Since becoming chair of the UNMC Department of Obstetrics and Gynecology on Aug. 1, Sarosh Rana, MD, has emphasized her leadership philosophy of collaboration.
In that spirit, the department is launching what it informally refers to as “collaboration clinics.” The goal is to bring the full expertise of the academic medical center together to make delivery even safer for both mother and baby at Nebraska Medical Center.
Fetal and Neonatal Care Coordination Clinic
The UNMC Divisions of Maternal-Fetal Medicine and Neonatology have partnered to offer a new monthly clinic designed to support patients whose pregnancies carry a higher chance of NICU care for their newborns.
One Monday afternoon each month at the Olson Center for Women’s Health, eligible expectant mothers can meet with physicians and advanced practice providers to learn:
- What to expect if their baby needs care in the NICU.
- What care options are available for both mother and baby.
- How ultrasounds and other appointments fit into their care plan.
- Opportunities to participate in ongoing research.
“For families facing a higher-risk pregnancy, having access to the right experts at the right time can make all the difference,” said Neil Hamill, MD, director of collaborative clinics, section chief for the UNMC Division of Maternal-Fetal Medicine and an associate professor of obstetrics and gynecology. “It helps mothers understand what to expect and reassures them that a highly specialized team is ready to care for their baby from the very beginning.”
“The neonatology team is thrilled about this partnership, and we’ve already seen the profound impact it’s having on our mothers and babies,” said Nic Torbert, DO, neonatologist with Children’s Nebraska and Nebraska Medicine. “The early collaboration fosters more seamless, family-centered care for some of our most vulnerable patients.”
Diabetes in pregnancy
The maternal-fetal medicine team also is partnering with the med center’s endocrinology experts to offer a weekly clinic for patients whose pregnancies are complicated by pre-pregnancy diabetes, both Type 1 and Type 2.
Key takeaways
New specialized collaboration clinics are being offered for expectant mothers who meet the following criteria:
- They have risk factors for cardiovascular disease.
- Their babies may require NICU care.
- They have pre-pregnancy type 1 and type 2 diabetes.
“During pregnancy, the placenta releases hormones that make the mother’s body less responsive to insulin, which can cause blood sugar levels to rise,” said Lynn Mack, MD, a physician in endocrinology, diabetes and metabolism for Nebraska Medicine and an associate professor in the UNMC Division of Diabetes, Endocrinology and Metabolism.
“Most of the time, the body adjusts by making more insulin. But if it cannot keep up, gestational diabetes can develop, or pre‑existing diabetes can become harder to control. When blood sugar is not well managed, it can affect a baby’s growth and development.”
Dr. Mack said it also raises the risk of complications including high blood pressure and early delivery. With close monitoring, doctors can help keep blood sugar in a healthy range so both mom and baby stay safe throughout the pregnancy.
Dr. Hamill said, “We’ve been working closely with our endocrinology partners for decades. This effort builds on that established partnership to provide the best care possible for our expectant mothers.”
Eligible patients meet in clinic on Thursday afternoons at the Olson Center for Women’s Health.
Cardio-obstetrics program
In January, Nebraska Medicine announced an upcoming collaboration between the Heart and Vascular and Maternal-Fetal Medicine Teams to strengthen efforts to manage cardiovascular disease during pregnancy. It’s part of the Women’s Cardiovascular Program, which was developed to better address the prevention, diagnosis and management of heart disease in women.
“Cardiovascular disease is the leading cause of maternal death,” said Christina Dunbar Matos, DO, medical director for women’s cardiovascular health and an assistant professor in the UNMC Division of Cardiovascular Medicine. “Our cardio-OB program was established to focus on the cardiovascular health of mothers, working closely with our OB colleagues to monitor patients before, during and after pregnancy.”
Patients who are seen in this program include those diagnosed with hypertension, cardiomyopathy and coronary heart disease. The clinic is expected to launch in August, one-half day per month.
Dr. Dunbar said her team will provide input on a patient’s birth plan to provide the best care to both mother and baby.
Collaboration in progress
Dr. Rana, Dr. Hamill and their team also are working to offer a similar collaboration clinic in partnership with the UNMC Department of Anesthesiology.
“When we coordinate and provide risk-appropriate care for expectant and postpartum mothers, we can make a real difference in the lives of our patients,” Dr. Rana said. “Our goal is simple: Healthier mothers. Healthier babies. Everywhere.”