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Maternal-Fetal Medicine

Department of Obstetrics & Gynecology

Division of Reproductive Genetics, Maternal Fetal Medicine, and Ultrasound

1400 South Coulter St. (3rd Floor)

Amarillo, TX 79106

 

To schedule an appointment call (806) 414-9560.

 

holmes

Heather J. Holmes, M.D., F.A.C.O.G.

Associate Professor, Department of Obstetrics & Gynecology

Director, Division of Maternal Fetal Medicine

Director, Ultrasonography

 

Dr. Holmes is a board-certified and fellowship-trained physician. She received her OBGYN residency training at Texas Tech University Health Sciences Center – Amarillo and continued her education at UT-Southwestern in Dallas to become a certified Maternal Fetal Medicine specialist. 

 

 

As one of the only comprehensive referral centers in the Texas Panhandle, our unit is capable of a variety of genetic and high risk consultations, tests, and ultrasound services. We have an exceptional team composed of specialized physicians, nurses, and ultrasound technicians. Our team members are dedicated to serving the needs of our patients and providing the highest quality of care.

 

Mission

Our mission is to reduce the Texas Panhandle perinatal mortality rate to less than 1 in 1000. Additionally, we wish to further develop genetic and reproductive sciences in our communities. Our third mission is to provide cancer screening throughout the lives of our patients. We intend to achieve this by:

  • Research that will allow for identification of our community's specific health problems.
  • Delineation of specific clinical protocols and medical services.
  • Commitment to education and support of our communities.

 

Maternal Fetal Medicine

For those pregnancies identified as 'High Risk' with an increased risk for perinatal death or infant morbidity we are available for and offer qualified consultations. Consultations in the Maternal-Fetal Medicine Unit will ensure a complete perinatal evaluation with recommendations and follow-up as desired or needed.

Indications for consultation include:

  • Uterine malformations
  • Family history of genetic disorder, congenital anomaly or mental retardation
  • History of maternal medication or teratogenic exposure
  • History of pregnancy loss
  • History of preterm labor, preterm premature rupture of membranes, or preterm delivery
  • History of maternal alloimmunization or fetal hydrops
  • Abnormal maternal serum screening for genetic or fetal anomalies
  • Diabetes
  • Maternal cardiac disease
  • Maternal renal disease
  • Hypertension
  • Systemic Lupus Erythematosus, antiphospholipid syndrome or other connective tissue disorders
  • Other critically ill patients
  • Twin/multifetal pregnancy
  • Fetal anomalies
  • Suspected or established abnormal fetal growth
  • Fetal cardiac arrhythmias or abnormal heart rate
  • Placental abnormality
  • Oligohydramnios or polyhydramnios

Currently available ultrasound guided prenatal therapeutic procedures include:

  • Amnio-reductions and amnioinfusions
  • Fetal vesicocentesis, thoracocentesis, and shunting procedures
  • Fetal blood transfusions
  • Fetal biopsies for specific conditions
  • Alternative managements for monochorionic twin pregnancies with Twin-Twin Transfusion syndrome.
  • Coordination of care and referral for fetal surgery

 

Reproductive Genetics

Modern obstetrical practice takes into consideration how a variety of diseases can be passed down in a family or even appear for the first time during pregnancy. Many genetic abnormalities, environmental exposures and maternal diseases can be tested for at-risk parents.

Indications for prenatal genetic counseling include: anyone with questions about diseases or traits in their families; desire for more information or testing about genetic conditions that are common in their ethnic group; maternal medical conditions; previous pregnancy or infant loss; family history of inherited disorder, birth defect, mental retardation or cancer; maternal age greater than 34 at delivery; exposure to radiation, chemicals, medications, drugs or infections during pregnancy; consanguinity; positive maternal serum screening, any suspected abnormal ultrasound findings and twin/multiple gestations.

Our genetics nurses perform risk assessments, analyze the genetic contribution to disease risk and discuss the impact of risk on health care management for individuals and families. They also provide genetic education, provide nursing care to patients and families and conduct research in genetics.

Currently available universal genetic screening tests include:

  • Advanced maternal age counseling and screening
  • Second trimester maternal serum screening
  • First and second trimester genetic ultrasound
  • Cystic Fibrosis screening
  • Hemoglobinopathy screening and testing for at risk populations
  • Specific panel for Ashkenazi Jewish population

Currently available ultrasound guided prenatal diagnostic procedures include:

  • Amniocentesis
  • Chorionic Villus Sampling (CVS)
  • Fetal blood sampling
  • Fetal vesicocentesis
  • Fetal biopsies for specific conditions

Currently available universal neonatal screening tests include:

  • Hypothyroidism
  • Galactosemia
  • Congenital adrenal hyperplasia
  • Phenylketonuria
  • Sickle cell anemia

 

Ultrasound

Ours is the only Ultrasound Unit in the Texas Panhandle that has met the standards for Accreditation in Obstetrics and Gynecological Imaging by the American Institute of Ultrasound in Medicine (AIUM). We provide high quality evaluations for a variety of women's needs using state of the art equipment and certified staff capable of obtaining accurate and thorough medical information from ultrasound examinations.

Our providers use 2-D and 3-D imaging, Hemodynamic Doppler evaluations, Color imaging, and a Computerized Reporting System to ensure that patients and referring physicians will receive the best available and most comprehensive service in human reproduction.

Our Ultrasound services include:

  • First Trimester screening for abnormalities
  • Complete Pelvic and Infertility evaluations
  • Chorionic Villus Sampling (CVS) referrals
  • Non-surgical evaluation of uterine cavity-Saline Sonohysterography
  • Endometrial cavity echo-contrast enhanced examinations.
  • Pregnancy dating
  • Evaluation of abnormal implantation
  • Diagnosis and follow-up of multiple pregnancies.
  • First and second trimester genetic ultrasounds.
  • Ultrasound-guided prenatal genetic testing.
  • Fetal evaluation due to maternal medications or teratogenic exposures.
  • Level II and perinatal evaluations for maternal medical disorders.
  • Screening for pregnancy induced hypertension.
  • Screening for preterm delivery
  • Fetal echocardiography
  • Assessments of fetal growth
  • Assessments of fetal well-being
  • Biophysical profile
  • Fetal and maternal blood velocity wave form studies.
  • Placental and amniotic fluid evaluations.

Ultrasound examinations may look easy, but it takes the best equipment and well-qualified staff to obtain accurate and complete medical information from every ultrasound exam. To ensure that you receive the best care, our certified and accredited ultrasound unit and personnel have met standards set by the American Institute of Ultrasound in Medicine.

 

Pregnancy Loss
Sometimes, even when the mother does everything possible to ensure a healthy pregnancy outcome, something goes wrong and a pregnancy loss or infant death occurs. Parents who have experienced a loss feel sad, alone, frightened and have many concerns and questions.

It is known that a systematic, comprehensive and directed support service helps these families in the process of grieving for their loss.

With the Panhandle Pregnancy Loss Program, an interdisciplinary team is available to meet the psychological and medical needs of a family experiencing a miscarriage, stillbirth, perinatal or infant death.

When a pregnancy ends in failure, the Panhandle Pregnancy Loss Program is available to provide inpatient and outpatient counseling, to assist in informing and to support the family during recovery. Through understanding the events and issues concerning their loss, parents can begin to resolve their emotional conflicts and questions.

The Panhandle Pregnancy Loss Program staff is available to physicians and families to assist in any way possible during this intense and complicated process.

 

We gratefully acknowledge past and current support by the Don and Sybil Harrington Foundation, and past and/or current support of the Amarillo Area Foundation and Amarillo Women's Health Research Institute.

 

 

 

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