by Poppy Sundeen

Kenneth Goldaber, M.D., chose perinatology as a specialty for several reasons. The name wasn’t one of them. “The term ‘perinatology’ tends to get blank stares,” he explains. “It’s less confusing to say that I specialize in high-risk pregnancies.”

Once people understand what Dr. Goldaber does, the blank stares turn into smiles and nods. It seems everyone knows someone who’s had a difficult pregnancy. In fact, one in four pregnant women experiences some kind of complication.

High-risk pregnancies fall into several categories. The mother may have a medical condition, such as high blood pressure or diabetes, that endangers the health of the fetus. Sometimes the nature of the pregnancy, such as carrying twins, adds complications. A previous history of high-risk pregnancies is enough to warrant concern.

When a risk is identified, the mother’s obstetrician often recommends involving a perinatologist, such as Dr. Goldaber.

In the months since Dr. Goldaber opened Arlington Perinatal Associates, he’s already begun caring for a number of women whose pregnancies are designated as high risk. “We’re filling an important need in the Mid-Cities,” says Dr. Goldaber. “That’s one of the reasons I was drawn to practice here.”

His new offices, located a few minutes from Arlington Memorial, are designed for the comfort and convenience of his patients as well as for the eventual expansion of his practice. “My wife, Wendy, is responsible for putting this whole thing together,” Dr. Goldaber confesses. “She’s been working alongside me since the start.”

While Dr. Goldaber has been on the front lines of perinatal medicine for more than a decade, Arlington Perinatal Associates is his first private practice. From 1992, when he completed his perinatology residency at UT Southwestern Medical Center, until August 2003, Dr. Goldaber treated patients in conjunction with his teaching position at the medical school.

“Practicing at a major teaching hospital was a wonderful experience,” he comments. “I had the opportunity to treat a wide variety of cases, along with the satisfaction of teaching perinatal medicine to others.”

The goal of perinatology is to help ensure that even difficult pregnancies have the results all parents hope for: successful births of healthy babies. Sometimes, the involvement of a perinatologist makes a life-or-death difference.

Dr. Goldaber describes a case in which his patient was carrying identical twins. An imbalance of amniotic fluid seriously endangered one of the two fetuses. By equalizing the amniotic fluid early in the pregnancy, the condition of both twins was normalized, and the mother ultimately delivered two healthy babies. Today, those twins are active preschoolers.

“There are no words to describe the thrill of getting holiday cards from former patients with pictures of their thriving children,” says Dr. Goldaber.

Dr. Goldaber and his fellow perinatologists rarely have the opportunity of meeting the babies they help bring into the world, since the perinatologist’s role ends at childbirth.

Often, the perinatologist’s departure coincides with the introduction of a neonatologist, a doctor who specializes in the care of newborns. Since high-risk pregnancies are more likely to result in premature births, neonatology plays an important role.

Scott Tisdell, M.D., director of Arlington Memorial’s neonatal intensive care unit, describes the coordination of the various specialists as a team endeavor. “The obstetrician is the constant in the team,” Dr. Tisdell explains. “He or she stays involved from the beginning of the pregnancy through the postpartum follow-up, while the perinatologist and neonatologist each play specific support roles.”

Dr. Goldaber also stresses the importance of the obstetrician in providing continuity of care, especially prenatal care early in pregnancy. “So many of the conditions that can cause serious problems have no symptoms,” he explains. “For example, a pregnant woman might not know that she has high blood pressure or diabetes until the pregnancy is compromised.

“Perinatal medicine has resulted in more successful pregnancy outcomes,” he concludes. “So many more pregnancies could benefit from early risk identification and perinatology testing.”