Tuesday, April 12, 2011

Perinatology

I am often asked why I call myself a perinatal nurse. I have a special certification in perinatal nursing. That means that I take care of women at all stages of the pregnancy and birth process. Perinatologists also take care of women who are at the "birth" stage of their lifespan.

Perinatologists are either obstetricians or radiologists who go on to study further so that they can specialize in their specific field. That means that they are the top rung of the obstetrical care ladder. They take prenatal care to another level. They generally work on a referral basis but not necessarily. They often have a geneticist working along side them in the office.

They often see women with fertility problems or histories of high risk pregnancies, sometimes before a pregnancy has occurred. They see women whose pregnancies are considered high risk by virtue of age, prior family or personal history or multiples, medical conditions or problems already identified with the fetus. They can do very early diagnostic testing like chorionic villus sampling and amniocentesis and they monitor pregnancies and often share care with the delivering obstetrician.

They can visualize and interpret much by use of very detailed sonograms. They are able to see markers that may indicate the need for further sometimes invasive procedures. And their years of training give them the edge when considering plans of care.

Often the delivering obstetrician will defer to the specialist when determining how best to manage and monitor their mutual patient. They can do amniocentesis for determining maturity for delivery and they can handle the difficult and sometimes obscure cases for best outcomes. But it is the obstetrician who delivers the baby ( ies ).

They are experts in embryology and fetal development. They have experience with unusual diseases of both the mother and fetus. They understand the genetic implications of the specific family. They have extensive knowledge about the predictability of events and outcomes. They sometimes will refer to pediatric specialists so a plan of care can be established for a compromised baby even before its birth.

Looking at a sonogram of a pregnancy at six weeks for a heartbeat, at twelve weeks for nuchal translucency, sixteen weeks for gender and twenty weeks for a complete anatomy scan provides information for medical monitoring and intervention and reassurance for normalcy. Later in the pregnancy the continued monitoring and guidance provides the best care that can be offered in the twenty-first century

Referral to a perinatologist isn't an instant verdict of a problem, as many parents-to - be perceive. But rather, it is a certainty that the pregnancy will be cared for in the best possible way.