Photo by Lynn Margalit/Margalit Studio

High-risk pregnancy at Summa Health


Published: 07/01/2016

by Patricia Nugent

The Maternal-Fetal Medicine Department at Summa Health is one of a handful of Level III prenatal centers in the region that provides the highest level of care, especially to the six to eight percent of pregnancies that are high risk.


“From preconception to pregnancy to delivery, we do everything within our power to produce the best possible outcome,” says Dr. Michael Cardwell, who works with Dr. Angela Silber, chief of Maternal-Fetal Medicine. “In addition to addressing patients with risk factors such as diabetes and hypertension, we are also one of the few centers in Ohio that focuses on treating mothers with substance abuse issues.”


Drs. Cardwell and Silber work within a multidisciplinary team of other obstetricians/gynecologists, midwives, endocrinologists, hematologists and neonatologists to ensure mother and baby get the best level of care. They deliver more than 1,000 new patients each year.


New Procedures For Specialized Care

“For many years, amniocentesis was the test of choice to determine chromosomal abnormalities,” says Dr. Cardwell. But with new highly specialized diagnostics, such as chorionic villus sampling and percutaneous umbilical blood sampling to diagnose genetic conditions and blood disorders, he reports that over the past five years they’ve seen a 75 percent reduction in amniocentesis.


“Ultrasound is also instrumental in discovering abnormalities by surveying fetal anatomy, especially around 18-22 weeks,” he says. 


If it’s discovered that a baby’s and mother’s blood are incompatible, the doctors can give the baby a lifesaving blood transfusion in-utero directly through the umbilical cord.


Another potentially serious complication of pregnancy is placenta previa, where the placenta implants itself into a lower portion of the uterus (normally it would implant in the upper part of the uterus). It occurs in about one in 200 pregnancies and can cause placental bleeding, premature separation from the fetus and pre-term delivery.


Oftentimes, high-risk pregnancies require urgent medical care. Summa is also tops in hospital-to-hospital maternal transports.


“We have a network of hospitals that send us their high-risk patients,” he says. “For instance, last night I cared for a patient in pre-term labor. Most of the time we are able to stop the labor from progressing. But if not, we are fortunate to have a Level III nursery designed to care for premature babies.”


Sound Pre-Natal Care Makes a Difference

A myriad of factors can contribute to what may become a high-risk pregnancy, including advanced maternal age of 35 or older, and lifestyle choices such as smoking, alcohol and drug use. Often a medical condition that’s present before the pregnancy, such as diabetes, high blood pressure and epilepsy, can cause risk.


“If a patient is thinking about becoming pregnant and suffers from any chronic medical condition, we recommend she make a preconception appointment,” he says. “That way we can consult on steps she can take to be in the best possible health to prepare for the pregnancy. Then once a woman conceives, in addition to a healthy diet and prenatal vitamins, prenatal visits, monitoring and screening can further prevent complications from arising.” 


Summa Health is an integrated healthcare delivery system that provides coordinated, value-based care to more than one million patients each year and is consistently ranked one of the top healthcare providers in the country. Referrals to the Maternal-Fetal Medicine Department are welcome, just call 330-535-1143.