Perinatal Services

Perinatal ServicesKOFINAS PERINATAL, located in New York City, was founded on a total commitment to you, the patient, and the health of your unborn baby. We have carefully combined all the elements that will ensure your optimal care, including state of the art services, a warm environment, and a compassionate staff.

Our perinatal services include:

Recurrent Pregnancy Loss

  • First trimester recurrent miscarriage (2 or more losses prior to 12 weeks)
  • IVF failure (one or more)
  • Fetal demise (in utero death) in the second and third trimesters
  • Known existence of acquired and/or genetic thrombophilia (clotting disorder)
  • Family history of clotting disorders and pregnancy loss
  • Incompetent Cervix related loss
    • Loss with premature rupture of membranes
    • Loss with vaginal bleeding with or without pain
    • Previous Cerclage (cervical stitch) failure
    • Patients with short Cervix from prior surgery
    • Patients with history of LEEP procedure for cervical HPV disease
    • Preterm labor related loss
  • History of premature rupture of membranes between 24 and 37 weeks gestation
  • History of a previous child with deficient Intrauterine growth (IUGR/ Small for dates Neonate )
    • Patients with a previous child with cerebral palsy
    • Patients with a previous pregnancy complicated by Preterm labor and/or Preterm delivery.
    • Management of pregnancy in patients with history of infertility prior to current pregnancy (patients with history of infertility are at significantly higher risk for fetal growth failure, fetal loss and premature delivery during the current pregnancy regardless of the number of fetuses they carry).
    • Pregnancies complicated by uterine anomalies and leiomyomata (fibroid tumors)

Ultrasound Services

  • General pregnancy assessment (low risk patients included)
  • First trimester genetic ultrasound
    • Nuchal translucency
    • Nasal bone
    • Ductus venosus Doppler
  • Diagnosis of spinal defects
  • Targeted anatomical ultrasound (Level II/III)
  • Computerized fetal growth analysis
  • Fetal Biophysical Profile (assessment of fetal behavior and well being)
  • Uteroplacental Doppler assessment
    • Maternal uterine arteries
    • Fetal umbilical arteries
    • Fetal Umbilical vein
    • Placental intervillous flow patterns (power color Doppler and 3-D power Angiography )
  • Fetal brain sparing Doppler assessment (evaluation of peripheral and central fetal vessels which help us determine the quality of oxygenation of the fetus).
  • Fetal Echocardiography (detailed assessment of the anatomy and function of the fetal heart).

Fetal Therapy

  • Fetal injections
  • Fetal Intrauterine intravascular transfusion
  • Amniotic fluid removal in twin-to-twin transfusion syndrome
  • Fetal management of:
    • Ascites
    • Pleural effusions
    • Fetal urinary tract problems (posterior urethral valve/fetal hydronephrosis)

Genetic Procedures

  • Chorionic villous sampling (CVS). We perform only transabdominal CVS which is the safest procedure at 11-12 weeks (this an invasive procedure with low risk for pregnancy loss).
  • Amniocentesis (this is an invasive procedure with low risk for pregnancy loss done after 15 weeks).
  • Fetal Blood Sampling (PUBS) (this is an invasive procedure with higher than Amniocentesis pregnancy loss risk)
  • Nuchal Translucency and first trimester genetic screening for Down syndrome (non-invasive, no risk to the baby). This is a test that combines ultrasound assessment of the baby's nuchal translucency (NT), nasal bone, dutus venosus Doppler and maternal blood testing.
  • Level II (targeted anatomical and genetic marker) ultrasound {a negative such ultrasound at Kofinas Perinatal reduces the risk for Chromosomal defects (Down syndrome and other Trisomy ) by as much as 80%.

Diagnosis of Genetic Disorders

  • Chromosomal defects
  • Gene disorders
  • Fetal anatomical defects

Genetic Counseling

  • Patients with family history of genetic conditions
  • Patients with abnormal genetic screening tests
    • Abnormal Ultra-screen test (first trimester Chromosomal anomaly test)
    • High maternal Serum Alpha-fetoprotein (risk for spinal defects/Anencephaly )
    • Low maternal Serum Alpha-fetoprotein (risk for Chromosomal defects)
    • Patients with a previous pregnancy complicated by any genetic defect

High Risk Pregnancy Consultation

  • Hypertensive_Disorders (select to download file)
    • Chronic Hypertension
    • Pre-eclampsia
  • HELLP syndrome
  • Diabetes
    • Gestational
    • Pre-Gestational (Insulin dependent)
  • Lupus disease
  • Renal (Kidney) disease
    • Diabetic renal disease
    • Chronic renal disease of unknown etiology
    • Lupus related renal disease
  • Thyroid disease
    • Hyperthyroidism
    • Goiter
    • Hypothyroidism
  • Cardiac disease (Congenital heart disease and other heart problems)
    History of Preterm delivery
  • History of child with growth retardation (small for age-IUGR ) or very low birth weight neonate
  • History of Placenta abruptio in prior pregnancy
  • History of premature rupture of membranes (pPROM) in prior pregnancy
  • History of Cerclage (cervical stitch) that failed in prior pregnancy
    Suspected fetal anomaly by means of ultrasound
  • History of clotting disorders (leg clots, pulmonary embolism, placental Thrombosis ) and pregnancy
  • History of Placenta Thrombosis (clotting) in prior pregnancy

Kofinas Perinatal ServicesWe recognize the emotional frustration, which can often accompany pregnancy complications, and this leads our staff to treat each patient with the understanding and care she deserves.

We emphasize:

Personal attention:

We take a one on one approach to all care and are sensitive to your individual needs and concerns. During your visits, you are assured of our undivided attention, detailed explanations of your tests and your condition, and Dr. Kofinas' involvement through every step of your diagnosis and treatment.

Attention to detail:

Pregnancy is the result of extremely complex processes. When all goes right, a pregnancy can be healthy without any help. However, when the process is derailed and things do not work out as expected, we make every effort to identify the underlying problem and treat it. Nothing is left to chance! Every detailed step of the pregnancy is monitored with out-most respect and effort.

A team approach:

We work closely with your primary obstetrician. This includes maintaining close communication during the decision making process and providing complete reports of all test, evaluations, and recommendations regarding your care.

State-Of-The-Art Services:

Advanced diagnostic technology allows us to detect and treat many fetal disorders before your baby is born. These treatments can minimize neonatal intensive care, improve neonatal outcomes, and decrease long-range medical costs. We provide complete diagnostic and treatment services for both low and high-risk women.

Affordable services:

We equip all our offices with advanced diagnostic technology that is found only in major diagnostic centers. Because we can perform 99% of all procedures in the convenience of our office, we are able to offer cost-effective services with charges that are comparable to local facilities. Because we prevent all major obstetric complications, we save tens of thousands of dollars by preventing expensive hospital treatments.

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