Division of Maternal-Fetal Medicine
 Arkansas Reproductive Genetics Program

Clinics and Services

Genetic Counseling:

Prenatal Screening and Diagnosis can help detect many types of birth defects before a baby is born. A genetic counselor will meet with you and review your family background, pregnancy and medical histories, , previous pregnancy information and then provide genetic and risk counseling. This session will help you better understand the risks in your pregnancy, as well as what screens and tests may be helpful to you.  Our program is the only one in the state of Arkansas with Board-Certified Genetic Counselors.  Amniocentesis:
Amniocentesis is performed after the 14th week of pregnancy. To perform this procedure, our maternal-fetal medicine physicians insert a needle through the mother’s abdomen and into the uterus to extract amniotic fluid surrounding the unborn child. Ultrasound is used to guide the needle into a pocket of fluid that is not close to the baby.  The mild discomfort is similar to having blood drawn and/or menstrual cramping. The risk associated with amniocentesis is extremely small; approximately 1 in 300-400 mothers will have a significant complication after an amniocentesis.   Genetic testing from an amniocentesis typically takes 10 days to 4 weeks for completion, depending on tests ordered.  Some tests can be performed more rapidly.  Our program is the only one in the state of Arkansas that offers amniocentesis by Board-Certified Maternal Fetal Medicine physicians.

Chorionic Villus Sampling:

Or CVS is typically performed in the 11^th or 12^th week of pregnancy.  To perform this procedure, our maternal-fetal medicine physicians insert a needle either through the mother’s abdomen (transabdominal approach) or through the vagina/cervix (transcervical approach) and remove a very small piece of the placenta.  Ultrasound is used to guide the needle to the correct location.  Discomfort can result from this test and is similar to menstrual cramping.  The risk for significant side effects from a CVS approaches 1 in 100 (1%).  This placental tissue can be studied for chromosome or genetic problems.  CVS can provide diagnosis much earlier in a pregnancy.  Test results can take 10 days to 4 weeks.  Again, only Board_Certified Maternal-Fetal Medicine physicians perform this procedure in our clinic.

Ultrasound:
Ultrasound uses sound waves to locate the position of the fetus and placenta. The typical ultrasound determines your due date, how many babies you are carrying, where your placenta is located, and if you have plenty of amniotic fluid. A level II, or targeted, ultrasound is used to examine the baby’s anatomy and development at a much more detailed level.  This includes the unborn baby’s head and spine, kidneys, bladder, stomach, heart, limbs, and other partsfor major abnormalities. A Level II ultrasound is commonly done during the second or third trimester. There is no known risk associated with ultrasound.

Maternal Screening:
Maternal Serum Screening Tests assess a woman’s risk of having a baby with certain birth defects, such as Down syndrome, spina bifida, and other chromosome problems. However, for many birth defects, there is no screening test.

There are two types of maternal screening tests: First Trimester Screening and Second Trimester Screening., .

• First Trimester Screening: involves one of our certified ultrasonographers/physicians obtaining a measurement of the skin thickness at the back of the baby’s neck, in addition to obtaining a blood sample to look at two particular markers.  This screening test is helpful in determining the risk for Down syndrome and other chromosome problems.  It can only be performed between the 11^th and 14^th weeks of the pregnancy.
   
• Second Trimester Screening: involves obtaining a blood sample to look at four particular markers.  This screening test is helpful in determining the risk for Down syndrome, other chromosome abnormalities, and spina bifida and abdominal wall defects.  It is best performed between the 16^th and 18^th weeks of the pregnancy.

Arkansas Teratogen Information Service:
The Arkansas Teratogen Information Service provides information on agents that might be potentially hazardous to a pregnant woman or her fetus. The program serves physicians, nurses, pharmacists, and other health professionals throughout the state. Agents of concern include prescribed or over-the-counter medications, vaccinations, diseases and infections, chemical agents in the workplace or home, radiation, and abused substances. The service also provides information on the use of medications while breast-feeding.

Fetal Echocardiogram:
This clinic allows pregnant women who are at risk for having a baby with a congenital heart defect to have a special ultrasound evaluation of the fetal heart. A Pediatric Cardiologist from Arkansas Children’s Hospital performs the evaluation of the fetal heart structure and function. Fetal echocardiograms are best performed between the 20th through the 24th week of gestation. Women seen in this clinic include those with a family history of heart defects, those with a history of diabetes or lupus, or those requiring certain anti-convulsant medications. Visits to this clinic will also include a discussion with a genetic counselor and a Level II obstetric ultrasound examination.

Interactive video clinic:
The Prenatal Diagnosis Inter-Active Video Clinic is available to high risk obstetric patients. The clinic serves rural, pregnant women who are unable to travel to Little Rock due to financial constraints, transportation problems, or medical condition restraints. Genetic counseling, obstetric ultrasounds, and obstetric consults are provided to rural sites through interactive video.