Perinatal Consultations

Dr. Keith Lescale consults patients with pregnancies progressing normally as well as patients with pregnancies that have high-risk problems. Often primary obstetricians will utilize the services of a specially trained Maternal-Fetal medicine specialist like Dr. Lescale to advise on the management of the high-risk patient.

Dr. Lescale tailors his consultation to the patient’s needs and the referring obstetrician’s capabilities and requirements. Keeping the referring physician involved in each stage of care is important to Dr. Lescale’s consultative approach to high-risk care. This is why prompt feedback is always provided to the referring physician via telephone or fax. Referring physicians are also provided a direct number in case they need to reach Dr. Lescale.

In addition, Dr. Lescale believes that quality care is facilitated best when enough time is taken to gather all pertinent information and communicate well with patients. A Maternal-Fetal consultation entails a detailed discussion with the patient. During this discussion Dr. Lescale gathers all relevant information for the patient’s current and future pregnancies. Next, the doctor explains to the patient how her pregnancy may be at risk, and makes recommendations including screening tests, diagnostic testing, and precautionary measures.

Examples why a patient may be referred to have a Maternal-Fetal consultation include:

  • Maternal/family history of heart disease
  • A known or newly diagnosed history of hypertension (high blood pressure)
  • Preeclampsia (toxemia)
  • Maternal metabolic diseases, including diabetes (both pregestational and gestational types)
  • Maternal/family history of renal, gastrointestinal disease, seizure disorders, and cystic fibrosis
  • Maternal Age
  • Maternal lupus
  • History of drug or alcohol abuse
  • Infectious diseases (including parvovirus, toxoplasmosis, hepatitis, HIV and AIDS)
  • Red cell alloimunization (Rh- mother sensitized to an Rh+ fetus)
  • Multiple gestation (twins or higher order multiples)
  • History of premature labor, premature rupture of the membranes, premature birth or premature cervical dilatation
  • Previous pregnancy loss or stillbirth
  • An abnormal AFP (alpha fetoprotein) blood test (including suspicion of a neural tube defect)
  • An abnormal triple screen (including suspicion of a chromosomal abnormality such as Down syndrome, Trisomy 13, or Trisomy 18
  • Suspected abnormal fetal growth, both macrosomia (a baby that is too large) or fetal growth restriction (a baby that is too small)
  • In utero therapeutic procedure (such as fetal blood sampling/transfusion)
  • Choroinic villus sampling or amniocentesis
  • Genetic Counseling Services
  • Antepartum fetal testing
  • First trimester screening
 

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