Here at North Texas Perinatal Associates, we believe our patients should be well informed and knowledgeable about the world of perinatal care. We also want to share some vital information with you about our office, our staff, and our services. Listed below are some of the questions we frequently encounter. Please click on the question to find the answers you need. If you are curious about a topic that does not appear on this list, please contact us at the NTPA office nearest you.
Perinatologyist, also known more formally as Maternal-Fetal Medicine, is a relatively new subspecialty that concentrates on high-risk pregnancies.
A Maternal-Fetal Medicine physician (aka: an MFM) is an Obstetrician/Gynecologist who has undergone further training in the field of high-risk pregnancy. As the name implies, an MFM is trained to deal with both maternal and fetal conditions.
Your doctor may have referred you here because of our special expertise in maternal conditions that can complicate pregnancy such as high blood pressure, diabetes, autoimmune disorders, or prior pregnancy complications such as preterm labor or cervical incompetence.
We also specialize in diagnosing and treating fetal conditions through the use of state-of-the-art ultrasonography, sono-guided invasive procedures, and advanced techniques for screening and evaluating fetal health and wellbeing.
Lastly, a large part of our practice is comprised of co-management of high-risk multiple gestations, and targeted Level 2 ultrasonography (the highest level) for the detection and management of a broad range of potential fetal birth defects.
It is worth noting that the doctors in this practice are board certified/board eligible in both general OB/Gyn and in Maternal-Fetal Medicine, and that this practice is accredited by the American Institute of Ultrasound in Medicine (AIUM), so you know you are getting the highest quality medical care available.
We are a strictly consultative practice, which means we do not perform primary care services. Patients must have a formal referral from their primary care physician and generally must have insurance preauthorization prior to their appointment.
There are different types of ultrasound examinations. A standard examination can generally be performed in your doctor's office and includes evaluation of fetal viability, fetal number, fetal position, amniotic fluid volume, placental location, fetal size, and a general evaluation of fetal anatomy.
NTPA, on the other hand, performs specialized or targeted examinations. These are examinations generally intended to answer a specific question ("Is the heart normal?") or address specific issues ("Does that blood test mean my baby has a genetic problem?").
NTPA can perform such high level examinations because our doctors have specialized training in prenatal diagnosis and genetics, our sonographers are obstetrical sonography specialists, we have the best, state-of-the-art equipment available, and we are accredited by the American Institute of Ultrasound in Medicine (AIUM). We are confident you will be impressed and reassured by the detail and quality of your examination.
Probably not. While there are a few circumstances wherein 3-D ultrasound can provide valuable extra information, in most cases it is simply not as good or informative as conventional 2-D ultrasound. Our 2-D equipment and techniques are of the highest level available in medicine today, and in most cases provides better, more definitive answers than 3-D sonography. However, 3-D ultrasound can be utilized in those rare cases where it may be medically indicated.
What is a Genetic Counselor?
A genetic counselor is an important member of the perinatal health care team with specialized training in genetics and genetic disease. Because their training is so focused and specialized, the genetic counselor often has access to information and resources not readily available to your doctor. This puts the genetic counselor in the unique position of being able to serve as a liaison among you, your doctor, and the sometimes daunting world of medical genetics. If a diagnosis has been made, genetic counselors provide supportive counseling to families, serve as patient advocates, and refer individuals and families to community or state support services. Often, the genetic counselor interprets medical information and can become a most welcome support person if the information turns out to be stressful or complex.
Why do I need to see a Genetic Counselor?
Every parent hopes to have a healthy child. The good news is that most babies are born healthy. However, there are occasions where a genetic disease or birth defect may occur, or the possibility of a birth defect might exist. In these cases, you may be referred to a genetic counselor to learn whether your baby may be at increased risk for having a genetic disorder. You can discuss the choice of having one or more special tests done. Some of the more common reasons your doctor may want you to receive genetic counseling are:
- You have concerns about the chance of having a child with a birth defect or genetic disease.
- You will be 35 years of age or more at the time of expected delivery.
- You or your partner has a previous child with a birth defect or genetic condition.
- You or someone in your family have a genetic disorder or birth defect.
- You or someone in your family have a child with mental retardation or developmental delay.
- You have experienced a stillbirth or multiple miscarriages with no known explanation.
- You have a medical condition (e.g. epilepsy) requiring medications.
- You want to know more about testing for recessive genetic diseases common for certain ethnic backgrounds (e.g. sickle cell disease, Tay-Sachs disease, cystic fibrosis).
- You have a positive screening test result (e.g. first trimester screen, triple/quad screen, or AFP test).
- You have had an ultrasound examination revealing a physical abnormality or variation in the fetus.
What will the counseling session involve?
In general, the counselor will take a detailed family genetic history called a pedigree. The reason for your visit will determine just how detailed the history will be. The topic you bring to the genetic counseling session may determine the content of the discussion. Session length will depend on the reason your physician referred you, the number of questions or complexity of the family history, and may take from 15 to 60 minutes. The accuracy and appropriateness of prenatal diagnostic, genetic screening, and other tests will vary depending on your individual health and family history. Most appointments include testing preformed on the same day, if appropriate. However, you may need additional time to consider the information given to you. In those cases, an appointment for testing will be made on a separate day. Our goal is to ensure that you and your family are comfortable with your decisions and that you feel you made an informed choice.
No doctor or doctor's office can operate without at least some paperwork, so please be prepared to fill out a form or two. The most important form is your medical history. Your primary doctor may have forwarded some of your medical information to us (with your permission, of course), but that generally just deals with the problem at hand. Since your perinatologist may be making important medical assessments and recommendations, it is important that you provide us with a complete medical history. Yes, we need to know about that tonsillectomy as it may affect anesthesia decisions. Yes, we need to know about that hernia surgery when you were a baby as it may influence surgical plans. So paperwork is part of the deal.
Depending on the reason for your visit, you may consult with a genetic counselor before you see the perinatologist. An integral part of your visit is the sonogram. Some of our offices utilize sonographers to initiate the ultrasound examination. A sonographer is a person specially trained (and in our offices, specially certified) to perform obstetrical sonography. The sonographer performs the measurements and documentation required for a complete obstetrical ultrasound. Her findings are then presented to the perinatologist who verifies the findings and completes the examination. Some offices do not utilize sonographers, in which case the perinatologist will perform the complete ultrasound.
Fortunately, in most cases, the findings are normal, the news is good, and you are done! In some cases, the news is not necessarily bad, but high risk circumstances may require putting together a game plan and scheduling repeat visits. Such plans are always discussed with you in detail and implemented only with the approval of your primary care doctor.
We are only consultants – your primary Ob/Gyn remains captain of the ship, has absolute veto power over our recommendations, and will always be a part of any major decision. In cases where the news is bad (fortunately these are rare), the perinatologist (and where indicated, our genetics counselor) will discuss the situation with you in detail, immediately consult your primary care physician by phone, and make plans for any further diagnostic or therapeutic steps necessary. In all cases, a detailed report is sent to your primary care provider the day you are seen.
If you are referred to NTPA to address a specific problem, such as a problem with a previous pregnancy, abnormal laboratory result, existing medical condition, or other such issues, please make sure your doctor has your permission to forward relevant medical information to us prior to the date of your visit.
Within our site you can find our NTPA forms that can be downloaded and filled out ahead of time to streamline your office visit.