• In vitro fertilization
• Donor egg procedures
• Donor sperm procedures
• Artificial insemination

These services are provided in conjunction with DMC Hutzel Women’s Hospital and the Wayne State University Department of Endocrinology and Infertility.

Prenatal Genetic Disease Carrier Screening and Counseling

The hospital can test parents for unknown diseases and conditions they might pass along to baby including, Down syndrome, Tay-Sachs disease, cystic fibrosis, sickle cell anemia, congenital heart defects and spina bifida.

For the Jewish community, DMC Sinai-Grace perfoms blood testing and counseling specifically for diseases with high incidence in that population, such as Dor Yeshorim.

Intrauterine Surgery

DMC Sinai-Grace partners with DMC Hutzel Women’s Hospital, one of the few hospitals in the country to perform these complex procedures, to treat congenital birth defects.

Fetal Blood Transfusions

Fetal blood transfusions are performed using ultrasound to guide a needle into the mother’s uterus. The fetus either receives blood or has unhealthy blood exchanged for healthy blood to treat some problems. In this case, it may be necessary to give a sedative medication to keep the baby from moving.

Invasive Perinatal Testing

Amniocentesis
An obstetrician may recommend amniocentesis to test for certain birth defects or malformations in the fetus. Amniocentesis is usually performed between 15 and 20 weeks of pregnancy and is done using ultrasound as a guide. The healthcare provider inserts a thin needle through the mother’s abdomen and uterus. A small amount of amniotic fluid (the fluid that surrounds the baby) is removed and tested. There is a one in 200 risk of miscarriage when doing this procedure.

Fetal Blood Sampling
Fetal blood sampling is a procedure to remove a small amount of blood from the fetus during pregnancy. In the past, fetal blood sampling was used only during labor through the mother's open cervix to test blood from the fetal scalp for oxygenation. Today, at DMC Sinai-Grace, fetal blood sampling is performed by specially trained perinatologists to help diagnose, treat and monitor fetal problems during pregnancy. A fetal blood sample may be taken to:

• Diagnose genetic or chromosome abnormalities
• Check for and treat severe fetal anemia or other blood problems such as Rh incompatibility
• Check for fetal oxygen levels
• Check for fetal infection
• Give certain medications to the fetus

Fetal blood sampling is conducted using ultrasound to guide a needle into the mother’s uterus where blood is drawn from the placenta or the baby.

After a fetal blood sampling procedure, mothers will need to rest in the hospital and have the fetal heart rate monitored for a few hours.

Fetal blood sampling is a very complex procedure that must be performed by a specially trained physician. It is used when other tests or procedures are not possible or not effective. While there are serious risks to the baby, the test does provide important information about the health of the fetus, often allowing treatment before birth.

Fetal Echocardiography
Some pregnant women are at elevated risk of giving birth to a baby with a heart defect. They may be referred for a specialized fetal echocardiogram to detect heart defects before the baby is born. Women at risk may have:

• A family history of congenital heart disease
• An abnormal fetal heart rhythm
• Fetal heart abnormalities detected during a routine pregnancy ultrasound scan
• Abnormality of another major organ system
• Insulin-dependent diabetes mellitus (type 1 diabetes)
• Gestational diabetes in the first trimester, which can cause heart defects
• Exposure to some drugs in early pregnancy, for example, some anti-epileptic drugs can damage the developing heart.
• Abnormal amniocentesis results

Fetal echocardiography uses ultrasound to show more detail of the structure of an unborn baby's heart than can be seen in a routine pregnancy ultrasound. The ultrasound scanning may be done through the vagina or through the abdomen. There are no known risks to the mother or fetus.

High-Risk Pregnancy Care

Some women face a higher risk of problems during pregnancy. DMC Sinai-Grace provides a range of services from one-time consultations to long-term medical management of high-risk pregnant women. Our board-certified Maternal/Fetal Medicine specialists can co-manage high-risk cases along with the patient's primary obstetrician, who can perform the delivery.

High-risk patients include women with serious medical conditions such as asthma, high blood pressure and diabetes. Women who are over age 35 are at a higher risk of complications, including fetal abnormalities, during pregnancy.

Other high-risk patients include:

• Very young mothers
• Women who have had previous miscarriages
• Women who have had previous preterm deliveries
• Women carrying multiple babies

High-Resolution Ultrasound

Our certified sonographers perform diagnostic ultrasound in traditional 2D format or in advanced formats:

• 3D with three dimensions for more clarity
• 4D format with real-time 3D video

Ultrasound is used to:

• Determine the age of the baby
• Analyze development of the baby
• Evaluate multiple pregnancies
• Detect structural problems with the uterus
• Detect placental abnormalities
• Detect abnormal bleeding
• Determine ectopic pregnancy
• Detect ovarian tumors or fibroids
• Locate the placenta

Biophysical Profile (BPP)

A BPP is a series of tests to measures the health of a baby during pregnancy. The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby. A BPP test may include a nonstress test with electronic fetal heart monitoring and a fetal ultrasound.

A BPP is commonly done in the last trimester of pregnancy. If you have a high-risk pregnancy, a BPP may be done by 32 to 34 weeks or earlier. Some women with high-risk pregnancies may have a BPP test every week or twice a week in the third trimester.

You may be a high-risk pregnancy if you have:

• Hyperthyroidism
• Bleeding problems
• Lupus
• Chronic kidney disease
• Type 1 diabetes or gestational diabetes
• High blood pressure (hypertension)
• Preeclampsia
• A small amount of amniotic fluid (oligohydramnios) or too much amniotic fluid (polyhydramnios)
• A multiple pregnancy (twins, triplets, etc.)