The pregnancy process is a special period for every expectant mother; however, some pregnancies may involve additional risk factors for the mother or the baby. In such cases, perinatology, the branch of science dealing with high-risk pregnancies, comes into play to protect the health of both the mother and the baby. Perinatology is an advanced sub-specialty of obstetrics and gynecology that specifically deals with the diagnosis, follow-up, and treatment of high-risk pregnancies.
What is Perinatology?
Perinatology is the branch of science that evaluates the development, health, and genetic structure of the baby in the womb using advanced imaging methods, while also managing medical issues in the expectant mother that may affect the pregnancy. A perinatologist (maternal-fetal medicine specialist) is a physician who has completed additional sub-specialty training in this field following their residency in obstetrics and gynecology.
Working Principle
In perinatology practice, advanced ultrasound devices, Doppler imaging, fetal echocardiography, and invasive tests are used in combination. The goal is to detect structural and genetic anomalies in the baby at an early stage, manage chronic diseases in the expectant mother in a way that is compatible with pregnancy, and ensure a safe delivery.
In Which Situations is Perinatology Follow-up Required?
Not every pregnancy requires perinatology follow-up; however, a perinatologist evaluation is recommended in the following cases:
- Advanced maternal age (generally over 35)
- History of recurrent pregnancy loss and miscarriage
- History of anomalies, stillbirth, or preterm birth in a previous pregnancy
- Multiple pregnancies (twins, triplets, etc.)
- Chronic diseases in the expectant mother such as diabetes, hypertension, thyroid, kidney disease, or heart disease
- Pregnancy-specific diseases such as gestational diabetes or preeclampsia (pregnancy poisoning)
- Pregnancies with high-risk screening test results
- Suspicion of structural anomalies in the baby on ultrasound
- Family history of genetic diseases
- Rh incompatibility and blood group incompatibilities
- Intrauterine growth restriction or abnormalities in the baby's amniotic fluid
Methods Used in Perinatology
Perinatology offers a wide range of diagnostic and treatment methods:
- Evaluation of all the baby's organs with detailed ultrasonography
- Early risk assessment with 11-14 week screening (nuchal translucency, NT)
- NIPT (non-invasive prenatal test) performed from maternal blood
- Examination of the baby's heart structure with fetal echocardiography
- Evaluation of placental and fetal circulation with Doppler ultrasound
- Invasive genetic tests such as chorionic villus sampling (CVS) and amniocentesis
- Cordocentesis (sampling blood from the umbilical cord)
- In-utero treatments such as intrauterine transfusion
- Special follow-up protocols for multiple pregnancies
Advantages of Perinatology
- Early detection of structural and genetic anomalies
- Anticipating conditions that threaten maternal and fetal health
- Evaluation of in-utero treatment options when necessary
- Planning the mode and timing of delivery based on scientific data
- Reducing complication rates in high-risk pregnancies
- Providing comprehensive genetic counseling to the family
- Advance preparation for neonatal intensive care that may be needed after birth
Follow-up Process
Perinatology follow-up is carried out with a program determined according to the risk and gestational week of the pregnancy. During the initial evaluation, the expectant mother's medical history, family history of genetic diseases, previous pregnancies, and current complaints are questioned in detail.
Stages of Pregnancy
First trimester (weeks 1-13): Early ultrasound, nuchal translucency measurement, and screening methods such as the double test or NIPT are applied.
Second trimester (weeks 14-27): The baby's organs are examined in detail with a detailed ultrasound, fetal echocardiography may be performed, and invasive tests are recommended if necessary.
Third trimester (weeks 28-40): The baby's development and placental functions are monitored with Doppler evaluations; the mode and timing of delivery are planned.
Points to Consider
- It is of great importance not to miss check-ups in high-risk pregnancy follow-up
- All medications used by the expectant mother, chronic diseases, and previous medical history must be reported to the physician
- Smoking, alcohol, and medications not recommended by the physician should be avoided
- Balanced nutrition, appropriate weight gain, and vitamin supplementation recommended by the physician are important
- In case of severe headache, visual impairment, intense abdominal pain, vaginal bleeding, or a decrease in fetal movements, one should apply to the hospital without delay
- Results of genetic tests must be interpreted by an expert perinatologist
Difference Between Perinatology and General Obstetrics Follow-up
A general obstetrics and gynecology specialist can successfully manage the routine follow-up of healthy pregnancies. However, some pregnancies require more advanced evaluation due to the mother's chronic diseases, structural anomalies in the baby, or genetic risk factors. This is where the perinatologist steps in; they plan the follow-up according to the risk of the pregnancy, perform in-utero interventions if necessary, and manage the delivery process with a multidisciplinary team.
Perinatology does not just provide a diagnosis; it also provides genetic counseling, psychological support, and postpartum care planning for the family. In this way, the goal of a healthy delivery can be safely reached even in high-risk pregnancies.
Frequently Asked Questions
- Is a perinatologist evaluation necessary in every pregnancy? No; it is only recommended for pregnancies carrying risk factors.
- When are invasive tests performed? They are planned when screening tests show high risk or when there is a suspicion of structural anomaly.
- Are multiple pregnancies followed by a perinatologist? Since multiple pregnancies are considered high-risk, perinatology control is recommended.
- Is postpartum follow-up also provided? When deemed necessary, the condition of the mother and baby is monitored in the postpartum period as well.
Multidisciplinary Approach in Perinatology
The successful management of high-risk pregnancies is not limited to the perinatologist alone. A multidisciplinary approach where pediatric cardiology, pediatric surgery, genetics, endocrinology, neurology, and neonatal intensive care specialists work together is essential. A pediatric cardiologist is involved in cases of heart anomalies detected in the womb, and a geneticist is involved in cases of suspected metabolic disorders.
This teamwork makes decisions taken throughout the pregnancy safer and ensures that the treatment the baby may need after birth is planned in advance. Rather than a one-time examination, follow-up that continues throughout the process also contributes significantly to the family's correct information and psychological support. Modern perinatology makes it possible to approach even high-risk pregnancies with hope by combining science and compassion.
Perinatology at Koru Hospital
As Koru Hospital, we offer a holistic approach that prioritizes the health of the mother and baby with our experienced perinatology team in the management of high-risk pregnancies, our advanced ultrasound devices, genetic laboratory, and neonatal intensive care infrastructure. We evaluate every pregnancy within its own conditions; we aim for a healthy pregnancy and a safe delivery through accurate diagnosis, careful follow-up, and multidisciplinary treatment when necessary.
