State-of-the-Art Services
Since its inception, our perinatal practice has strived to be the leader in obstetrical ultrasound in Central Pennsylvania. We were the first diagnostic ultrasound center to introduce the revolutionary 3D/4D obstetrical ultrasound imaging to the Harrisburg area. 3D ultrasound imaging is a valuable tool in the prenatal assessment of the fetal anatomy. It has enabled us to obtain views of your baby’s anatomy not possible with previous technology. It also allows us in some situations to provide better communication with you concerning your pregnancy by visually understanding any underlying issues involving your baby.
The services we provide to patients, their families, and our referring obstetrical providers are listed below. Many times all of our services may be used to assist in the management of your pregnancy. Our credentials for the provision of these services include the distinction of being accredited by the American Institute for Ultrasound in Medicine (AIUM). The following are the main services we provide on a regular basis:
Ultrasounds
There are many types of prenatal ultrasounds that may be performed during the course of a pregnancy. The following are examples.
Evaluation of Fetal Development, Position, Amniotic Fluid (Level 1)
This type of ultrasound is usually performed after you have had the initial full anatomical evaluation of your baby and follow-up evaluation is recommended. In some cases your doctor or midwife may be concerned about the baby’s position and/or size and will request an ultrasound evaluation of your baby’s growth pattern.
Genetic Anatomical Ultrasound (Level 2)
Detailed evaluation of the fetal anatomy including measurements of the head, body, and extremities as well as careful observation of any structures able to be visualized by ultrasound. Routinely performed after 18 weeks of pregnancy, the anatomical evaluation can also be used to make a genetic risk assessment for your pregnancy in conjunction with any other genetic screening you may have had earlier in the pregnancy.
Fetal Echocardiography
This type of ultrasound entails special ultrasound imaging of the heart and its major vessels, including blood flow studies (Doppler). Our perinatal center performs fetal echocardiography beginning in the second trimester. This procedure is not necessary for every baby as the heart is extensively evaluated during the anatomical ultrasound. A fetal echocardiogram may be offered if a physician feels that further study of the baby’s heart is necessary due to risk factors in your history (medical or family). An echocardiogram may be recommended if there is a suspected fetal abnormality during your anatomical ultrasound.
Transvaginal Ultrasound
An ultrasound performed through placement of a slim ultrasound probe vaginally. This is recommended for better visualization of the baby in early pregnancy. This ultrasound evaluation is especially useful in patients with cramping, spotting or preterm contractions. It allows for an accurate measurement of your cervix and determines your risk for preterm delivery.
Biophysical Testing
Assessment of the baby’s well-being by observation of specific fetal movements and the amniotic fluid level.
3D Ultrasound Imaging
Provides a more detailed evaluation for certain parts of the fetal anatomy for suspected fetal abnormalities such as cleft lip, cleft palate and spine abnormalities (i.e. spina bifida).
Ultrasound Assessment of the cervix
Internal ultrasound especially useful in patients at risk for preterm delivery.
Biophysical Testing
Assessment of the baby’s well-being by observation of specific fetal” movements and the amniotic fluid level.
First Trimester Screening (FTS)
Using a combination of ultrasound measurements, maternal age, and maternal serum biochemical markers, about 90% of babies at risk for Down syndrome and Trisomy 18 can be detected.
Screening takes place between approximately 11 and 14 weeks of pregnancy*. The screening in the first trimester is unique from screening typically done in the second trimester as it involves a combination of ultrasound (nuchal translucency [NT]) and a blood test in conjunction with your maternal age. The results of the First Trimester Screen will then be discussed with you as to whether you desire more definitive testing (i.e. CVS or amniocentesis). Our practice is one of the few centers in central Pennsylvania certified to perform First Trimester Screen utilizing NT measurements.
*The gestational ages listed are an estimate of the time to have FTS. The actual criteria for performing FTS is dependent on the crown-rump measurement (CRL) at the time screening is performed.
Procedures & Treatments
- Chorionic Villus Sampling
- Amniocentesis
- Percutaneous Umbilical Sampling
- First Trimester Screening
- Heparin teaching
- 17-alpha hydroxyprogesterone caproate (17P) Therapy for history of preterm delivery (dependent on reasons and timing of preterm delivery)
- Insulin teaching
Chorionic Villus Sampling (CVS)
Procedure to obtain sample of placental tissue that can be used for genetic testing and chromosomal analysis. This diagnostic test is performed between 10-13 weeks of pregnancy. At our office, CVS is performed either by placing a thin needle through a woman’s abdomen or a narrow catheter through the woman’s cervix (with speculum exam). Ultrasound guidance is used during the procedure and a small tissue sample of placenta is collected. The risk of complications after a CVS is less than 1 in 200 (0.5%).
Amniocentesis
A procedure to obtain amniotic fluid that can be used for genetic testing, analysis for infection, or to check the baby’s lung maturity status. Genetic amniocentesis is typically performed between 15-21 weeks of pregnancy although can be performed later in pregnancy if indicated. Amniocentesis may also be used to evaluate fetal lung maturity or the presence of infection in the pregnancy. At our perinatal center, the risk of complications after an amniocentesis is less than 1 in 500 (0.2%).
Percutaneous Umbilical Blood Sampling (PUBS) In Utero Transfusion
Sampling of the baby’s blood via the umbilical cord while still in utero that can be used for genetic testing and diagnosis of hematic diseases. In some cases, direct treatment of the baby for certain hematic diseases can be performed during pregnancy.
Heparin teaching
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17P Therapy for history of preterm delivery
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Insulin Teaching
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Consultations
Pre-Pregnancy Consultation
The perinatologists and clinical staff at our perinatal center are available to discuss various conditions that may pose a risk to a future pregnancy of patients or couples wishing to get pregnant.
Genetic Counseling & Testing Services
Maternal Fetal Medicine of Central PA offers prenatal and preconception genetic consultation and testing. Our certified genetic counselors provide information about conditions that could affect a pregnancy. Genetic counselors have specialized training which allows them to explain to patients and their families medical information regarding the diagnosis or potential occurrence of a genetic condition or birth defect.This may include etiology, natural history, inheritance, disease management and potential treatment options. Genetic counselors promote patient-specific decision making involving genetic screening or testing in an unbiased, non-coercive manner that respects the patient’s beliefs and autonomy
High Risk Pregnancy Management
Clinicians at our perinatal center provide consultation to local obstetricians and their pregnant patients regarding maternal health issues and fetal concerns.
Co-Management for Maternal Disorders
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Consultation with other Specialists
Availability of pediatric cardiology and pediatric surgery are examples of the consultative resources available for you during pregnancy.
