Obstetrics & Gynecology

High Risk Pregnancy Conditions & Testing

We perform an extensive range of tests through our maternal-fetal medicine program. Many of these tests are highly specialized and require experienced health-care professionals to perform them. These include:

First Trimester Ultrasound Screening

Performed at 11-13 weeks of pregnancy, this test measures the fluid behind the fetal neck. By measuring the space and combining this information with the mother's age, physicians can refine the risk for Down Syndrome and other chromosomal abnormalities.

Women & Infants Ultrasound Screening

CVS (Chorionic Villus Sampling) Testing

Usually performed during the first three months of pregnancy, CVS can identify certain problems with your baby. CVS can be done earlier in pregnancy than amniocentesis, which is usually done at 14 to 18 weeks. It is usually done when either you or the baby's father has a family history of an identifiable inherited genetic disorder, such as Tay-Sachs disease or hemophilia, or when you are over age 35, which may increase your risk of having a baby with chromosomal birth defects, such as Down syndrome.

During CVS, a sample of the chorionic villus cells is taken from the placenta for analysis. The general health of your baby can be predicted by examining the chorionic villus cells for abnormalities.Only a limited number of maternal fetal specialists are trained to perform CVS testing. Our specialists do more of these specialized, delicate procedures than anywhere else in the entire St. Louis region so you can feel confident you're in experienced hands.


Amniocentesis involves collecting a sample of the amniotic fluid surrounding the fetus; it can be done after 14 weeks. Amniocentesis can detect neural tube defects and some of the same inherited genetic disorder detected by CVS and can help your doctor estimate your baby's lung maturity late in the pregnancy, when performed during the third trimester.

Doppler Blood Flow Studies

Doppler blood flow studies are used to look for certain conditions, such as if the fetal growth is restricted or if the baby is at risk for anemia due to blood type incompatibilities. Specialists can monitor fetal anemia by measuring the blood flow.

Fetal Blood Sampling and Fetal Intrauterine Transfusion

This is a highly specialized procedure that requires inserting a needle in the umbilical cord and special preparation of the blood. An intrauterine transfusion of blood may be needed when maternal antibodies, usually caused by Rh incompatibility between the mother's blood type and that of the baby, attack the baby's red blood cells.

Fetal MRI

Our ultrasound specialists work closely with pediatric radiologists to perform a fetal MRI if an ultrasound has detected something unusual that needs more detailed imagery.

Genetic Testing

If you have a known risk factor for a genetic disorder, such as cystic fibrosis, our genetic specialists can perform genetic testing. To counsel patients about genetic testing, our staff includes genetic counselors. A counselor will discuss screening and diagnostic options of genetic testing. Genetic testing generally requires a simple, non-invasive blood test and is often the first step before considering more invasive testing such as amniocentesis or CVS.

Erica, Breast Cancer Survivor

Erica Griffin, patient of Dr. Julie Margenthaler, shares her story of the healing and hope she found at the Alvin J. Siteman Cancer Center and the importance of giving to find cures.


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