High Risk Pregnancy

Maternal-fetal medicine (perinatology) provides specialized care for mothers and unborn babies considered at higher risk for complications. It is a subspecialty of obstetrics and gynecology. The physicians and staff at Greenwich Hospital are expert at the medical management of high risk pregnancies. Comprehensive services are available to women in a caring and compassionate environment. These services may include testing as well as treatment, depending upon test results and diagnosis.

When a Maternal-Fetal Specialist Can Help

  • Healthy women whose pregnancy is considered high risk, due to conditions such as:
    • Advanced maternal age (35 years or older)
    • Abnormal AFP (alpha fetoprotein) blood test
    • Multiples (twins, triplets or more)
    • Recurrent preterm labor and delivery
    • Premature rupture of membranes
    • Recurrent pregnancy loss
    • Suspected fetal growth restriction (baby appears to be growing slowly)
  • Women with health problems such as:
    • Heart disease
    • High blood pressure
    • Preeclampsia (toxemia)
    • Diabetes or other endocrine disorders
    • Kidney or gastrointestinal disease
    • Infectious diseases

Most women are referred to the maternal-fetal medicine department by their obstetricians or infertility specialists. Some patients may refer themselves.

Depending upon individual circumstances, a woman may see a maternal-fetal specialist once or more during her pregnancy. Most women remain under the care of their personal obstetrician, who continues to manage the pregnancy and will deliver the baby.

If necessary, the maternal-fetal specialist will develop a care plan tailored to the patient's personal needs and medical history. The maternal-fetal specialist is typically not present at the birth of the baby. This specialist may, however, consult with a neonatologist (who specializes in premature babies) before the delivery to make sure all necessary services are in place.

Pregnancy Exercise and Nutrition Initiative Program

Women with a Body Mass Index (BMI) at or above 30 are at higher risk of developing health problems and so are their babies. This is why we developed the Pregnancy Exercise and Nutrition Initiative (PENI) Program, which provides coordinated, multidisciplinary care to women with a BMI at or above 30 who are pregnant or are working with a Reproductive Endocrinologist to become pregnant. The goal of the program is to help women have a healthy pregnancy and deliver a healthy baby.

How the PENI Program works:

  • Patients are seen from pre-pregnancy through post-pregnancy and can enter the program at any time. 
  • The PENI team consists of board-certified Perinatologists, Registered Dietitians, Physical Therapists, an Exercise Physiologist and a Coordinator who will help schedule appointments, answer questions and coordinate care. 
  • A health plan is tailored to help each woman meet her personal goals and provides her with the resources and support she needs to accomplish them.
  • Women enrolled in the program can expect to go to Greenwich Hospital at least once a week for an hour to attend a nutrition class, meet with a Perinatologist or a physical therapist, use the hospital’s fitness equipment or participate in a supervised exercise program.

For more information about the Pregnancy Exercise and Nutrition Initiative Program, call 203-863-4585.

Expert and Compassionate Care

Our maternal-fetal medicine team has one of the area’s highest levels of specialty certification. It includes board certified maternal-fetal physicians, obstetricians, ultrasonographers, neonatologists, genetic counselors, and nurses. All work together to provide superior expertise and care for mother and baby.

Because the uncertainty of a high risk pregnancy can be difficult, the team is focused on patient education and clear communication – from diagnosis through treatment and delivery. The staff clearly explains every aspect of care, discussing all appropriate options to help patients and their families make the best decisions.

Early test results (sometimes within 24-36 hours) for CVS and amniocentesis are provided whenever possible.

Learn more about maternal-fetal tests and procedures


As the due date approaches, the maternal-fetal physician remains in close contact with the obstetrician who will deliver the baby. If necessary, the staff will also coordinate care with neonatologists in the Neonatal Intensive Care Unit.

Learn more about preparing for labor and delivery

Neonatal Intensive Care Unit

It's reassuring for parents-to-be to know that Greenwich Hospital offers a Level III Neonatal Intensive Care Unit for sick and premature newborns.

Learn more about Neonatal Intensive Care


To make an appointment or for more information about Maternal-Fetal Services at Greenwich Hospital, please call 203-863-3674.