First-time mother Elyse always had a link to UPMC Magee-Womens Hospital in Pittsburgh. Not only is this where the Economy, Pa. local was born, but it is also where she volunteered as a teenager.
Elyse learned she was pregnant in 2022. And it came as no surprise that she wanted to have a doctor who would deliver at UPMC Magee.
“I never considered any other hospital. I was born at UPMC Magee,” says Elyse, a UPMC Western Behavioral Health child therapist. “Magee has been delivering babies for a long time. It was comforting to me knowing that they have seen every scenario.”
The First Diagnosis
Elyse, now 31, got her prenatal care at UPMC Greater Pittsburgh OB/GYN. This clinic is part of UPMC Magee-Womens in Cranberry Township at the UPMC Lemieux Sports Complex. The office is just 15 minutes from her home.
“It started off as a normal pregnancy,” Elyse says. But at 15 weeks, doctors saw her blood pressure was edging up. They diagnosed her with hypertension.
“Hypertension can be dangerous for both the mother and the baby,” says Marydonna Ravasio, DO, an ob-gyn who cared for Elyse. “Once she was diagnosed with hypertension, her pregnancy was considered high risk.”
Convenient Care Via Telemedicine
High blood pressure during pregnancy raises the risks for the mother. It can lead to preeclampsia (high blood pressure with protein in the urine), stroke, or heart attack. It also can slow the baby’s growth and lead to preterm delivery and stillbirth, Dr. Ravasio says.
Elyse stayed in Dr. Ravasio’s care, who referred her to the maternal-fetal medicine (MFM) experts at Magee in Pittsburgh. She was happily surprised to have her visit with MFM expert Tiffany Deihl, MD, via telemedicine.
“I was relieved to have the additional team of specialists monitoring the health of me and my baby,” Elyse says. “Being able to do this via telemedicine was so convenient. I could continue seeing my doctors in Cranberry and still get that specialized care.”
Elyse’s doctors worked closely to manage her care for the rest of her pregnancy. They prescribed baby aspirin and gave her a blood pressure cuff to use at home. They ordered extra ultrasounds to check her baby’s growth.
Elyse’s test results, imaging, and doctor’s reports were all in MyUPMC, the electronic health records system. “It’s seamless,” Dr. Ravasio says. “We work as a team to ensure women and their babies receive top-notch care.”
Getting Diagnosed with Gestational Diabetes
As her pregnancy moved forward, Elyse’s blood pressure stayed stable. But at 28 weeks, a routine glucose test found a second high-risk health issue: gestational diabetes.
If it’s not closely managed, the high blood sugar levels from gestational diabetes can cause health issues. For the mother, it can raise the risk of high blood pressure, preeclampsia, and stillbirth.
It also can cause the baby to grow too big, leading to a complex delivery or emergency cesarean section. The baby’s blood sugar may also be very low at birth. Magee’s MFM team met with Elyse — again via telemedicine — to review her diagnosis and treatment.
“Controlling these high-risk conditions is very important. It translates to much better outcomes for the mom and baby,” MFM expert Mary Lee, PA-C, says. “We also want to ensure that patients understand their diagnoses, have the opportunity to ask questions, and are fully informed and part of the decision making.”
An MFM diabetes educator met with Elyse to discuss changes she’d need to make to keep her blood sugar in check. These included what she should eat, how to count carbohydrates, and how to check her blood sugar after eating. When her blood sugars were still high, another diabetes educator taught Elyse how to give herself insulin.
“These specialists were an amazing resource,” Elyse says. “Being able to meet virtually was great. I didn’t have to worry about traffic, parking, or taking time off from work.”
Joint Treatment and Testing
Because of her diagnoses, Elyse began having more frequent visits. That included twice weekly nonstress tests to check her baby’s heartbeat. She also had monthly ultrasounds to check the baby’s growth and placental health.
Elyse’s test results were shared with her doctors in Cranberry and at the hospital.
When her blood pressure rose, Mary met with Elyse via telemedicine. She put her on a beta blocker to control it. They also suggested changes to her delivery plans.
“It’s a big deal if we can’t get the blood pressure down,” Mary says. “I sent a plan to her obstetrician recommending that she deliver at 37 weeks if her blood pressure remained elevated.”
Tailored Care
Dr. Ravasio agreed, and at 37 weeks, doctors at Magee induced labor. The next day, Elyse gave birth to a 5-pound, 12-ounce Elliot via c-section by Dr. Ravasio.
“I never thought I’d have hypertension or gestational diabetes during my pregnancy. And I never imagined being induced at 37 weeks,” Elyse says. “But everyone looked after me and my baby throughout my pregnancy. And I have a perfect, healthy baby boy.”
Elyse’s care didn’t end with her delivery. Her blood pressure got worse at the end of her pregnancy, so she was at risk of getting postpartum preeclampsia. Preeclampsia is a serious health issue that can lead to brain damage, stroke, and death.
After leaving the hospital, Elyse got care remotely through the UPMC Postpartum Hypertension Program at UPMC Magee. A team of nurses carefully watched Elyse’s blood pressure readings for six weeks. They got the readings sent via text message and had protocols to follow if it became elevated.
Thankfully, Elyse never got preeclampsia. “This program can be lifesaving because preeclampsia must be treated quickly,” Dr. Ravasio says. “Elyse had the best care possible throughout her pregnancy and beyond. It doesn’t get any better.”