Kofinas Perinatal: Maternal-Fetal Medicine High Risk Pregnancy
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Did You Know
That successive term pregnancies can be achieved simply by managing cervical incompetence and preterm labor?
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Frequently Asked Questions
As a physician practicing for over 20 years, I have encountered countless questions and have heard infinite concerns from mothers and their families about everything from smoking during pregnancy to what sort of music may or may not be harmful to the development of a baby’s ears. Hopefully, going through this list will ease some of your worries, or in the least inform you as to what you should and should not be concerned about. - Alexander D. Kofinas, MD

» Premature Labor

» Incompetent Cervix

» Pregnancy Loss

» Nutrition & Exercise

» Thrombophilia

» Fetal Monitoring

» Meds and Supplements

» Cerebral Palsy

» Medical Conditions

» Miscellaneous


My first baby was less than 5 pounds at 39 weeks and he now has many health problems. Can I prevent this from happening again in my next pregnancy?

The prevailing wisdom among perinatal specialists is that there is no known intervention that might prevent recurrence of IUGRIUGR:
This stands for intrauterine growth restriction, which is defined as deficient fetal growth usually caused by placental failure.  (IUGRIUGR:
This stands for intrauterine growth restriction, which is defined as deficient fetal growth usually caused by placental failure. ) . Instead, the only beneficial treatment is to deliver the baby (remove the baby from the hostile IntrauterineIntrauterine:
Occurring or situated within the uterus.  environment) when the condition is diagnosed. This unfortunately is not true. At Kofinas Perinatal we have been fortunate to realize that planning the next pregnancy and providing appropriate care can help us prevent such adverse outcomes. We believe that a healthy PlacentaPlacenta:
A membranous vascular organ that develops in female mammals during pregnancy, lining the uterine wall and partially enveloping the fetus.  is the most important organ for healthy fetal development. Buy identifying the cause of placental damage early in the pregnancy and with proper treatment, we have been able to almost eliminate IUGRIUGR:
This stands for intrauterine growth restriction, which is defined as deficient fetal growth usually caused by placental failure. . Patients with history of IUGRIUGR:
This stands for intrauterine growth restriction, which is defined as deficient fetal growth usually caused by placental failure.  in a previous pregnancy must be seen prior to conception in order to achieve the best results. Most cases of IUGRIUGR:
This stands for intrauterine growth restriction, which is defined as deficient fetal growth usually caused by placental failure.  are the result of PlacentaPlacenta:
A membranous vascular organ that develops in female mammals during pregnancy, lining the uterine wall and partially enveloping the fetus.  failure due to placental ThrombosisThrombosis:
Formation or presence of a thrombus; clotting within a blood vessel which may cause infarction of tissues supplied by the vessel.  (clotting).

What happens to my baby if I get sick?
In general maternal illness does not affect the baby as long as the mother’s body functions remain normal. However, it is possible for infections to affect the baby independent of the mother’s condition. A small number of viruses relating to the common cold known as AdenovirusAdenovirus:
Any of a group of DNA-containing viruses that cause conjunctivitis and upper respiratory tract infections in humans.  have been associated with fetal infections, which may lead to fetal loss. However, most of the common cold viruses are benign and do not affect the baby, although it is important to be cautious when you are feeling “under the weather,” making sure to keep your body temperature at less than 1010 F. Sustained fevers of over 1010 F during the first trimester may be associated with fetal CongenitalCongenital:
Of or relating to a condition that is present at birth, as a result of either heredity or environmental influences.  defects.
Are patients with infertility more likely to have pregnancy complications?
Patients with a history of infertility (i.e. experience a difficult time conceiving) who choose to conceive with assisted reproductive technologies (ART) do traditionally experience an increased number of complications during pregnancy. Common complications include PretermPreterm:
Occuring or appearing before the expected time at the end of a full-term pregnancy.  delivery, fetal growth failure, and fetal losses. These are primarily related to placental failure due to poor placental VascularVascular:
of or relating to or having vessels that conduct and circulate fluids, such as blood.  development. Almost all of these patients suffer from genetic and/or acquired thrombophilia, which is known to cause all of these complications as well as several others.
Are pregnancies conceived by artificial reproductive technologies (ART) high-risk pregnancies by default?
The answer is resoundingly yes. Many years ago we realized that such pregnancies suffer from serious placental pathologies that can cause all kinds of pregnancy complications. Because of this understanding, we have developed, in conjunction with the KOFINAS FERTILITY INSTITUTE, management protocols that have increased the success rates of these pregnancies and the quality of the fetuses. Despite the fact that several studies have reported increased incidence of abnormal pregnancy outcomes (PretermPreterm:
Occuring or appearing before the expected time at the end of a full-term pregnancy.  delivery, growth failure and increased pregnancy loss), our patients continuously achieve outcomes that are better than those of the so-called “low risk” patients.
How does implantation relate to fertility?

The vast majority of pregnancy failure occurs in the early stages of pregnancy (the first few days after ovulation and conception). As many as 50% of all patients with suspected infertility suffer from some form of implantation failure. KOFINAS PERINATAL in conjunction with the KOFINAS FERTILITY INSTITUTE identified this problem several years ago and has since developed protocols for the successful management of such patients. These protocols involve a thorough assessment of the parents for certain conditions linked to implantation failure, after which individual treatment of each patient is pursued more effectively.
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