Perinatal Institute

  • High-Risk Delivery

    The Highest Level of Care for Premature and Ill Newborns

    Most pregnancies progress routinely, and the majority of newborns in Greater Cincinnati are healthy. But when doctors identify complications in mom or baby during pregnancy, obstetricians / gynecologists refer families to a team of specialists who can provide advanced care.

    This team is led by maternal fetal medicine specialists (also known as perinatologists) − obstetrician / gynecologists specializing in high-risk pregnancies. Families facing a high-risk delivery also have the opportunity to meet with a neonatologist from the Perinatal Institute at Cincinnati Children’s before delivery. During this time, the neonatologist − a pediatrician specially trained to care for ill or premature newborns − talks about the baby’s health and possible medical needs, explains what might happen in the delivery room and answers questions.

    Prior to delivery, the perinatologist and neonatologist meet with other team members, including neonatal nurse practitioners and respiratory therapists, to plan appropriate interventions in the delivery room and newborn intensive care unit. The entire team is present during delivery, and many of these same specialists provide follow-up care in the Newborn Intensive Care Unit (NICU).

    The Best Care in the Best Place

    One of the goals of our team at Cincinnati Children’s is to ensure that a woman experiencing a high-risk pregnancy delivers at the Cincinnati-area hospital best suited to care for her and her baby.

    Most of the time, high-risk deliveries take place at Good Samaritan Hospital or University of Cincinnati Medical Center, which are equipped with Level III newborn intensive care units.

    However, babies who need immediate surgery or ECMO (Extracorporeal Membrane Oxygenation) may be delivered at Cincinnati Children’s, where EXIT-to-airway and EXIT-to-ECMO procedures are performed by the surgeons of the Cincinnati Fetal Center. These specialized procedures are used only for babies expected to experience potentially lethal respiratory or cardiac distress immediately following delivery.

    Further care is provided for the babies in the Level IV Newborn Intensive Care Unit at Cincinnati Children’s, which is equipped to meet their specialized medical needs. All three newborn intensive care units work in collaboration with the Perinatal Institute at Cincinnati Children’s.

    Caring for Very Premature Babies

    Research demonstrates that the best place for a very premature baby (born at 32 weeks’ gestation or less) to be born is at a hospital with a Level III newborn intensive care unit. That’s why our team works so hard to ensure this happens. In fact, approximately 90 percent of these babies in our community are delivered in Level III centers. This greatly reduces the risk of medical complications and death, and also meets one of the national “Healthy People 2010” health objectives to ensure a healthier society.

    Keeping Mom and Baby Together When Possible

    One important goal of our team is to keep families together whenever possible because studies show that this benefits both mom and baby. Therefore, when babies with medical needs are born at a hospital with a Level II nursery, we keep them there as long as safe and appropriate care can be provided, rather than transferring the baby to a Level III nursery.

    By working in close collaboration with our healthcare partners in the community to provide advanced care in Level II nurseries, we successfully keep mom and infants together more frequently. In fact, we have lowered the number of babies born beyond 32 weeks’ gestation who require transfer to a Level III nursery by more than half.