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Maternal-Fetal Medicine, OB/GYN Ultrasound & Genetics

If you are looking for the nation’s latest, cutting-edge technology and the most experienced professionals in Maternal-Fetal Medicine (MFM), Miami Valley Hospital is the place.

Our Maternal-Fetal Medicine program is an internationally recognized center of excellence. It plays an important role in the advancement of Maternal-Fetal Medicine in the United States.

Miami Valley Hospital has the only MFM facility of its kind in the entire region. Our Center has five board-certified maternal-fetal medicine specialists who are available 24/7 - the most in the region.

For most expectant mothers, pregnancy goes smoothly. For others, pregnancy-related health concerns may develop. In this case, the woman's obstetrician may suggest she consult with a Maternal-Fetal Medicine specialist.

Maternal-Fetal Medicine physicians (perinatologists) are obstetricians who specialize in the diagnosis, treatment, and ongoing care of expectant mothers and their unborn babies, who may be at high risk for special health problems. The team of specialists with Miami Valley Hospital’s Maternal-Fetal medicine program is specially trained to work with women who need extra attention before and during their pregnancy.

Fetal to Newborn Care Center

Every 4.5 minutes, a baby is born with a birth defect or congenital anomaly requiring specialized care. Miami Valley Hospital and Dayton Children's Hospital have come together to form the Fetal to Newborn Care Center, a new resource to provide a seamless continuum of care to women facing a high-risk pregnancy. The Fetal to Newborn Care Center was created out of the Southwest Ohio Neonatal Collaborative, a joint venture between the Level IIIB neonatal intensive care units at Miami Valley and Dayton Children's. Women at the Fetal to Newborn Care Center will have access to the expertise at both locations depending on the unique needs of each pregnancy including full access to a dedicated team of maternal-fetal care specialists, high-risk obstetricians, neonatologists, neonatal surgeons and pediatric subspecialists.  Our nurse navigator will guide patients from diagnosis to delivery and beyond.

Learn More about the Fetal to Newborn Care Center.Off Site Icon

Maternal-Fetal Medicine Team

The MFM team is dedicated to providing patients with competent, compassionate, and consistent care during pregnancy. Because we work closely with your primary obstetrician, you can be confident that you will receive informed, individualized, and comprehensive treatment through every stage of pregnancy and childbirth.

Dr. Jiri Sonek serves as the Maternal-Fetal Medicine Center’s medical director. Our clinical staff includes:

  • 23 registered and accredited perinatal sonographers – the most of any perinatal center in the U.S.
  • Three board-certified genetic counselors
  • Eight nurses who specialize in high risk obstetrics and diabetes in pregnancy
  • Support staff who are committed to serving the needs of high-risk patients

Services

The MFM Center offers comprehensive services including:

Routine/normal OB ultrasound

An obstetrical ultrasound is a diagnostic test to help your physician manage your care. It provides information regarding the dating of your pregnancy, viability, and number of gestations. No test can detect all birth defects, but a thorough ultrasound in the second trimester can help in identifying birth defects of the heart, digestive system, skeletal system, brain, and spinal cord.

An OB ultrasound can also tell if the fetus is growing normally, if the placenta is in the correct location, and if there is the right amount of amniotic fluid. Be sure the person performing the ultrasound and the doctor reviewing it are both experienced and credentialed.

First Trimester Ultrasound/Screening & Biochemistry

A first trimester ultrasound is often used to confirm viability during the early stages of pregnancy, to confirm the age of the baby, and to make sure the pregnancy is in the proper location.

The first trimester is also an excellent time to assess a woman's risk of having a baby with a chromosomal abnormality such as Down syndrome. An ultrasound can be performed to evaluate the nuchal translucency (space behind the neck of the fetus) and presence or absence of the nasal bone.

Other types of birth defects may also be detected in the first trimester as a result of this screening. Because of our extensive expertise at the MFM center, Miami Valley Hospital is internationally recognized as the place for first trimester ultrasounds.

Gynecological ultrasound

Information obtained from a manual pelvic exam may prompt further evaluation and your physician may want you to have a pelvic ultrasound. With a pelvic ultrasound, the uterus and ovaries are evaluated. The ultrasound may help explain findings from the manual exam or provide additional information.

Common indications for a pelvic ultrasound include pelvic pain, abnormal vaginal bleeding, and suspicion of an abnormality on a manual gynecologic examination.

Occasionally, sonohysterography (image the uterine cavity) may be done as a part of a transvaginal (across the vagina) ultrasound examination. In this procedure, a small amount of fluid is introduced into the endometrial cavity. This may further clarify the exact nature of certain endometrial abnormalities such as polyps and fibroids, which commonly cause abnormal vaginal bleeding.

Amniocentesis, Chorionic Villi Sampling (CVS)

There are two procedures commonly performed to test fetal chromosomes. The first is CVS, a biopsy of the placenta typically performed from 10 to 13 weeks. The second is amniocentesis, a common prenatal test in which a small sample of the amniotic fluid surrounding the fetus is removed and examined. It is usually performed in the second trimester after 15 weeks.

Some of the indications to have one of these tests performed are:

  • Maternal age (if a woman will be 35 or older at time of delivery)
  • Previous child with a birth defect
  • Abnormal screening results
  • Other family history

Co-management of high-risk pregnancies

Our team of specialists is specially trained to work with women who need extra attention before and during their pregnancy. Fortunately, very few women face the potential of having a high-risk pregnancy. Still, not all pregnancies go smoothly.

Most commonly, these are women with high blood pressure or diabetes. Some may have lupus or other autoimmune diseases and thyroid problems. We offer consultative services and a co-management program that allow the patient to remain with her primary OB physician and visit us for the high-risk care.

If you or your unborn baby has certain conditions that make the pregnancy “high risk” or “complicated”, your primary care obstetrician and your Maternal-Fetal medicine specialist can collaborate to provide your care.

Some reasons a pregnant woman may need co-management include:

  • High blood pressure (hypertension)
  • Preeclampsia (toxemia)
  • Diabetes or other endocrine disorder
  • Lupus or other autoimmune disease
  • Thyroid problems
  • Clotting disorders including antiphospholipid syndrome (APA)
  • Twins, triplets, or more

While in many cases, these conditions only arise during pregnancy, some may be risk factors to underlying heart disease. Premier HeartWorks seeks to identify individuals at risk for heart attack or stroke through advanced screening and help them take the necessary steps to lower the risk.  For only $99, you will be provided with a cardiac assessment that can help determine your risk and treatment options after your baby is born.  Physician referrals or insurance approvals are not needed for this program.

Fetal Monitoring – Non Stress Test

A non-stress test (NST) is a safe, painless way to check on a baby's well-being. Two small monitors are placed on the abdomen and held in place using elastic belts. One of these monitors records contractions and the other records the baby's heart rate. The test normally takes about 20-40 minutes and is done in the comfort of our private rooms.

A non-stress test is a simple, painless procedure. We “listen to” and “see” your baby’s heartbeat. This electronic fetal monitoring is a way of observing your unborn baby.

Genetic counseling

The genetic counselors are health professionals with specialized graduate degrees and experience in the areas of medical genetics and counseling. They provide information and support to families at risk for having a child with a birth defect, mental retardation, or genetic condition. They also identify the risks, investigate the condition, analyze inheritance patterns, determine recurrence risks, and review available options with families.

Our counselors provide support and act as advocates for patients. Reasons your physician may refer you to our genetic counselors include:

  • Advanced maternal age (35 or older)
  • Abnormal maternal serum screen
  • Family history or previous child with a birth defect, mental retardation, or genetic syndrome
  • Recurrent pregnancy loss
  • Abnormal ultrasound
  • Abnormal amniocentesis
  • Ethnicity screening
  • Positive cystic fibrosis, sickle cell, or thalassemia screen

Diabetes in pregnancy program

Our multidisciplinary diabetes program provides comprehensive care for the mother and her growing baby, whether the mother had diabetes before or developed it as a result of pregnancy. For the mother with diabetes prior to pregnancy, the most common birth defects affecting her baby concern the structure of the heart, spine, or kidneys.

By receiving early, intensive management of her diabetes, a mother can help decrease the risk of these complications. For women who develop diabetes during pregnancy (gestational diabetes), we also provide the additional care to ensure the health of mom and baby.

Our team of maternal-fetal medicine specialists, nurse educators, and dietitian provide education which includes:

  • Individualized meal planning
  • Blood glucose monitoring
  • Medications
  • Follow up and support to enable each woman to adequately manage her blood sugars

Patients and referring physicians appreciate our intensive, compassionate approach. It significantly improves the results in pregnancies complicated by this relatively common medical condition.

Not all OB ultrasounds are the same

At the MFM Center, OB ultrasounds are performed using cutting-edge technology considered to be the most advanced in the United States. All of our sonographers are specially trained in perinatal sonography by Dr. Jiri Sonek, a world leader in the field of MFM/perinatology.

Although most OB ultrasounds are perfectly normal, some detect defects or abnormalities. Some of the defects may include:

  • Abnormal growth
  • Heart defects
  • Spine and head malformation
  • Club feet
  • Facial clefting
  • Neural tube defects
  • Spina bifida
  • Anencephaly
  • Abnormal kidneys
  • Abdominal wall defects
  • Skeletal dysplasia

It is very important to have a skilled registered and accredited sonographer, and an experienced perinatologist, performing the OB ultrasound.

Over the past 10 years there has been significant advancement in the world of OB ultrasound. While it is still routine to have an ultrasound at 20 to 22 weeks to check the fetal anatomy, it is now also routine, and recommended, that all pregnant women have a first trimester ultrasound between 11 and 13 weeks gestation.

Due to the advancement in technology and the discovery of certain ultrasound markers, we can now detect potential abnormalities and defects in the first trimester. There are five markers used worldwide that detect abnormalities in the first trimester. Dr. Sonek, is credited with discovering the nasal bone and the fronto-maxillary facial angle markers.

The board-certified maternal-fetal medicine specialists, nurses, sonographers, genetic counselors, administrative and support staff are a team of skilled professionals dedicated to helping mothers and their babies complete pregnancy and begin a healthy life together.

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