SLUCare–The Physicians of Saint Louis University: Providing Comprehensive Maternal-Fetal Care

Thursday, August 22, 2013

Equipped with expertise and offering a range of maternal-fetal care for complex and uncomplicated pregnancies alike, SLUCare–The Physicians of Saint Louis University provides women across the Midwest a skilled partner to safeguard their health and the health of their babies.

“There is no complication we are not equipped to handle, no situation in which one or more of our faculty members will not have independent expertise,” says Gilad Gross, MD, SLUCare Division Director of Maternal-Fetal Medicine. “Our scope is quite vast. We have 11 physicians specializing in care for pregnant women with any complication. We provide a full spectrum of care for pregnancy, from pre-conception counseling to prenatal and postpartum care.

Extraordinary Expertise for Complex Conditions

When an expectant mother hears that her baby may have any abnormality, especially congenital anomalies or birth defects, she often reacts with fear. SLUCare physicians meet that fear with hope grounded in an array of advanced surgical expertise, capabilities and treatment options.

“We treat open neural tube defects, twin-to-twin transfusion syndrome and amniotic band syndrome, in addition to some fetal masses and tumors,” Dr. Gross says. “In the past, many of these cases could not be treated. It’s exciting to tell an expectant mother there is hope for her baby.”

In one highly specialized line of research, Emanuel Vlastos, MD, SLUCare OB/GYN, is pioneering ways to treat bronchopulmonary sequestrations. In this rare congenital abnormality, a potentially life-threatening mass develops in an unborn baby’s lung. Dr. Vlastos performs minimally invasive laser surgery on vessels millimeters in diameter to interrupt blood flow to the mass and control its growth.

“Dr. Vlastos has pioneered the use of laser to treat these lesions in utero,” Dr. Gross says. “It is exciting to help not only the individual patient but potentially an entire field of medicine by developing techniques that may be adopted by physicians around the globe.”

Another example of SLUCare physicians’ capabilities is the care they provide to patients with higher-order multiple gestations. Quadruplet pregnancies accounted for only 313 — or 0.008 percent — of the approximately 4 million live U.S. births in 2010, according to the Centers for Disease Control and Prevention. Almost all quadruplets are born prematurely, which is associated with high rates of perinatal mortality, respiratory, feeding, hearing and vision problems, as well as developmental disorders.

Yet Dr. Gross and his colleagues are among the select few U.S. physicians who have successfully delivered healthy quadruplets. In a recent case, they employed a combination of therapies during a prolonged hospitalization to help an expectant mother of quadruplets lengthen her pregnancy. The result was the safe and healthy delivery of all four babies.

A Natural Approach

Even with the most complicated pregnancies, SLUCare physicians are committed to helping women experience childbirth as they prefer, including natural labor and vaginal delivery. In fact, the maternal-fetal program has achieved Caesarean section rates of less than 30 percent, one of the lowest rates for high-risk patients in the Midwest.

“We are dedicated to giving women the most natural birth process they can have,” Dr. Gross says. “While we can perform emergency deliveries if necessary, our physicians are skilled in managing labor and vaginal delivery safely in high-risk situations.”

Meeting Women Where They Are

With a catchment and referral area stretching across the Midwest, SLUCare’s Maternal-Fetal Medicine program treats patients either in their hometowns or in St. Louis — whether through one-time consults, as their primary obstetrician or via co-management with their primary care physician.

“We help women in whatever manner necessary,” says Dr. Gross, who is also Medical Director of Labor and Delivery at SSM St. Mary’s Health Center. “This can range from a single consultation at the start of a pregnancy to help map its course, to treating a patient throughout pregnancy, to providing care while she is hospitalized.”

The physicians see women at the SLUCare office primarily based at SSM St. Mary’s Health Center as well as at DePaul Health Center, St. Clare Health Center, St. Joseph Hospital West, Anderson Hospital and, for special circumstances, Cardinal Glennon Children’s Medical Center. High-risk patients from outside the Metro Area who require acute care benefit from a highly skilled medical team that transports patients via ground or air to SSM St. Mary’s Health Center. For more stable patients who live considerable distances from St. Louis, a wide range of telemedicine services allows real-time perinatal consultation, imaging and diagnosis.

Focusing on Relationships

As an important component of care, SLUCare physicians and other health professionals proactively address the health of expectant mothers and women who are contemplating pregnancy.

Jaye Shyken, MD
Jaye Shyken, MD (standing), part of a highly skilled Maternal-Fetal Medicine team, works with neonatologists, medical geneticists and genetics counselors whenever complications of pregnancy occur or whenever fetal or genetic testing detects an abnormality.

“Patients who are obese or have diabetes benefit from a high level of maternal-fetal care and also from one-on-one counseling with a nutritionist and diabetes educator,” Dr. Gross says. “Sometimes, patients speak to our educators on a weekly basis, sometimes every other day. Those steady relationships provide patients with individualized, continual care.”

Additionally, in cases in which unborn babies have abnormalities or a family history of a genetic condition exists, skilled genetics counselors help women understand the complexities of their pregnancies.

Partnering with Other Providers

SLUCare physicians complete the circle of maternal-fetal care by prioritizing collaboration with other providers. Whether a SLUCare physician or, as is often the case, a woman’s own doctor ultimately delivers her baby, the emphasis on collaboration is unwavering.

“Nothing makes us happier than seeing a patient through a pregnancy and having her return to her hometown physician for ongoing care,” Dr. Gross says. “It is a privilege to work together to help women and infants thrive.”

SLUCare–The Physicians of Saint Louis University practices at multiple locations throughout the St. Louis area. The 11 specialists in the Maternal-Fetal Medicine program care for patients with any complication and provide a full spectrum of care, from pre-conception counseling to prenatal and postpartum care. For more information, please visit