Newsletters

Family Health Magazine - Spring/Summer 2002

Physicians Provide Advanced Care for
High-Risk Pregnancies

Edward Wolf, MD, Dom Terrone, MD, Richard Miller, MD. Front Row: Wendy Warren, MD, Leon G. Smith, Jr., MDFirst diagnosed with Type 1 diabetes at age ten, Cheryl Meidling grew up believing that she could never give birth to a healthy baby. The American Diabetes Association reports that as recently as 20 years ago, women with diabetes were often advised to avoid having children due to the risk of birth defects for the baby and complications for the mother.

“I realized that if I was going to try to have a healthy baby, I needed the diabetes to be well controlled before I became pregnant,” says Mrs. Meidling. “It was all in my hands.”

In Type 1 diabetes, the body does not produce insulin, a substance necessary for the human system to use sugar. When sugar accumulates, it can damage the eyes, kidneys, nerves or the heart. In the same way that high blood sugar can cause complications for the mother, it can also cause birth defects for her baby.

Careful Prenatal Planning
In 1996, Mrs. Meidling worked closely with Robert Melfi, M.D., endocrinologist with the Endocrine and Diabetes Group at the Saint Barnabas Ambulatory Care Center, an affiliate of the world renowned Joslin Diabetes Center, to tightly control her blood glucose levels, and was referred to physicians who checked the health of her eyes, heart and kidneys. Next, she met with the perinatologists at the Division of Maternal-Fetal Medicine to create a prenatal plan. This plan included prenatal vitamins, folic acid and tight monitoring of her blood sugars.

“It is crucial for diabetics to control their blood glucose levels prior to conception and during early pregnancy to help prevent birth defects and lower the risk of miscarriage,” says Richard Miller, M.D., Associate Director of Maternal-Fetal Medicine.

“When diabetes is well controlled, the risk of birth defects drops from 17 percent to 3 to 5 percent, which is the same as Cheryl Meidlingthat of women who do not have diabetes,” he relates.

A Closely Watched Pregnancy
After controlling her diabetes with the help of an insulin pump, Mrs. Meidling became pregnant and monitored the health of the baby with the assistance of the perinatologists and their varied diagnostic tools, including ultrasound.

“At first I was afraid something was going to be wrong with the baby, but the doctors kept a very close watch over my pregnancy,” she says. “I felt very secure and was impressed by the care I received.”

Mrs. Meidling checked her blood sugar levels with a home blood sugar monitoring system performed seven to nine times each day.

After many months of careful planning and diligent monitoring, Mrs. Meidling delivered a healthy 6 pound, 14 ounce baby boy named Matthew on February 1, 1997. With the help of the Division of Maternal-Fetal Medicine, Mrs. Meidling and husband, Richard, continued to enlarge their family with the birth of 7 pound, 9 ounce Sean on July 6, 1999 and 7 pound, 10 ounce Justin born on November 25, 2001.

“When we saw each of our perfect babies we were just so thankful,” Mrs. Meidling says. “I was in shock because I never thought I would be able to have children. The hard work and numerous doctor visits and tests had finally paid off. Maternal-Fetal Medicine helped me to deliver three healthy babies. The entire staff was wonderful and I would recommend them to anyone.”

Maternal-Fetal Medicine
The members of the Division are extensively trained experts in the field of perinatal medicine and the treatment of women who anticipate or are experiencing a high-risk pregnancy. High-risk pregnancies can be managed with both special testing and procedures.

Care beginning in the months prior to pregnancy or during the pregnancy can include advanced diagnostics (including ultrasound, amniocentesis and chorionic villus sampling); direct fetal assessment (including invasive procedures such as intrauterine therapies and fetal surgeries); and genetic counseling and education.

The medical team consists of perinatologists, perinatal nurses, ultrasonographers and genetic counselors with extensive training in high-risk pregnancy care. The perinatologists are board-certified in obstetrics and gynecology, as well as maternal-fetal medicine. They serve as consultants to physicians in managing a complicated pregnancy, and assist obstetricians in the tri-state area in the care of high-risk patients.

For an appointment with the Division, please call
(973) 322-5287
.

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