High-risk obstetric problems may involve medical conditions that existed prior to pregnancy, conditions that develop during pregnancy, or problems involving the current pregnancy. An obstetrician may request a perinatologist’s review of a patient’s medical history with the patient and her family. After the consultation, a recommendation for care is forwarded to the referring obstetrician for review with their patient.

Genetic counseling may be recommended for families with a history of birth defects, mental retardation, or other potential genetic problems. All patients referred for consideration of an amniocentesis or chorionic villus sampling (CVS), will have the opportunity to discuss their situation with a genetic counselor for a birth defect risk assessment and a discussion of the procedures.

Fetal ultrasound is a test performed during pregnancy that uses reflected sound waves to produce a picture of the baby, the placenta, and the amniotic fluid. The picture is displayed on a small screen and the images (sometimes called sonograms, echograms or scans) are usually saved as part of the baby’s record. Ultrasound is the safest way to check for problems and get information about your baby, such as its size and position. It does not use X-rays or other types of radiation that may harm a developing baby. It can be done as early as the fifth or sixth week of pregnancy.

Noninvasive prenatal testing (NIPT) is a blood test drawn in the office that examines your baby’s DNA in the mother’s blood to assess a risk for Down syndrome, extra copies of chromosomes 13 and 18, sex chromosome abnormalities and determines the baby’s gender. Noninvasive prenatal testing might help avoid the need for further tests that could put a pregnancy at risk for miscarriage.

Amniocentesis is a prenatal screening test in which a small amount of amniotic fluid is removed from the sac surrounding the baby for testing. The sample of amniotic fluid, usually less than an ounce, is removed through a fine needle inserted into the uterus through the abdomen, under the guidance of ultrasound technology. Once removed, the fluid is sent to a laboratory for analysis. A number of different tests can be performed on a sample of amniotic fluid, depending on the genetic risk and the nature of the need for the test.

As part of a woman’s prenatal care, her obstetrician may require a non-stress test. This test is used to check the well-being of the developing baby. Reasons for requesting such a test include evaluating the health of babies of mothers with diabetes, high blood pressure, preterm labor, pregnancy past the due date, abnormal fetal growth, and a decrease in the baby’s movements. The test is a simple, painless procedure where a fetal monitor is placed on the mother’s abdomen to record the baby’s heart rate and movement.

This nuchal translucency scan, or NT test as it is more commonly known, can help the obstetrician assess a baby’s risk of having Down syndrome, other chromosomal abnormalities, or major congenital heart problems. The NT test uses ultrasound to measure the clear (translucent) space in the tissue at the back of the developing baby’s neck, and must be done between 11 and 14 weeks of pregnancy. This test is accompanied by a blood test which analyzes the blood for two specific hormones that are present in the blood of pregnant women. Though the NT test cannot confirm diagnosis, the combined results can estimate the level of risk for these conditions.