One-of-a-Kind Program Cares for High-Risk Pregnancies
The Arkansas High-Risk Pregnancy Program at UAMS Medical Center is the only one of its kind in the state.

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NOV. 29, 2001 | Although it’s one of the most natural conditions in the world, pregnancy carries high risks for some women and their babies. Approximately 10 percent of all pregnancies in Arkansas are classified as high risk. Ensuring that these special cases receive the special medical care necessary requires a special health-care facility. In Arkansas, that facility is UAMS Medical Center.

“The Arkansas High-Risk Pregnancy Program at UAMS Medical Center is the only one of its kind in the state,” according to Teresa G. Berg, M.D., a physician in the Maternal/Fetal Medicine Division of the UAMS Obstetrics and Gynecology Department. “UAMS Medical Center also has the state’s only physicians who are board-certified in maternal-fetal medicine, which means that we’ve undergone extensive training in high-risk obstetrics and have received certification to practice this subspecialty.”

A high-risk pregnancy is one in which the risk of illness or death before or after delivery is greater than usual for the mother and/or her baby. Risk factors include the woman’s age (35 years and older), having twins and triplets, problems with previous pregnancies (including miscarriage and stillbirth), and premature rupture of the fluid-filled membranes that contain the fetus and premature labor. Several medical conditions can also complicate pregnancy, including chronic hypertension (high blood pressure), diabetes, kidney disease, lupus, heart disease, epilepsy, asthma, lung disease, herpes, HIV/AIDS, liver disease, sickle cell anemia, thyroid disease, genetic defects (such as spina bifida and Down’s syndrome) and Rh incompatibility (a mismatch of the Rh factor in the blood of a pregnant woman with that of her baby). Cigarette smoking, alcohol use, and drug abuse and addiction also pose risks in pregnancy.

A common factor in many of the medical conditions associated with high-risk pregnancy – especially diabetes, kidney disease and lupus – is pre-eclampsia.


Teresa G. Berg, M.D., a board-certified maternal/fetal medicine specialist at UAMS Medical Center, has the professional training and experience necessary to deal with high-risk pregnancies.

For more information about the Arkansas High-Risk Pregnancy Program at UAMS Medical Center, call 501-686-5847 or visit www.baby.uams.edu. To make an appointment, call 501-296-1800.
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“Pre-eclampsia is sometimes called toxemia of pregnancy and occurs in 5 percent of pregnant women,” Dr. Berg says. “This condition is characterized by high blood pressure, an abnormally high level of protein in the urine, and swelling of the face and hands due to retention of fluid. The increased blood pressure develops because of an inadequate supply of blood – and, therefore, oxygen – to the placenta. In an attempt to obtain more blood, the fetus forces the mother’s blood pressure to go up. Possible results of untreated pre-eclampsia are seizures, growth retardation of the fetus, premature separation of the placenta and stillbirth.”

The Arkansas High-Risk Pregnancy Program offers a full range of inpatient and outpatient services to manage complications. It also provides several diagnostic services:

Together, high-resolution ultrasound – which uses sound waves to examine the structure and function of the fetus – and color flow Doppler – which shows blood flow distribution in the baby’s tissues – help the physician identify fetal abnormalities.

Amniocentesis employs ultrasound to guide a needle through the woman’s abdominal wall and withdraw some of the amniotic fluid that surrounds the fetus; these fluid samples are most commonly used for genetic (DNA and chromosome) analyses.

In percutaneous umbilical blood sampling, an ultrasound-guided needle through the mother’s stomach and into the fetal umbilical vein enables the physician to obtain blood from the baby; in intrauterine fetal transfusion, blood is given to the baby by the same means.(Both procedures are exclusive to UAMS Medical Center in the state.)

Antenatal testing surveys the fetus in nonstress and contraction-stress situations. 

UAMS Medical Center’s Labor and Delivery Unit and Neonatal Intensive Care Unit (NICU) are two more important components of the Arkansas High-Risk Pregnancy Program. The Labor and Delivery Unit is equipped to monitor continuously patients’ vital statistics via a state-of-the-art computer station and to handle special cases and emergencies.

“For patients who need Cesarean sections or who develop problems during labor and delivery, there are two operating rooms and two technologically advanced, neonatal resuscitation rooms on the unit,” Dr. Berg says. “After total resuscitation, infants who are at high risk of complications remain in the resuscitation rooms until we stabilize them.  We then transfer them to the NICU.”

Through its affiliation with Arkansas Children’s Hospital, the NICU draws on the knowledge and skills of several board-certified neonatologists. The unit has superb control over noise and lighting – factors that reduce the chances of intraventricular hemorrhaging (bleeding in the brain), a common risk that premature babies face. The NICU also contains the most up-to-date mechanical ventilation equipment.

 “At birth, premature infants usually can’t breathe on their own,” according to Dr. Berg.  “Our high-frequency ventilators that breathe up to 900 times per minute – compared to 60 to 80 times per minute for conventional ventilators – help these tiny babies survive.”

Once premature and seriously ill infants are well enough to go home, the NICU’s two reacquaintance rooms make the transition from hospital to home easier. These rooms allow parents to spend the night with their babies and receive instruction in caring for them. Training includes cardiopulmonary resuscitation (CPR) – an important skill, especially since premature infants have a higher risk of developing heart problems and sudden infant death syndrome (SIDS).

In the University HealthSystem Consortium’s recent neonatal study of 30 U.S. academic medical centers, the NICU at UAMS Medical Center was named as a “Better Performer.”  The study involved newborns under 2 pounds, 3 ounces, who had been admitted to the NICU due to extreme prematurity or other pre-term diagnostic conditions (such as pulmonary, neurological and gastrointestinal complications). The study looked at several factors, including the medical and nursing management of the infants and the outcomes of that care.  

Carolyn M. Riggan

Links on This Page

New High-risk OB: http://www.uams.edu/today/112901/lowery.htm
Program Helps: http://www.uams.edu/today/051701/infertility.htm
UAMS Helps: http://www.uams.edu/today/032901/telemed.htm
UAMS Medical Center: http://www.uams.edu/medcenter/
Arkansas Children’s Hospital: http://www.ach.uams.edu/

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