Pregnancy can be an exciting time for a new mother and her family, but sometimes a pregnancy may not go as smoothly as planned. This is one reason the University of Arkansas for Medical Sciences (UAMS) has developed the division of maternal-fetal medicine (MFM).

Through a statewide network using the latest technology and the only board-certified high-risk pregnancy doctors in Arkansas, UAMS is giving women with high-risk pregnancies the extra attention they need and deserve.

Maternal-fetal medicine is a subspecialty of the Department of Obstetrics and Gynecology in the UAMS College of Medicine. Because UAMS is the state’s only comprehensive academic health center, moms-to-be are surrounded by some of the best clinicians, researchers and technicians in Arkansas. The clinical program also collaborates with Arkansas Children’s Hospital, an affiliate hospital where the UAMS Department of Pediatrics faculty is housed and is on staff.

“Some women and their babies are at a higher risk of complications, due to the mother’s age, medical conditions or history,” said Curtis L. Lowery, Jr., M.D., professor of maternal-fetal medicine in the UAMS College of Medicine, director of the MFM division and director of obstetrics at UAMS Medical Center.

“Being diagnosed as having a high-risk pregnancy can be frightening, but doctors in the maternal-fetal medicine division can work with you to test for any abnormalities and develop a plan for a healthy pregnancy and delivery,” he said.

A pregnancy is high risk when certain conditions or characteristics, called risk factors, are present.  Health care providers identify these factors and determine the degree of risk for a particular woman. Conditions that may complicate a pregnancy include: age (35 or older), multiple gestation (more than one fetus in the uterus), problems with a previous pregnancy, diabetes, high blood pressure, heart disease, asthma, lupus, epilepsy, pulmonary or lung diseases, kidney disease, Rh negative blood and sexually transmitted diseases. Factors such as alcoholism, smoking and drug abuse can also put a pregnancy into a high-risk category.

One of the most valuable services the maternal-fetal medicine division provides is genetic screening, testing and diagnosis. The MFM team works closely with genetic counselors in the Arkansas Genetics Program to screen for genetic disorders or hereditary risks, such as spina bifida or Down’s syndrome. Genetic screening can determine if a couple is in a high-risk group for having a baby with a hereditary genetic disorder. Genetic testing can confirm or rule out a problem. Knowing ahead of time if the baby has a genetic condition can help health care providers give the newborn the best care possible.

Women don’t have to live in central Arkansas to take advantage of the benefits of maternal-fetal medicine at UAMS. ANGELS (Antenatal and Neonatal Guidelines, Education and Learning System) is an innovative 24-hour consulting service to family practitioners and obstetricians in Arkansas. Through ANGELS, weekly telemedicine conferences enable family practitioners and obstetricians to confer with maternal-fetal medicine specialists at UAMS in real time about individual cases. The MFM team can provide ongoing assistance and consultations.  Arrangements can also be made for patients to deliver at a facility where specialty services can be provided if necessary.

ANGELS, a partnership between UAMS and the state Department of Human Services with the support of the Arkansas Medical Society, was recently named a national winner in the 2004 Innovations Awards Program of The Council of State Governments (CSG). It was one of two programs chosen for recognition among 90 applicants in the Southern Legislative Conference’s 16-state region and was one of eight national winners.

Research is a high priority at UAMS, and as new techniques and technologies are developed, they are shared with the clinical staff. Physician-investigators in the MFM division made their own contribution by developing a unique medical scanning device, called SARA, which can be used to detect fetal brain activity.

SARA is an acronym for Squid Array for Reproductive Assessment; “squid” is an acronym for super conducting quantum interference device. Lowery developed SARA with a $4 million grant from the National Institute of Neurological Disorders and Stroke.

During an examination, the pregnant woman sits against a concave shield that covers her abdomen. More than 100 sensors obtain three-dimensional data from the fetus and the uterus. This technology has been in use for 30 years for adult brain scans, but UAMS is the first medical center to adapt the technology for fetuses. Lowery and his colleagues use it for the investigation of neurological and heart problems occurring long before birth.

Other ongoing investigations include studies on how the placenta reacts to hypertension, research into the causes of fetal malformations as a result of diabetes, clinical improvements for the management of diabetes in pregnancy and the role of viral infection in pregnancy loss. Researchers in the College of Medicine also are studying the best types of care for fragile newborns, working both in the UAMS Neonatal Intensive Care Unit and at Arkansas Children’s Hospital.

Once it is time for the baby to arrive, the UAMS Medical Center provides a warm, welcoming setting in its state-of-the-art labor and delivery unit. The unit has private suites with many of the comforts of home. For deliveries that progress smoothly, mothers and their new babies can expect to stay at the hospital for about a day while the experienced staff provides instruction on the best ways to take care of herself and the new baby.

If there are complications, the labor and delivery unit also offers the latest technology in maternal-fetal medicine. The unit is equipped to monitor patients’ vital statistics continuously via a state-of-the-art computer station. There are also two operating rooms for patients who need Cesarean sections or who develop problems during delivery.

If your baby is born with medical problems, UAMS is equipped with a neonatal intensive care unit. In addition, the labor and delivery unit has two technologically advanced neonatal stabilization rooms. This allows infants who are at high risk for complications to be stabilized before moving to the neonatal intensive care nursery.

To schedule an appointment with a UAMS obstetrician, call the ANGELS Call Center at 526-7425 or 1-866-273-3835.  If you already have an obstetrician, but are in a high-risk pregnancy, ask your doctor about working with the physicians at UAMS.