For most parents, the thought of having a high-risk pregnancy is scary and stressful. While it certainly is a cause of caution and concern, the truth is that there are a wide range of situations that are labelled a “high risk pregnancy”. Understanding the classification and the care involved is important, not only to prepare, but to reduce the risk.
Toledo Area Parent asked local Maternal Fetal Medicine experts for their answers regarding this important issue — Shiraz Sunderji, MD (The Toledo Hospital), Claudel Jean-Pierre, MD, and Sriram Perni, MD (Mercy St. Vincent Hospital).
What is a high-risk pregnancy and the practice of Maternal Fetal Medicine?
Perni: There is no definition of a high-risk pregnancy. In general, it is a medical or obstetrical complication that is outside of what is considered “normal”.
Sunderji: Maternal Fetal Medicine is a subspecialty of Obstetrics and Gynecology. It is a team effort of different groups specializing in related areas, working together to provide the best care for the woman in a high-risk pregnancy.
Perni: It’s a team approach. We work with genetic counselors, pediatric surgeons, neonatalogists, etc. We even help connect patients with local nonprofit groups.
When should I see a Maternal Fetal Medicine physician?
Sunderji: There are several sources through which patients seek our care. The most common is through the maternity health care provider. Others are referred by medical specialists who may be taking care of a woman who may have a medical disease and is considering a family. The third group is highly educated patients who may have some concerns — of health, of a pregnancy that is coming “later in life”, etc. — they are testing to ensure that their unborn baby is in perfect health.
What are some common complications associated with high-risk pregnancies?Sunderji: The most common problems are the prevention of prematurity, medical diseases during pregnancy, diabetes, and high blood pressure.
Perni: Some medical complications include high blood pressure, pre-gestational diabetes, thyroid problems, lupus, and multiple gestation (twins, triplets, etc.).
Do I have to give up my primary maternity care provider if I have a high-risk pregnancy?
Jean-Pierre: We want people to be aware that high-risk physicians are consultants. We coordinate care, so that the patient can continue to visit and deliver with their OB GYN.
Sunderji: We work closely with the primary maternity care provider. The patient may come to us just once to make a plan, or may be seen by us periodically. In rare circumstances, we may deliver the baby.
What services are available to patients with high-risk pregnancy?Sunderji: The testing is tailored to the needs of the patient. We can perform an ultrasound to ensure the embryo is growing in the right place and it is the right size. Blood tests tell us if the patient is in a high-risk group. After that we can offer testing that would provide diagnosis regarding the unborn baby.
Perni: The services provided depend on the individual situation. At 11-14 weeks, we can perform a first trimester screening to look for defects. Other services include detailed ultrasounds and blood work. We monitor breathing, movement, and the fluid around the baby. At 32 weeks, we can perform a fetal monitoring nonstress test.
What can an expectant mother do to help reduce her chances of having a high-risk pregnancy?
Sunderji: All women desiring pregnancy should think of it as a 10 month condition, including the 4 weeks before they get pregnant and then the 9 months until delivery. Women should be in the best health they can possibly be — they should be up-to-date on immunizations, screened by their family physician to uncover diseases that may need attention, and have their medication modified.
Perni: For optimal health, women can have pre-conception counseling 1-3 months before pregnancy to be evaluated. Fifty percent of pregnancies are unplanned, which means that often women are not in optimal health at the time of pregnancy.
Jean-Pierre: We always advise women to see their regular physician before becoming pregnant. Also, women should take folic acid up to three months before becoming pregnant to reduce the risk for birth defects.
For more information regarding the Maternal Fetal Medicine services provided by Dr. Sunderji at The Toledo Hospital or Dr. Jean-Pierre, and Dr. Perni at Mercy St. Vincent Hospital, visit
local health spots
Mini Motions Dance Center
2249 Tremainsville Rd.
Dance for health
Sue Hays has been bringing the joy of dance to Toledo for over 18 years at Mini Motions Dance Center. Locally owned and operated, she and her team of experienced instructors offer a wide variety of techniques, catering to dancers of all skill and age levels. Their combined 50 plus years experience helps students reach their goals. Sue offers classes in everything from Tap, Jazz, Ballet, Tumbling, Ballroom, and many others. Students range in age from 12 months to 80 years young. Private instruction is available, and classes are forming now. Visit us online for more information. Keep on dancing!
2219 W. Laskey Rd.
Kicking off the new year
Start out the New Year with self confidence and physical fitness in Martial Arts classes, beginner through advanced in Karate, Boxing, Kick Boxing and Swordsmanship. Train with Master A.K. Geelani, 7th Degree Black Belt and Hall of Fame Master of Swordmanship and Karate. Certified to teach children with ADHD, Asperger’s Autism and Attention Deficit Disorder. Martial Arts supplies and apparel also available. Please call 419-473-7777 or visit our website at www.japankarateacademy.com for more information. We are also looking for a Yoga and Tai Chi instructor. Please contact Collen Morden, Program Director.
Toledo Vision Therapy
2600 North Reynolds Rd.
A better view
According to the American Optometric Association, 1 out of 4 children struggle with reading because of vision problems that are missed in vision screenings. Over 60% of children who have difficulty with school have vision problems that have not been identified.
Vision problems are often missed because people think that seeing 20/20 on the eye chart is enough. In fact, that is only one of 17 visual skills that are critical for academic success. Just because your child can see the eye chart doesn’t guarantee that they can see well enough up close for the length of time required to do schoolwork.
To be sure your child has all the visual skills required for reading, schedule a developmental vision evaluation (this is different than a regular eye exam and typically performed by a Developmental Optometrist).
For more information please call Dr. Zigulis at
419-578-4322 or visit www.toledovisiontherapy.com.
Mercy Health Partners
Healthy, active kids
As part of the ongoing mission to improve the health and wellness of children throughout the community, Mercy Children’s Hospital and Kohl’s department stores are proud to offer the Kohl’s Kids in Action program – designed to provide parents and other caregivers with practical advice on raising healthy children. Kohl’s Kids in Action offers support and guidance for individuals to foster positive behaviors in the health of children, targeting nutrition, physical activity, sleep and hydration.
By keeping active, children and adults lead healthier lives. Fun, physical winter activities don’t have to cost a lot of money and can be great ways to spend time together as a family.
Here are a few activities you and your child can do indoors to keep active and healthy:
•Run in place or do exercises such as pushups or jumping jacks while watching television.
•Limit TV, computer and video game usage to less than two hours per day.
•Turn on some groovy music and dance the night away!
•As a family, go to the mall, the art museum or to the Zoo to walk and stay warm.
To request additional information about keeping your child healthy, please call Mercy HealthLink at 419-251-4000 or visit us online at www.mercyweb.org/childrens.
American Mobile Fitness
5133 Main St., Sylvania
Fitness wherever you are
American Mobile Fitness brings degreed and certified personal trainers and licensed massage therapists right to your home and office. They give you a individualized workout that will produce the results you are looking for. Now serving Ann Arbor, Adrian, Blissfield, Dundee, Lambertville, Monroe, Tecumseh, Ypsilanti and surrounding areas in Michigan.
With the Virtual Trainer, you can workout in the comforts of your own home, live, real time, with a certified personal trainer. This is a brand new innovation of personal training. American Mobile Fitness brings the trainer right into your home, giving you a custom designed workout every time. We watch you to make sure you are the doing the exercises correctly for the most effective workout to get the best results to meet your goals.
Call us today and set up your free consultation and fitness assessment, personal training session, massage or cardio workout!
Sensory Learning Center
3454 Oak Alley Court
Take control of vision problems
Poor concentration, restlessness and frustration in the classroom are all too often unnecessarily labeled ADD/ADHD. Children who have to spend an excessive amount of energy to make sense of what it is they are trying to read tend to lose interest in the task at hand. As a result, they can be inattentive and disruptive. Many vision related learning issues have the same symptoms as ADD/ADHD. Dr. Jeffrey Schmakel offers FREE workshops for parents to learn how a child’s vision can affect learning and behavior. The next FREE workshops are on Tuesday, January 12, 2010 and Tuesday, February 16, 2010, at our office located at 3454 Oak Alley Court, Toledo, OH 43606. Call today to reserve your spot, 419-578-0057.