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Dr. Eugene Chang, high risk pregnancy doctor at MUSC Health

Frequently Asked Questions

Who should have a detailed ultrasound?

We recommend them for all our patients. All ultrasounds are not created equal! The ultrasounds performed at our Advanced Fetal Care Center include more views than required for the management of a low-risk pregnancy. These additional views are very helpful when a birth defect is suspected or identified during a standard examination.

While our center maintains certification by the American Institute of Ultrasound Medicine (AIUM), under the AIUM's ultrasound recommendations, only 50 percent of congenital heart disease is detected before birth. Because of this, all patients seen in our center are imaged to the highest degree possible. 

The result? Detection of congenital heart disease increases to 80-90 percent, depending on the cardiac lesion. The detection of neural tube defects (head and spine defects), meanwhile, approaches 98 percent.

In short, more detailed ultrasounds can result in more incredibly valuable information for you and your baby. 

Why should you request an ultrasound by a specialist in maternal fetal medicine... even if you're not high-risk?

An ultrasound performed by a maternal fetal medicine specialist reduces the likelihood of an undiagnosed surprise at birth, allowing you and your baby's medical team to prepare in advance, enabling and aiming for the best possible outcome.

A few eye-opening statistics:

  • About three percent of all children born in the U.S. have a major birth defect
  • Of these, 10 percent of the problems are associated with maternal medicinal complications, nutritional factors or drug/environmental exposures
  • Another 20 percent of  these are related to abnormal chromosomes

That means 70 percent of these major birth defects are ultimately unexplained or not predicted based on the mother's or father's medical history. An ultrasound performed by one of our maternal fetal medicine specialists will help us make sure you're not one of the 70 percent, but if you are, we want to be able to plan ahead with you for the best possible outcome for you and your baby. 


How are the ultrasounds at the Advanced Fetal Care Center different than the ultrasound at your OB/GYN's office?

The ultrasounds performed by our Advanced Fetal Care Center team are more detailed in their review of your baby's anatomy. 

If needed, too, we can perform advanced sonography with 3D and 4D imaging, as well as fetal echocardiography. (Echocardiography, also called a "cardiac echo" or simply an "echo," is a sonogram of the heart. It uses standard 2D, 3D, and Doppler ultrasound to create images of your baby's heart.)

These exams performed by our specialists increase the detection of many birth defects to 80% or better. 


Do you perform fetal MRIs?

Yes. Some birth defects warrant additional evaluation to more clearly understand the medical picture for your baby. For instance, some abnormalities as seen during an ultrasound may not be clearly defined enough to make decisions about treatment and delivery options, or to advise a family about a baby's prognosis. When this is so, we typically use a fetal MRI to assess a baby's head, chest, and/or spine abnormalities.


How can I know whether my baby might be at increased risk for a birth defect?

Some medical conditions in the mother are associated with a higher birth defect risk.

For instance, maternal diabetes and high blood sugars at the time of conception can increase the risk of many birth defects, especially abnormalities of the heart, brain, and/or spine. Maternal lupus is another complication that increases the possibility of cardiac problems in the baby during pregnancy and after birth.

Other risk factors include a fetus' exposure to medication like ACE inhibitors, psychiatric or seizure medicines, and/or retinoic acids, as well as a cardiac condition in the mother, which can lead to growth restriction in the fetus. Obesity, kidney diseases, seizure disorders, autoimmune diseases, viral infections, and age (35 and above) in the mother can also be factors. 


Why be screened by our Advanced Fetal Care Center team?

Today, improvements in ultrasound technology and prenatal diagnosis have made it possible to detect many more birth defects before birth. This gives you the opportunity to participate in expert consultations with the specialists and medical teams who will be taking care of your baby after delivery, enabling the development of the best plan of care for both mother and baby. 

What if I don’t live near the Charleston hospital?

Our Maternal Fetal Telehealth program offers specialty care to women who have high-risk pregnancies, regardless of where they live. This is especially important in rural South Carolina, where a number of counties have too few or no obstetrical providers. Our telehealth program pairs our Maternal Feta Medicine specialists with local providers to manage the care of women with high-risk pregnancies using secure video technology. It protects your privacy while allowing real-time conversations. We believe all women and their newborns deserve a chance to have the best possible outcome.