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What to Expect from High-Risk Pregnancy Care

Posted 1/1/2018 by Ellie Ragsdale, MD
Maternal-Fetal Medicine Specialist, UH MacDonald Women's Hospital
Assistant Professor, Case Western Reserve University School of Medicine

Illustration of pregnant female

If you’re a mother-to-be whose pregnancy isn’t routine – perhaps you’re expecting twins, or you or your baby has developed an unexpected medical condition – your doctor or nurse-midwife may refer you to a maternal-fetal medicine specialist (MFM) for extra care.

These high-risk pregnancy experts, also called perinatologists, are obstetrician-gynecologists with three to four additional years of advanced education and training in diagnosing, monitoring and treating pregnancy complications in a woman and her fetus. Their focus: keeping both mom and baby healthy before, during and after birth.

“A woman may consult with an MFM before conception, at any time in her pregnancy and after giving birth,” says Ellie Ragsdale, MD, a maternal-fetal medicine specialist at University Hospitals MacDonald Women’s Hospital. Dr. Ragsdale explains some of the most common reasons women see these specialists:

Ellie Ragsdale, MD

Ellie Ragsdale, MD

Before pregnancy:

  • Planning a healthy pregnancy: Meeting with an MFM before you conceive can help you plan a healthy pregnancy. Ongoing health issues, such as asthma, diabetes, a heart condition, high blood pressure and obesity can worsen during your pregnancy. This can affect you and, sometimes, your developing baby. This specialist can also monitor how your pregnancy is affecting chronic health conditions that involve your heart, blood vessels, lungs, kidneys, immune system, digestive system and more. She or he can advise about safe medications and other treatments, and how to stay healthy after delivery.
  • Helping if you’ve had past pregnancy problems: An MFM can look for the reasons for multiple miscarriages or early labor and delivery, and find solutions.

During pregnancy:

  • Diagnosing birth defects, fetal abnormalities, growth restrictions and genetic conditions: MFMs use advanced ultrasound, fetal MRI, fetal echocardiograms, and specialized testing to identify genetic conditions and birth defects. This allows parents to prepare for the birth of a child with special needs. It also helps other specialists, such as pediatric surgeons and neonatologists, develop a plan to treat the baby after, and sometimes before, birth. “After confirming a fetal diagnosis, it is critical to assemble the right care team for the baby’s unique needs,” says Dr. Ragsdale. “As one of a few facilities in the country with complete obstetric, delivery, newborn, pediatric and adult services and specialists all in one place, our patients truly benefit from the vast expertise we can provide.”
  • Checking the health of multiples: Twins, triplets and other multiples face a variety of risks and higher odds for early delivery. MFMs can track their growth and use advanced imaging techniques to look for causes of medical issues they may face, such as slow growth or circulation problems. In some cases, they can even perform procedures to correct issues before birth.
  • Assessing other problems and risks: MFMs care for women with pre-existing health problems and conditions that arise during pregnancy, such as diabetes and high blood pressure. “We provide expert advice and care throughout pregnancy to women with high-risk medical issues to minimize risk for complications, such as preterm birth,” says Dr. Ragsdale.

Labor and Delivery:

Depending on the complication or diagnosis, medical or surgical treatment may be required during or immediately after delivery. “If so, it is critical to deliver at a facility equipped to provide the highest level of care to both mom and baby,” says Dr. Ragsdale.


Women who have complications after birth, such as heavy bleeding or infections, may receive care from an MFM along with an intensive care team.

Experts in high-risk pregnancy care

University Hospitals provides exceptional care for high-risk pregnancies. To learn more, call 216-453-2309.

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