High-Risk Pregnancy

Ultrasound involves the use of sound waves to pass inside a pregnant person’s body to create a picture of the fetus and uterus. Ultrasounds do not involve any radiation exposure and are safe in pregnancy. They can be used to determine the age, size, and anatomy of the fetus as well as look at the pregnant person’s uterus and cervix. An ultrasound can provide clues about the health of the baby by looking closely at the developing organs. It can also diagnose twins or triplets and can often show whether your baby is a boy or a girl, if you wish to know in advance.

Most pregnant individuals have at least one ultrasound test, and those with complicated pregnancies may require more. 

Ultrasounds may be performed at about:

• 6-7 weeks or later to confirm pregnancy and estimate birth date
• 18-20 weeks to scan for birth defects and measure the baby for growth and development
• 32- 34 weeks to evaluate the baby's size and growth again.
• Other scans may be done as needed if further assessment or diagnosis is required.

Three-dimensional and four-dimensional ultrasounds

3D images are still photographs. Our Perinatologists use these advanced images in addition to standard ultrasound (2D) for more detailed evaluation of the baby the womb, to identify any abnormalities.

Level II or Targeted Ultrasound

Recommended when there is an increased risk of birth defects in the fetus either due to previous pregnancy history, family history, medication or drug exposures, medical complications, or advanced maternal age.

Vaginal Sonography

A form of ultrasound in which a vaginal probe is inserted into the patient’s vagina and is like an internal pelvic examination. This is safe to perform in pregnancy and can provide detailed information concerning early (less than 12 weeks) pregnancies. It is also used to measure a patient's cervix to assess risks of preterm labor and birth and may also be needed to identify abnormalities such as previa.

Biophysical Profile

Involves using ultrasound to look at the activity of the fetus, body movements, breathing movements, fetal tone, and amniotic fluid volume to determine fetal well-being.

Doppler Ultrasound

Uses sound waves to look at blood flow through the fetal or maternal blood vessels. This is useful in cases where the fetus may not be growing normally or may be anemic.

Color-Flow Doppler Ultrasound

Uses specialized ultrasound technology to look at blood flow through fetal organs.

Nuchal Translucency Scan (First trimester)

This ultrasound measures the amount of fluid at the back of your baby's neck. The test is done to determine the risk of chromosomal abnormalities, especially Down’s syndrome. This ultrasound may also determine:

• whether you are pregnant;
• how many babies you are expecting;
• how many weeks pregnant you are; and
• whether there are any obvious major abnormalities present at this time
• The test itself does not carry any risk to the pregnant person or the baby.

Amniocenteses and Chorionic Villus Sampling are commonly performed at our Antenatal Testing Unit. Amniocentesis involves placing a thin needle through a patient’s abdominal wall into the amniotic sac to obtain fluid for fetal testing. Chorionic villus sampling (CVS) involves placing a thin needle through the patient’s abdominal wall, or a thin catheter into the cervix to obtain genetic material from the placenta. Both tests are done to check the fetus for genetic disorders such as Down syndrome, or birth defects such as spina bifida.

After having an amniocentesis or CVS, be sure to:

• Relax for the remainder of the day.
• Decrease your activities on the day of your procedure. Do not engage in strenuous activity including exercise, housework, heavy lifting, carrying other children, sexual intercourse, or tub bathing.
• Watch for any signs of cramping, vaginal bleeding or discharge of amniotic fluid, or infection (fever, redness at tap site). Please contact us with any questions or problems at 203-384-3544.
• You may resume your normal activities the following day, if you have not had any complications. Turnaround time for test results depends upon the testing ordered; chromosomal analysis results are usually available within 10 days to 2 weeks, while other more complex testing may take 3 or 4 weeks to result.

Serum Screening tests are blood tests that can easily and safely identify pregnant individuals who may need for further testing on their fetus.

An abnormal screening test does not mean your baby has a birth defect or other problem but does suggest the need for closer evaluation. Further testing may include targeted ultrasound, genetic counseling, amniocentesis, fetal monitoring later in pregnancy, or additional blood screening.

Non-Stress Testing (NST)

Involves using an electronic fetal monitor to listen to the fetus's heart rate and measure uterine contractions. It is known that a healthy baby will increase its heart rate when it moves. T This test is performed when your doctor/midwife is concerned that the placenta is at risk for not functioning well. Typical reasons for non-stress testing include maternal medical problems such as high blood pressure or diabetes, suspected poor fetal growth, previous pregnancy complications, postdate pregnancies, fetal abnormalities, or medication exposures.

Genetic counseling involves meeting with a specialist in genetic counseling or prenatal diagnostician to review you and your partner's medical history, along with family histories to determine if the pregnancy is at increased risk for any genetic diseases.

Reasons for genetic counseling include:

• Advanced maternal age (> 35 years old at the time of delivery)
• Previous history of a fetus born with birth defects, intellectual disability, or genetic disorders
• Family history of birth defects, intellectual disability, or genetic disorders
• Medication usage in pregnancy
• Abnormal blood test results (cell free DNA AKA NIPT, AFP, quadruple screen)
• Certain ethnic groups (Ashkenazi Jews, Italians, African Americans, Southeast Asians, and others) may be at increased risk for certain genetic disorder

Diabetes in pregnancy is common and causes high levels of sugar in the pregnant person’s blood, which may cause complications before and during childbirth. Bridgeport Hospital provides both gestational diabetes and pregestational diabetes education and we closely follow pregnant individuals with diabetes to help them monitor and control their blood sugar levels.

Gestational Diabetes Team

• Perinatologists
• Certified diabetes education nurses provide education and counseling before, during, and after pregnancy
• Dieticians

The gestational diabetes team works closely with your physician to coordinate your care and ensure a safe pregnancy and delivery.

The Gestational Diabetes Program has been awarded recognition by the American Diabetes Association in accordance with the National Standards for Diabetes Self-Management Education Programs. For more information, call the Antenatal Testing Center at 203-384-4719.

Premature Birth (fetal age < 37 weeks at delivery) is a major cause of newborn injury. The Prematurity Prevention Program at our Antenatal Testing Unit involves reviewing pregnancy history and outcome, obtaining appropriate tests, and following patients who are at risk for preterm delivery. The use of vaginal ultrasound to look at cervical length and dilation (opening of the womb) can help identify patients who are at increased risk for preterm delivery so that proper measures can be taken, if needed.

Please plan to arrive at the Antenatal Testing Unit, at either Bridgeport Hospital on the 5th floor across from Labor and Delivery, or at Park Avenue Medical Center in Trumbull on the 2nd floor, Suite 500 15 minutes before your scheduled appointment. Every attempt is made to see all patients at their scheduled appointment time. However, as we are a high-risk referral center and accept emergency cases, delays are sometimes unavoidable. Please bring your insurance card and a photo I.D.

If you are unable to keep your appointment or need to reschedule, please give 24-hours' notice.

Specialized ultrasounds that focus on the growth and anatomy of your baby are done at the ATU. Your ultrasound will be performed by our staff of sonographers and perinatologists. Your results and any questions you may have will be addressed at the end of the procedure.

Children may be present during the ultrasound, but it is difficult to perform an optimal examination with increased activity in the room. A responsible adult capable of taking the child out of the examination room, if necessary, should accompany each child.

Maternal-fetal Medicine Specialist

A maternal-fetal medicine specialist is an obstetrician who specializes in high-risk pregnancies, prenatal diagnosis and medical complications of pregnancy. At Bridgeport Hospital, a close relationship has developed between the doctors in the community and our specialists to provide the best possible care in complicated pregnancies.

Nurses

Our nursing staff hold advanced degrees and provide diabetes education, fetal monitoring, premature birth prevention education, and perinatal education.

Sonographers

Sonographers assist our physicians in performing obstetrical ultrasound. Sonography training consists of a 1–2-year course in which sonographers learn physics, anatomy, and the interpretation of ultrasound images. Our sonographers have an average of 10 years of obstetrical ultrasound experience.

Genetic Counselors

Genetic counselors are health professionals with graduate degrees and experience in the areas of medical genetics and counseling. Genetic counselors work as members of a health care team, providing information and support to families who have members with birth defects or genetic disorders or who may be at risk of inherited conditions. Our genetic counselors are board certified by the American Board of Human Genetics.

Secretarial Staff

Our Secretarial staff performs scheduling, billing, and other clerical support. Feel free to call us anytime.

Contact Us

Park Avenue Perinatal Specialists Scheduling
203-372-0710

Bridgeport Hospital ATU
203-384-3227

Maternal-fetal medicine consultations
203-384-3544