Maternal Fetal Medicine

• Fetal diagnosis and treatment
• Prenatal genetics
• Fetal movement counts

High-risk obstetric care is directed by a staff perinatologist and assisted by the clinic staff. An advanced practice nurse with certification in the care of patients with diabetes mellitus works closely with physicians in the High Risk Obstetrics Clinic. Care is offered to patients with medical problems which complicate pregnancy, such as:

• Diabetes (or other endocrine disorders).
• Hypertension
• Cardiovascular problems
• Uterine abnormalities
• Neurological problems
• Musculoskeletal disorders
• Cancer
• Incompetent cervix
• Preterm labor
• Multiple gestations
• Preeclampsia
• Intrauterine growth retardation
• History of previous complications.

Care includes:

• Ongoing medical evaluation and treatment
• Nursing evaluation of patient educational needs
• Diabetic evaluation, education, monitoring, and management. Glucose tolerance tests are performed for monitoring.
• Dietary consultation services as needed
• Social service counseling as needed
• Nonstress tests (antenatal testing for fetal well-being)
• Postpartum evaluation

University of Iowa Hospitals and Clinics is the sole tertiary health care center for the State of Iowa, and referrals also come from out of state. The staff consists of full-time faculty in the UI Carver College of Medicine, and so the complete patient population is available for teaching and clinical research.

The Division of Maternal-Fetal Medicine presently includes five board certified maternal-fetal specialists. These doctors specialize in high risk obstetrics. They are:

• Jennifer R. Niebyl, M.D., (Department Head)
• Asha Rijhsinghani, MD
• Jerome Yankowitz, MD, (Yankowitz is also board certified in clinical genetics)
• Frank J. Zlatnik, MD
• Stephen K. Hunter, MD, PhD
• Roger A. Williamson, MD, double boarded in Genetics and Obstetrics, is also a member of the Division.

Fetal diagnosis and treatment

The multidisciplinary Fetal Diagnosis and Treatment Unit is directed by staff perinatologist and obstetric geneticist, and assisted by a nurse clinician and RNs. Patients are referred by a local physician or from one of the UI Health Care obstetric Clinics.

Services include:

• Specialized ultrasound testing to rule out anomalies
• Cordocentesis
• Intrauterine transfusion (IUT) for Rh disease and other disorders
• Fetal therapy-i.e., shunts in fetal bladder or chest
• Fetal blood sampling
• Counseling services for families regarding options for treatment, follow-up, and future childbearing

The majority of level II scans, anomaly consultations, and interventional fetal procedures in Iowa are performed by this unit. Many cordocenteses and intravascular transfusions are performed each year.

All obstetric scans are supervised and interpreted by board-certified obstetricians, maternal fetal medicine specialists, or geneticists with extensive ultrasound expertise and experience in fetal anomalies and intrauterine treatment. State of the art imaging modalities include power and color Doppler and others.

The Obstetrics and Gynecology Ultrasound Program is certified by American Institute of Ultrasound in Medicine (AIUM).

Prenatal genetics

State-wide screening

Genetic care in the state is regionalized, and when indicated, the patient is referred to e University of Iowa Health Care. The section of Obstetrical Genetics consists of Roger A. Williamson, MD, (director) and Jerome Yankowitz, MD The Genetics Clinic is a part of the Department of Obstetrics and Gynecology and it enjoys a close working relationship with the Division of Medical Genetics in the Department of Pediatrics.

Clinic is directed by a staff obstetric geneticist, nurse clinician, genetics counselor, and assisted by nurses and nurse assistants. Services include:

• Genetic counseling for couples with a family history of a known genetic problem
• Second trimester amniocentesis for fetal chromosome evaluation
• Chorionic villi sampling
• Counseling for parents with an abnormal fetus regarding options, follow-up, and future childbearing
• Consultation with physicians regarding patient status and care
• Postpartum counseling

Serum screening

A statewide maternal serum-screening program is regionalized by the central State Hygienic Laboratory by statute. Williamson is the physician coordinator for the program.

As a statewide program, services include:

• Education of local obstetricians and nurses regarding multiple marker screening via correspondence and presentations
• Contacting local physicians with abnormal test results and making recommendations for patient follow-up
• Counseling services for patients with abnormal test results
• Full range of follow-up options to patients with abnormal fetuses
• Frequent communication with the Foundation for Blood Research at Scarborough, Maine, for quality assurance

Quadruple hormone screening is now offered and more than 14,000 women are screened each year.

Scheduling: 319-356-8892

Fetal Movement Counts