Maternal-fetal care in North Texas

If you're experiencing pregnancy concerns, your obstetrician may refer you to a maternal-fetal medicine specialist.

At Fetal Care Center, our primary focus is maternal-fetal medicine, also known as perinatology. This subspecialty of obstetrics is meant to manage health conditions for mothers and babies prior to, during and after pregnancy.

Maternal-fetal conditions we treat

Types of conditions that might require specialized care from our maternal-fetal physicians include:

  • Autoimmune diseases
  • Bleeding disorders
  • Cancer
  • Diabetes
  • Gestational diabetes
  • Heart disease
  • HELLP syndrome
  • High blood pressure
  • Hypertension
  • Kidney disease
  • Placenta previa
  • Preeclampsia

Treatment for congenital abnormalities

Our obstetrician-gynecologists (OB/GYNs) specialize in high-risk pregnancy care, offering comprehensive diagnoses and treatment plans to families in need.

Perinatology treatments we offer

Our OB/GYNs are certified by the American Board of Obstetrician Gynecologists (ABOG) or the American Osteopathic Board of Obstetrics and Gynecology (AOBOG), with extensive experience in obstetric ultrasounds, chorionic villus sampling and invasive prenatal diagnosis using amniocentesis.

If your baby faces challenges, such as a birth abnormality or growth problem, our maternal-fetal medicine specialists can provide intervention options, including:

  • Amnioreduction
  • Blood transfusions
  • Chorioangioma care
  • Fetal surgery
  • Laser ablation
  • Spina bifida repair
  • Twin reversed arterial perfusion (TRAP) sequence care
  • Twin-to-twin transfusion syndrome (TTTS) treatment

Chorioangioma care

A chorioangioma is a benign tumor made up of blood vessels in the placenta that may be connected to the baby via the umbilical cord. Most pregnancies with a chorioangioma do not require immediate treatment while the baby is in the womb. Since many of the tumors are asymptomatic, they may be monitored throughout the pregnancy using ultrasound. However, in rarer chorioangiomas larger than four centimeters, the baby may need earlier treatment.

Intrauterine transfusion

Intrauterine transfusion is used to treat complications caused by chorioangiomas. The procedure may be particularly necessary if there is ultrasound evidence that your baby has a low red blood cell count, also known as anemia. Guided by ultrasound for maximum precision, intrauterine transfusion involves transfusing blood or platelets through a needle inserted through your abdomen, uterus and baby’s umbilical cord while your baby is still in utero.

Therapeutic amnioreduction

Amnioreduction is a procedure in which we insert a needle into the amniotic cavity to remove excess fluid. The procedure seeks to decompress the womb if the excess amniotic fluid causes preterm contractions or a shortened cervix.

Surgical fetoscopy and laser ablation

A minimally invasive fetoscopic procedure may be performed under ultrasound guidance to aid in laser closure of the vessels feeding the tumor. We seal the abnormal blood vessels, thus preventing them from enlarging and causing further blood flow restrictions.

Spina bifida repair

Spina bifida is a congenital birth abnormality in which an area of the fetal spine doesn’t develop and close properly early in pregnancy. This leaves a section of the spinal cord and corresponding nerves exposed, which may cause them to become damaged.

Myelomeningocele is the most common and serious form of spina bifida, occurring when part of the spinal cord and surrounding nerves push through the spinal vertebrae and protrude from the fetus’ back. It can also cause neurological injury if left untreated over the course of gestation. Our maternal-fetal specialists may offer to treat your baby by performing an in-utero meningomyelocele repair to help prevent further damage and improve your baby's quality of life.

Open fetal surgery may also prevent other injuries or complications of spina bifida from developing during the remainder of the pregnancy, as a result of spina bifida. During the procedure, a surgeon will access the uterus and repair the spinal abnormality using tiny instruments and image-guided technology. They will then close the opening with skin from your baby’s back, to protect their developing spinal cord and nerves.

If you and your fetal care team decide the best course of action is to repair your baby’s myelomeningocele after birth, we can perform postnatal spina bifida repair. You will receive frequent ultrasounds to monitor the growth of your baby throughout the pregnancy, and surgery to close the spina bifida will likely take place within the first few days of your baby’s life.

TRAP treatment

TRAP sequence is a rare condition that occurs in pregnancies of identical twins that share a common placenta. This is considered a high-risk pregnancy that requires close monitoring by a skilled maternal-fetal medicine team. We care for a high volume of monochorionic twin pregnancies each year, and continuously expand our proficiencies of these complex pregnancies.

Radiofrequency ablation (RFA)

We may perform RFA within the womb to block the flow of blood to the acardiac twin. The acardiac twin typically has a less developed body and may be missing limbs, a head or torso. This process allows the healthy twin to survive and develop as well as possible. With ultrasound guidance and a spinal anesthesia administered to you, your physician will perform RFA using a thin needle-like device placed through your abdomen and uterus, into the abnormal twin’s umbilical cord. Heat energy is then applied to stop the flow of blood to the cord.

TTTS treatment

TTTS is another rare fetal condition that may affect identical twins who share a common placenta. The condition is caused by an inequality in the blood supply between two fetuses as a result of abnormal blood vessel development.

With TTTS, one twin may have an insufficient blood supply to provide the necessary nutrients to survive or grow normally. Early detection is critical to help improve outcomes for both babies and mothers.

For decades in the United States, serial amnioreduction had been the most widely accepted therapy for TTTS. However, selective fetoscopic laser photocoagulation has become more common, with a much more limited role for amnioreduction and even less so for selective reduction.