In the Right Hands

While most women experience a perfectly normal pregnancy complete with swollen feet and  food cravings or aversions, there are others who experience serious complications along the way.  The Children’s Hospital of San Antonio has assembled a team of highly trained subspecialists in the field of Maternal-Fetal Medicine (MFM) to care for those moms and their unborn babies.

The Center for Maternal and Fetal Care is the first of its kind in San Antonio to offer a comprehensive approach to address those difficult diagnoses and the area’s high rate of premature births and the lack of prenatal care provided during the first 14 weeks of a woman’s pregnancy. 

Dr. Peter Nielsen, Obstetrician-in-Chief at The Children’s Hospital of San Antonio, leads the team of Maternal-Fetal Medicine specialists and Obstetric Hospitalists who are part of the academic faculty of Baylor College of Medicine. Those specializing in Maternal-Fetal Medicine provide consultations in three outpatient clinics that have opened over the past two months: downtown (across from The Children’s Hospital of San Antonio), Westover Hills (on the campus of CHRISTUS Santa Rosa Hospital – Westover Hills), and a telemedicine suite in New Braunfels (inside CHRISTUS Santa Rosa Emergency Center – Creekside).

“In some areas of Bexar County, less than half of expectant moms are receiving prenatal care during their first trimester. The March of Dimes has given the county a ‘D’ grade for this lack of prenatal care and the increased risk it can present,” Nielsen said. “Our focus is to enhance care for women experiencing a high-risk pregnancy by providing a continuity of care that offers the best possible outcomes for mom and baby.”

A high-risk pregnancy can include the following diagnoses: high blood pressure, diabetes, obesity, prior miscarriages or premature birth, and multiple gestations (twins, triplets, or more).  Perinatal sonographers with state-of-the-art technology provide outstanding images to facilitate a diagnosis. The team is complemented by a genetic counselor who can consult with families. A high-risk pregnancy may also mean that the baby has a birth defect or condition that will require pediatric subspecialists at The Children’s Hospital such as neonatologists, cardiologists, neurologists, gastroenterologists, surgery, pulmonology, and more.

“On the inpatient side of our services, we have obstetricians on call 24/7 to assist with the deliveries of new moms with high-risk pregnancies. The OB Hospitalist program will allow expectant moms to receive their prenatal care from an obstetrician practicing in the community, a family practice or primary care physician who may not necessarily attend the birth. This aspect of the program will help expand the availability of prenatal care to more women with the hospital delivery handled by a member of the OB Hospitalist team,” Nielsen added.

The Center for Maternal and Fetal Care has already attracted patients from the Rio Grande Valley, Laredo, and San Angelo. Physicians in South and West Texas now have a partner in the care of their high-risk patients. Additionally, a telemedicine unit was established in New Braunfels to improve access for patients in need of a consultation with a MFM physician based at the Westover Hills clinic. A perinatal sonographer provides real-time images for the physician to evaluate the pregnancy. A nurse facilitates the visit while the physician appears on a monitor and discusses the results with the mom and her partner. “The program’s presence in New Braunfels has already been met with great enthusiasm by patients in the area who don’t have to make the drive into San Antonio,” Nielsen shared.

Members of the Maternal-Fetal Medicine Team (pictured from left to right): Richard Wagner, MD; Andrea Shields, MD; Peter Nielsen, MD; Dana Knutzen, MS, CGC, genetic counselor; James Hill, MD; and Brook Thomson, MD.