Fetal complications of pregnancy include birth defects, genetic problems, growth problems and problems due to maternal antibodies. An accurate diagnosis allows us to start treatment during pregnancy and to prepare to treat the newborn at delivery. In many cases, ongoing monitoring allows us to prepare a baby for early delivery, and to decide the best timing for delivery.Complications we treat include:

• Fetal anomalies, or structural birth defects such as fetal heart defects, brain abnormalities and dwarfism
• Fetal growth disorders, when the baby is too big or too small and which can be caused by genetic problems, problems with the placenta or maternal diabetes or hypertension
• Genetic conditions, which may be passed through family or by chance during a pregnancy
• Multiple pregnancies, when there is more than one baby (twins or more) and possible risks to both mother and babies; fertility treatments and family history may contribute to a woman’s chance of conceiving multiples

If we identify any fetal complications, we offer numerous services to gather information and manage your pregnancy:

• Genetic counseling, during which counselors will review family history and pregnancy information in detail
• Genetic testing
• Maternal Fetal Medicine physician consultation
• Pediatric specialty consultation and care conference
• Social work
• Additional testing, such as nonstress tests and periodic ultrasounds
• Delivery recommendations, including vaginal or cesarean deliveries

We want to keep you and your baby as healthy as possible during pregnancy. Some chronic and acute conditions, as well as the medications used to treat them, may cause complications for you or your baby. If you have a chronic medical condition, it’s ideal to see a specialist before conceiving to optimize management of your condition during pregnancy.

We can help you with your pre-existing health challenges such as:

• Asthma or other lung problems
• Autoimmune diseases, such as lupus or arthritis
• Cancer
• Cardiovascular conditions
• Clotting disorders
• Fibroids
• High blood pressure
• Inflammatory bowel disease
• Kidney disease
• Lymphatic disorders
• Mental health issues
• Multiple sclerosis
• Neurological problems
• Obesity
• Seizure disorder
• Severe anemia
• Substance abuse
• Type 1 and Type 2 diabetes
• Thyroid problems

Even if you don’t have any pre-existing conditions, you may still need special attention when you become pregnant, including if you’re over 35 years old or are carrying more than one baby. These factors, among others, can contribute to the development of other conditions during pregnancy, including:

• Gestational diabetes
• High blood pressure (preeclampsia)

Whatever the condition, our team of specialists will work toward the best possible outcome: a healthy baby and a healthy you.

At Swedish, we are highly trained to treat the most complicated conditions that develop during pregnancy. Whatever you are experiencing, we’re deeply committed to helping you by guiding complex pregnancies toward the best possible outcome: healthy moms and healthy babies.

• Placenta previa - where the placenta develops low in the uterus and can obstruct the passageway to the cervix
• Invasive placenta - occurs when the placenta attaches too strongly or grows into the wall of the uterus
• Placenta abruption - occurs when the placenta releases too early, most often late in pregnancy

Learn more about plecenta complications.

This condition, which occurs before the 36-week mark of pregnancy, means that babies are born when they are not yet fully developed and can have serious problems with breathing, feeding and keeping warm. At Swedish, premature babies are expertly cared for around the clock in our Level IV Neonatal Intensive Care Unit.

PPROM occurs when the amniotic sac ruptures before the 37th week of pregnancy, which increases the risk of premature delivery. If PPROM is confirmed, you’ll be admitted to the hospital and kept under observation until your baby’s lungs are mature enough to be born – typically after 34 weeks. Babies born before the 37-week mark are automatically admitted to our Neonatal Intensive Care Unit for care and observation.

Losing a baby can be physically and emotionally overwhelming. We work with you to provide support if miscarriage or stillbirth occur, and to identify genetic, hormonal, immune or structural causes that, if treated, might enable you carry a healthy pregnancy in the future.

Prenatal genetic counseling and testing aims to help you make sense of what can sometimes be complex and confusing medical information.

With recent advances, there are many genetic testing options during pregnancy. Through counseling, you may feel more educated about declining genetic testing. The discussion can help you be more prepared through:

• Discussion of the pros and cons of prenatal genetic testing options during and before pregnancy
• Personal guidance on test decision-making through test results
• Patient-friendly explanations of complex medical information
• Guidance to make informed, independent decisions about your health care and reproductive options
• Resources and educational materials

If you choose to continue with genetic testing, your provider may recommend genetic carrier testing, which is a blood test to check if you or the father are a genetic disease carrier or unlikely to be a carrier. Learn more about carrier screening.

Before your baby is born, we may look for additional screening or procedures to ensure your baby is growing in a healthy way.

Swedish offers a variety of ultrasounds to monitor your baby throughout your pregnancy, including:

• Nuchal translucency ultrasound
• Detailed fetal anatomic ultrasound
• Follow-up or complete OB ultrasound
• Targeted or limited ultrasound
• Amniotic fluid index (AFI) ultrasound
• Transvaginal ultrasound
• Biophysical profile (BPP)
• Doppler flow ultrasound
• 3-D ultrasound
• Fetal echocardiogram

Although uncommon, there are times when babies need medical treatment even before birth. At the Maternal and Fetal Specialty Center, we can provide many of these treatments, including:

• Intrauterine transfusion - a baby is given blood before birth due to severe anemia
• Amnioreduction - drains excess fluid around the baby to ease maternal discomfort or preterm contractions
• Medication administration - delivers medication directly to the baby for certain conditions
• Draining fluid collections - drains fluid prior to birth when there are large fluid collections in the baby