High-risk pregnancy care

A high-risk pregnancy means you have certain health conditions that may lead to complications during your pregnancy or delivery. But with specialized maternity care, many people with high-risk pregnancies deliver healthy babies.

We offer advanced high-risk pregnancy services at Penn Medicine. Our specialists, including maternal-fetal medicine experts, have years of experience and training in difficult pregnancies. They provide pregnancy care and support for you and your baby before, during, and after your pregnancy journey.

When needed, we coordinate your care with other medical specialties to protect your and your baby’s health. You have access to advanced diagnostic services, genetic counseling, and 24/7 emergency care. We also provide the highest quality care for babies who arrive early or need medical support in one of our Level III neonatal intensive care units (NICUs).

We know the experience of a high-risk pregnancy can feel stressful and overwhelming. We strive to keep you worry-free with expert guidance and support. Our providers offer compassionate care for you every step of the way. Families across the region come to Penn Medicine for our expertise in complex pregnancies.

Protect your high-risk pregnancy with genetic counseling and screenings

We offer a full range of screenings and tests to monitor your baby’s development throughout your pregnancy. Our prenatal testing and genetic counseling services include tests for genetic conditions, chromosomal abnormalities, and other issues that may affect your baby’s health. If we detect a health concern, we’ll discuss the diagnosis with you and help you plan your next steps.

Prematurity prevention

High-risk pregnancies are at an increased risk for premature birth. Babies born before the 37th week of pregnancy are considered preterm and can experience serious or long-term health problems.

Our maternal-fetal medicine specialists work with you to create a care plan to reduce your risk of premature birth. They partner with your OB/GYN to manage medical conditions and support you throughout your pregnancy. You also have access to:

• 24/7 emergency care
• Dedicated programs for conditions like diabetes and heart disease
• Support for your mental and emotional health before, during, and after your pregnancy
• Telehealth appointments for your convenience

Your heart works for both you and your baby when you’re pregnant. If you have a known heart condition, we offer dedicated services to protect your and your baby’s health. We provide care before pregnancy, while you’re expecting, and after you deliver.

Our program combines maternal-fetal specialty care with cardiology expertise to manage heart conditions. You have access to:

• Pre-pregnancy planning: Our multidisciplinary team provides pre-pregnancy planning and support to prepare your body to carry a baby. We offer comprehensive fertility care if you need help getting pregnant, including fertility preservation to protect your future fertility. We also support you with third-party reproductive services if you want to explore using a gestational carrier.
• Medication advising: Before you become pregnant, we will discuss any medications you currently take for your heart condition. If appropriate, we may recommend changing to a medication that’s safe to take during pregnancy.
• Prenatal heart procedures: We safely monitor your heart throughout your pregnancy with heart imaging tests, including echocardiograms, stress tests, MRIs, and CT scans. If needed, we can also perform heart procedures that won’t harm your baby.
• Support and counseling for complex pregnancies: A heart condition risks your and your baby’s health. Our experts assess your situation, explain the concerns and risks, and help you make informed decisions. If you’re unable to continue a pregnancy due to health risks, we provide compassionate abortion and perinatal palliative care.

Monitored care during and after delivery

When it’s time to deliver, we’ll closely monitor you and your baby. You give birth in a room equipped with advanced heart monitoring technology. Our specially trained obstetric anesthesiologists are skilled in choosing heart-safe medications for pain relief. After delivery, you recover in a room where we monitor you remotely and can respond immediately if a problem arises.

Personalized diabetes care for pregnant people

Perinatal diabetes care at Penn Medicine provides expert support for gestational diabetes, type 1 diabetes, and type 2 diabetes during your pregnancy. Because diabetes can also affect your baby’s health, we offer coordinated care with a team of certified diabetes care and education specialists (CDCES), maternal-fetal medicine specialists, dietitians, and social workers.

We help you manage your blood sugar levels before you become pregnant and monitor them weekly while you’re expecting. You receive nutritional support and counseling to maintain good health. We also monitor your baby’s development with ultrasounds, fetal echocardiograms, and other prenatal tests.

Monitoring your blood pressure during pregnancy and after delivery

Preeclampsia (high blood pressure that occurs during pregnancy) can put you at risk for a stroke, seizure, or other serious health problem. Penn Medicine offers two unique programs to protect your health during and after pregnancy.

Heart Safe Motherhood postpartum blood pressure program

Many people who experience preeclampsia don’t get follow-up blood pressure checks after they deliver. Untreated high blood pressure can endanger your health.

We understand it can be difficult to find time for follow-up care when you have a newborn at home. To ensure you receive the care you need, we offer Heart Safe Motherhood, a postpartum remote blood pressure program. Developed by Penn Medicine obstetricians, the award-winning program significantly improves health outcomes for postpartum people with high blood pressure. Around 15 percent of people enrolled in the program require intervention to protect their health.

After delivery and before you leave the hospital, a nurse will give you a blood pressure monitor to take home and show you how to use it. For 10 days, you’ll check your blood pressure twice daily and text the numbers to your care team. If your blood pressure is high, we’ll recommend the appropriate treatment, including medications, if needed.

Heart Safe Motherhood is available throughout the Penn Medicine hospital system.

Take Home Electronic Assessment (THEA)

Offered through our downtown Philadelphia locations, THEA combines virtual prenatal visits, prenatal education, and remote blood pressure monitoring starting in your second trimester. You receive a blood pressure cuff and check your blood pressure at home once a week. This monitoring helps us detect and treat preeclampsia quickly and effectively.

Penn Medicine’s Placenta Accreta Spectrum Center of Excellence

Placenta accreta is a rare but serious condition in which your placenta grows into your uterus during pregnancy. It is sometimes detected during a prenatal ultrasound screening while you are pregnant.

Placenta accreta requires highly specialized care across multiple disciplines. We offer coordinated support and treatment through the Placenta Accreta Spectrum Center of Excellence, located at Hospital of the University of Pennsylvania (HUP). Your team of experts includes specialists in gynecologic oncology, maternal-fetal medicine, neonatology, OB/GYN, perinatal nursing, and transfusion medicine. If appropriate, we can partner with your OB/GYN so that you can continue seamless maternity care until your delivery date.

Our team creates individualized care plans to support you before, during, and after childbirth. We often recommend a planned delivery between 34 and 36 weeks of pregnancy to better control your care. However, we know that placenta accreta may affect the timing and location of your delivery. You can be confident that our team is available to care for you 24/7.