Our board-certified Maternal-Fetal Medicine specialists have advanced training and extensive experience evaluating and managing complex pregnancies. We work closely with referring obstetricians to co-manage care and ensure patients receive comprehensive, coordinated support throughout their pregnancy.
Most patients are referred when risk factors are identified — such as maternal medical conditions, abnormal test results, ultrasound concerns, or prior pregnancy complications. Patients may also self-refer for preconception or prenatal consultation to better understand how health conditions or prior pregnancy history may affect current or future pregnancies.
Special Monitoring Programs
Patients With History of Preterm Birth or Second-Trimester Loss
For patients with a prior spontaneous preterm birth or second-trimester pregnancy loss, we offer specialized monitoring to help reduce the risk of recurrence. Care may include:
- Serial cervical length measurements via transvaginal ultrasound
- Cervical cerclage placement when indicated
- Individualized care plans and close surveillance
- Prophylactic cerclage
Our goal is timely detection of cervical changes and interventions that may help prolong the pregnancy.
Fetal Growth Restriction (FGR)
Many patients are referred when their baby measures smaller than expected on fundal height or ultrasound. Some babies are constitutionally small (genetically normal), while others may have true growth restriction. We provide:
- Detailed fetal ultrasound to evaluate anatomy and interval growth
- Doppler studies of:
- Umbilical artery
- Middle cerebral artery
- Other fetal vessels
- Evaluation for potential causes (placental insufficiency, maternal conditions, fetal anomalies, genetic conditions)
- Recommendations regarding timing and frequency of surveillance
- Consideration of amniocentesis when indicated
- Serial growth scans
- Biophysical profile
Early identification and targeted monitoring help optimize timing of delivery and improve outcomes for babies affected by FGR.
Twins and Higher-Order Multiples
Twin and triplet pregnancies require specialized care due to increased risks. At Specialty Obstetrics of San Diego, we follow a tailored monitoring program based on the latest clinical guidelines. This may include:
- Nutritional counseling
- Patient education and anticipatory guidance
- Serial ultrasounds
- Customized appointment schedules
Dichorionic Twins
These twins have two separate placentas and are at lower risk than monochorionic twins but still require monitoring for:
- Growth restriction
- Preeclampsia
- Preterm labor
Care includes serial ultrasounds to assess growth, fluid levels, and fetal well-being.
Monochorionic Twins
Monochorionic twins share one placenta and are at higher risk due to shared circulation. Surveillance begins in the second trimester and includes monitoring for:
- Twin-Twin Transfusion Syndrome (TTTS)
- Twin Anemia-Polycythemia Sequence (TAPS)
- Selective Growth Restriction (sGR)
Advanced Doppler evaluations and detailed imaging help identify these conditions early and guide management.
Triplet Pregnancies
Triplet pregnancies require close monitoring and specialized management. Due to the increased complexity and frequency of visits needed, we typically recommend transfer of care to our practice for complete prenatal and delivery management.
