of ways, including reading content on a center’s website, calling a center to ask questions, reading online reviews, watching videos, or even making an initial consultative appointment to ask questions of the providers directly.

Experience and expertise

Do your research on the physician team. Find out where and with whom they trained. Be sure they have specialized training in fetal care and high-risk pregnancies, and that they have experience with your baby’s specific diagnosis.

National rankings

Hospital rankings, such as those published by U.S. News & World Report, can help you assess a hospital. While they don’t rank fetal care specifically, you can learn a lot from how well the hospital ranked in other specialties.

Nursing care is also a hugely important factor, so look for a Magnet hospital. This means the facility has earned the highly coveted designation from the Magnet Recognition Program, which is granted to only those organizations that demonstrate sustained superiority in nursing. The Magnet program was developed by the American Nurses Credentialing Center (ANCC) to recognize hospitals that demonstrate excellence in patient care, and it is the highest level of recognition that an organization can receive for nursing care.

Fetal surgical intervention options

Fetal surgery is an option in only a small percentage of cases, so be sure to choose a center that offers a wide range of fetal interventions. You’ll want to go to an advanced center that is well-equipped to handle a variety of cases, such as:

  • Twin-to-twin transfusion (TTTS) treatment
  • Fetal myelomeningocele repair (fMMC) for spina bifida
  • Open fetal surgery for congenital pulmonary airway malformation (CPAM)
  • Open fetal surgery for sacrococcygeal teratoma (SCT)
  • Fetal cardiac interventions
  • TRAP sequence treatment
  • Ex-utero intrapartum treatment (EXIT)
  • Immediate postpartum access to cardiac therapy (IMPACT) procedure
  • Vesicoamniotic and thoracoamniotic shunting
  • Fetal intrauterine transfusion

Multidisciplinary approach

It’s important to find a fetal center that takes a collaborative, multidisciplinary approach with each individual case. Exceptional fetal care centers incorporate highly trained experts from a wide variety of specialties, including:

  • Maternal fetal medicine
  • Pediatric and fetal surgery
  • Pediatric and fetal cardiology
  • Neonatology
  • Pediatric and fetal imaging
  • Obstetric, pediatric, and fetal anesthesiology
  • Pediatric and fetal neurosurgery
  • Genetics

Fetal imaging

Look for a fetal care center that has state-of-the-art imaging capabilities, including fetal MRI, high-level ultrasound, and echocardiography. It’s also important to make sure that the center is mindful about the use of radiation, choosing appropriate imaging technology with the lowest dose of radiation necessary for each specific situation. Additionally, choose a center with special certifications or designations, such as the American College of Radiology’s Diagnostic Center of Imaging Excellence designation.

Fetal heart expertise

If your baby has been diagnosed with a heart condition, it is crucial to choose a fetal care center that specializes in heart care and is linked to a highly ranked heart center. Consider the number of specialists within the heart program and the type of follow-up care available. The American Academy of Pediatrics recommends that congenital heart patients should be seen at specialized centers that include:

  • Congenital heart surgeons
  • Pediatric cardiologists subspecializing in invasive and noninvasive cardiology
  • Pediatric cardiac anesthesiologists
  • Pediatric cardiac critical care specialists

Innovation and research

A fetal care center that values innovation and research is one that is continually improving outcomes. These centers attract the best doctors and put a strong focus on research and clinical trials.

Look for a center that is a member of the North American Fetal Therapy Network (NAFTNet), an association of fetal centers with established expertise in fetal surgery and fetal care. The goal of NAFTNet is cultivate and encourage collaborative research in fetal medicine.

Care coordination

Fetal care often involves various doctors and health care professionals from different specialties. This can easily get overwhelming, so look for a place that provides a single point of contact for you (often a nurse). This person should provide individualized care, answer your questions, coordinate your appointments, and make you and your family feel comfortable and at ease.

You’ll also want to be sure the center you choose communicates, collaborates and coordinates your care with your original obstetrician or maternal fetal medicine specialist so that all providers are involved in your care plan.

Delivery arrangements

Depending on your diagnosis, some fetal care centers will allow you to choose whether you’d like to deliver your baby in their delivery unit or in your community hospital. However, some fetal centers require delivery in their hospital. You’ll want to determine the best option for your specific situation.

Wherever you decide to deliver your baby, do your research on the quality of the birth center. Make sure it is well-equipped for a high-risk birth and potential complications.

NICU access

In addition to the birth center, it is important to look for a center with immediate access to a Level IV neonatal intensive care unit (NICU) that is co-located with the birth center. Should your baby require NICU care after he/she is born, this will ensure that you both can remain under the same roof while getting the care you need.

More than anything else, always be an advocate for yourself and your unborn baby. Do your research, ask questions, and explore all options.

Fetal Concerns Center

The Fetal Concerns Center at Children’s Hospital of Wisconsin provides a comprehensive team approach — incorporating the referring physician, patient family, maternal fetal medicine specialist, fetal surgeon, nurse care coordinator, neonatologist and pediatric care specialists — when caring for women and their fetuses. The Fetal Concerns Center operates in close collaboration with Froedtert & The Medical College of Wisconsin to deliver high-quality, comprehensive fetal care. Our providers are employed by the Medical College of Wisconsin.

We are here to help. Please feel free to contact us if you have any questions.

Nancy Wojciehowski, RN, MS- Nancy Wojciehowski, RN, MS, program manager, Fetal Concerns Center, Children's Hospital of Wisconsin

If your baby has been diagnosed with a birth defect or other medical condition during your pregnancy, we can help. The Fetal Concerns Center offers compassionate, individualized care for you and your baby — from pregnancy to delivery and beyond.

 

 

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