Departments

Treating complicated pregnancies is our priority. We provide care for the entire spectrum of conditions related to high-risk pregnancy, and for women whose pregnancies require special testing, monitoring, treatment, and care . We offer state-of-the-art approaches to caring for women with high-risk pregnancies related to diabetes, hypertension, heart disease, and genetic disorders, among other medical conditions that can complicate a pregnancy. Maternal-Fetal Medicine (MFM) at Yale pioneered the development of chorionic villus sampling (CVS) and fetal blood sampling (FBS), and has the most experienced team for these procedures in New England. In addition, our skilled specialists, who are internally recognized for their expertise, conduct fetal echocardiography to diagnose congenital heart disorders of the fetus. We offer a variety of services for our patients across the following specialty programs: High-Risk Pregnancy Program, which supports ongoing care and management for women with a history of pregnancy risks or current medical complications. Prenatal Genetic Diagnostic Program, which provides expert genetic screening and testing for MFM patients. Available tests include first-trimester screening, CVS, amniocentesis, and FBS. After diagnosis, we provide counseling and connect patients when necessary to appropriate support networks to help parents adjust to and prepare for their child's special needs. Recurrent Pregnancy Loss Program, offered in conjunction with Yale’s Reproductive Endocrinology and Infertility Section. Our multidisciplinary team of pathologists, geneticists, and perinatologists uses a whole-patient approach to help couples with recurrent miscarriages and/or pregnancy losses. Other services offered in our MFM section include: First-trimester risk assessment for Down Syndrome Targeted ultrasound Fetal therapy, including percutaneous umbilical blood sampling (PUBS) and intrauterine transfusion Antenatal testing Diabetes management MFM physicians can also co-manage patients with high-risk pregnancies with referring practitioners. We can develop care plans with community obstetricians for cases that require intensive oversight by the team, or consultative guidance alone.

The Prenatal Genetic Diagnostic Program provides expert genetic screening, testing, and counseling for parents. Our tests and services includefirst-trimester screening, chorionic villus sampling (CVS), amniocentesis, fetal blood sampling (FBS), and many others. After diagnosis, we provide counseling and connect patients to appropriate support networks to help parents adjust to and prepare for their child's special needs. In addition to pioneering the development of CVS and FBS, Yale has the most experienced team for these procedures in New England. Between 11 and 12 weeks after a woman's last menstrual period, she can instantly learn the baby's risk for Down syndrome and other abnormalities with our safe, noninvasive first-trimester risk assessment. Our team of specially-certified physicians, sonographers, and genetic counselors will provide patients with accurate information as quickly as technology allows. The procedure is simple: Patients provide a blood sample at least one week before their scheduled appointment, then visit us between weeks 11 and 14 of their pregnancy. Our comprehensive prenatal testing and genetic counseling services include: First and second trimester screenings Targeted ultrasound (formerly known as Level II ultrasound). We are equipped to perform targeted vaginal ultrasounds at an early gestational age, and provide diagnostic information early in a woman's pregnancy. Antenatal testing services. These services include nonstress testing, biophysical profiles, fetal versions, and PG gel insertions to help ensure fetal well-being throughout pregnancy. Fetal echocardiography. The Yale Fetal Cardiovascular Center is the most experienced diagnostic and treatment program of its kind in New England and provides the full range of prenatal surgical care. Prenatal ultrasound testing is typically performed during the second trimester to diagnose cardiac conditions in an unborn baby. Chorionic villus sampling (CVS). This is usually performed between the 10th and 12th weeks of pregnancy and involves the removal of a small sample of the placenta from the uterus. Amniocentesis. This is usually performed during the 15thweek of pregnancy or later, the procedure removes a sample of amniotic fluid from the uterus for evaluation. Fetal blood sampling. Fetal bloodis collected directly from the umbilical cord orfetus to test for signs of anemia and otherblooddisorders. Fetal tissue biopsy. This is typically performed between the 17thand 20thweeks of pregnancy, for patients who carry an abnormal gene for a severe skin disease to find out whether or not their fetus is similarly affected. Fetal karyotyping. This involving the collection of chorionic villi, amniotic fluid, or fetalblood to obtain and analyze chromosomes for abnormalities. Biochemical testing Fluorescence in situ hybridization (FISH) analysis. This involves laboratory testing to detect chromosomal abnormalities and other genetic mutations in a patient

About Us At Yale Medicine, our cardiac surgery team consists of internationally recognized heart surgeons who provide personalized, compassionate care for adult and pediatric patients. We understand the challenges of living with a heart condition and are committed to partnering with patients and their families to find the best treatment plan and offer ongoing support after surgery. Our team includes highly experienced, board-certified cardiac surgeons along with an expert group of cardiologists, cardiac-focused nurses, physician assistants, and nurse practitioners. Our cardiac surgeons collaborate with Yale's cardiologists, vascular surgeons, and internists to manage heart-related issues such as heart failure, coronary artery disease, heart valve conditions, and heart rhythm disorders. Our surgeons perform the latest, most advanced techniques in minimally invasive and traditional surgeries to treat a full range of cardiac diseases and conditions, including: Coronary artery bypass grafting (CABG) Valve repair and replacement (aortic and mitral) Aneurysm repair (aortic, thoracic aortic, left ventricular) Arrhythmia (abnormal heart rhythm), including hybrid ablation heart failure and artificial heart or ventricular assist devices Heart failure, including artificial heart or ventricular assist devices Heart transplantation Congenital heart diseases in children and adults

Patients often hesitate to discuss miscarriages, or spontaneous pregnancy losses. While one miscarriage might prompt a doctor's visit, experiencing two or more losses warrants a thorough examination for underlying reproductive issues. Yale Medicine’s Recurrent Pregnancy Loss Program assembles experts from various fields to provide comprehensive and compassionate care to patients facing this condition. We utilize cutting-edge technologies for diagnosis and tailor individualized treatments to address the root cause. Recurrent pregnancy loss is defined as two or more failed pregnancies, including those confirmed via pregnancy blood test or ultrasound. Miscarriage is relatively common, affecting 15% to 20% of known pregnancies within the first 20 weeks. However, experiencing two or more consecutive losses, which affects 1%-3% of pregnancies, may indicate underlying genetic, physiological, or anatomical issues. Anatomic abnormalities in the uterus, such as fibroids , polyps, adhesions, or the presence of a septum dividing the uterine cavity, can lead to pregnancy complications. Hormonal disorders, like uncontrolled diabetes or thyroid issues , can also contribute to recurrent pregnancy loss. Additionally, chromosomal abnormalities in embryos, autoimmune conditions, infections, and lifestyle factors, such as smoking, drug use, caffeine and alcohol consumption, toxin exposure, and obesity, may play a role. Our multidisciplinary team works closely with patients to identify potential contributing factors while offering emotional support during this challenging time. Initial assessments include a thorough review of medical history, physical examinations, specialized ultrasounds, and consultations with specialists, such as reproductive endocrinologists, maternal-fetal medicine specialists, reproductive immunologists, geneticists, and pathologists. We employ advanced diagnostic techniques, including genetic testing and analysis of fetal tissue, to pinpoint underlying causes. Our team includes psychological counselors, dietitians, and experienced nurses who provide comprehensive support throughout diagnosis and treatment. At Yale Medicine, our Recurrent Pregnancy Loss Program combines compassionate care with state-of-the-art genetic analysis. Following a definitive diagnosis, we offer customized treatment options, which may include surgical interventions to address anatomical abnormalities, in vitro fertilization (IVF) , or a genetic screening of embryos. Even in cases where a specific cause cannot be identified, the outlook remains positive, with the majority of subsequent pregnancies proceeding normally. Throughout the process, we remain dedicated to understanding the root cause of difficulties and providing empathy and reassurance to patients facing recurrent pregnancy loss.

As our pediatric congenital heart disease patients move from childhood into adulthood, our program is there every step of the way to make sure they receive continuous, comprehensive care for even the most complex heart disease. Our multidisciplinary integrated program was the first in the state dedicated to the care of adult patients with complex congenital heart disease, and encompasses the full spectrum of care, including imaging, exercise testing, and surgical as well as less-invasive catheterization therapies. Our patients can expect to receive detailed information about their underlying congenital heart defect, its management, and the implications on their future heart function. Patients in the program are assured of the careful transition of care from their childhood diagnosis into adulthood, and appropriate wrap-around care for adults who are new to the program. Commonly encountered problems related to adult congenital heart disease (ACHD) include the following: Unrepaired congenital defects Complications associated with early surgical repair Heart failure Heart rhythm problems, including pacemakers and defibrillators Pregnancy issues Our expert, board-certified cardiac physicians and surgeons treat these, among other heart conditions: Atrial septal defect (ASD) Ventricular septal defect (VSD) Atrioventricular canal defect Bicuspid aortic valve Pulmonary stenosis Coarctation of the aorta Ebstein's anomaly Transposition of the great arteries, including those who have had a Mustard or Senning operation or arterial switch operation Congenitally corrected transposition of the great arteries Tetralogy of Fallot Complex single ventricle patients, including those who had a Fontan operation Cyanotic heart disease Patients who had a Ross operation as a child Congenital coronary anomalies, including ALCAPA (anomalous left coronary artery from the pulmonary artery) Instead of delaying treatment for complex congenital heart disease, our state-of-the-art imaging, including echocardiograms (ultrasound) and MRI, allows for early diagnosis, before symptoms may interfere with a patient’s life. Our program also works closely with Yale's maternal-fetal medicine team to care for women with congenital heart disease before and after they give birth. Yale’s world-class congenital cardiac catheterization lab provides access to the latest advances in transcatheter valve placement, treatment of atrial septal defects, and all forms of congenital heart disease. We provide comprehensive electrophysiology services, including management of arrhythmias and placement of pacemakers and defibrillators.

Yale’s Department of Obstetrics, Gynecology and Reproductive Sciences is dedicated to helping women at all stages of life. A global leader in women’s health, Yale is known for its innovative contributions to diagnosis and treatment, including: Developing the first fetal echocardiography Pioneering the first obstetrical ultrasound Developing the first fetal blood sampling and first fetal transfusion Offering the first chorionic villus sampling in New England Co-authoring the first U.S. study for first-trimester risk assessment Developing the first comprehensive first-trimester risk assessment program in New England Inventing fetal monitoring and many prenatal diagnostic and treatment techniques Our physicians tap into the broad expertise of our entire institution to provide compassionate, customized care for all of our patients, from adolescence through adulthood. Through eight subspecialty areas, we offer the most advanced diagnostics and therapies that harness the latest advances in technology. Recent clinical research includes a new emphasis on therapeutic vaccines in gynecologic oncology, novel treatments for endometriosis and menopause, a comprehensive patient safety program in maternal-fetal medicine, and an advanced fetal therapy program. Specialized care is offered in the following areas: Family planning Gynecologic oncology Gynecologic specialties Maternal-fetal medicine Obstetric specialties & midwifery Pediatric & adolescent gynecology Reproductive endocrinology & infertility Urogynecology & reconstructive pelvic surgery Maternal-fetal medicine service offers 24-hour on-site dedicated space for complex pregnancies and fetal care First in Connecticut to perform in-utero laser therapy in pregnancies complicated by twin-to-twin transfusion syndrome Outstanding survival outcomes for all types of gynecologic surgery, from open to robotic Pioneer in caring for patients with sexual intimacy issues after cancer surgery Fetal therapy program Midwifery and birthing center

The Advanced Heart failure Program is a rapidly expanding service at the front lines of treating heart failure. Launched in 1988, the program builds upon decades of experience treating failing hearts. In 2019, we performed 49 heart transplants, putting us among the top centers of the country. Our left ventricular assist device program treats more cases than any other program in the Northeast. It provides heart pumps for patients who need support while they are waiting for a donor heart or who are ineligible for a transplant and need another permanent solution. Heart transplants are the gold standard treatment for patients with end-stage heart failure. But many face a long, difficult wait for a donor heart, and some don’t survive. Yale Medicine is one of a handful of centers in the country to push existing boundaries in heart transplant by aggressively seeking out donor hearts other centers turn down even though they may be suitable for some patients. This process, using what’s called “donation after circulatory death” (DCD) organs, is helping more of our patients get heart transplants sooner. What’s more, our one-year survival rates for heart transplants—93%—are better than the national average. Multi-organ transplants People who live with heart failure have a high likelihood of also having kidney dysfunction from a variety of causes, and this can be a limiting factor in being able to get a heart transplant. For these patients, our heart specialists collaborate with Yale Medicine’s world-class abdominal transplant team and have achieved a robust volume and successful track record in performing heart-kidney transplants. Pioneers in LVAD Yale Medicine helped to pioneer the use of left ventricular assist devices (LVADs), providing patients whose hearts are too weak to function on their own with implantable devices that can pump blood for them. Yale Medicine is one of the leaders in the Northeast in volume and outcomes with LVADs and is certified by the Joint Commission, the nation’s predominant standard-setting and accrediting body in health care. Each one of our patients is treated by a team that includes cardiologists, transplant surgeons, infectious disease specialists, nephrologists, critical care doctors, nurses, pharmacists, social workers, nutritionists, and transplant coordinators, among others. Transplant doctors at Yale are national leaders in the field. Currently, the presidents of United Network for Organ Sharing (UNOS) and the American Society of Transplantation are at Yale, and they have helped to write the guidelines for how to treat patients after solid organ transplants as the field advances. Outcomes above average Patients whose future once seemed difficult have survived for decades after a heart transplant or LVAD implant. The average one-year survival after a Yale Medicine heart transplant is 93%, which is higher than the national average. This is partly due to meticulous follow-up care that includes treatment with immunosu

Pulmonary hypertension is high blood pressure in the arteries of the lungs, which makes the heart work harder and can lead to heart failure. If it is diagnosed properly and quickly, we have effective therapies that can slow the progression of the disease and possibly reverse some of the damage to the lungs and heart. Our doctors have extensive experience dealing with pulmonary hypertension, and we treat adults and children over the age of 12. We are fully committed to defeating pulmonary hypertension and caring for the disease regardless of its cause, which may include pulmonary arterial hypertension (PAH), pulmonary venous hypertension, or chronic thromboembolic pulmonary hypertension, among other causes. We are a national Pulmonary Hypertension Association-accredited Center of Comprehensive Care and Center of Excellence. As the only accredited pulmonary hypertension program in the state, we offer patient- and family-centered care to patients from throughout the Northeast. Our doctors, nurses, coordinators, and researchers are specifically trained and experienced at managing and treating patients with pulmonary hypertension. Patients will have access to other highly skilled specialists, including pulmonologists, cardiologists, rheumatologists, and gastroenterologists. We work closely with members of the Adult Congenital Heart Disease Program, General and Advanced Heart Failure Program, Hereditary Hemorrhagic Telangiectasia Program, and the Liver Transplant Program. We also work in concert with specialists in connective tissue disease such as scleroderma (we are a Scleroderma Center as designated by the Scleroderma Foundation), lupus, Sjogren’s disease, myositis, and dermatomyositis—pulmonary hypertension can be a serious complication of these conditions. Outpatient specialized clinic Designated floors in the hospital for pulmonary hypertension patients State-of-the-art heart catheterization laboratory Highly trained and qualified cardiologists who read echocardiograms focusing on the right side of the heart, which is a key clinical factor in patients with pulmonary hypertension Physicians, nurses, pharmacists, and quality-tested systems in place that provide effective complex therapies to patients in a safe environment.

The Fetal Care Center brings together a team of leading experts in maternal-fetal medicine , neonatology , genetics , pediatric surgery , and an array of other top-ranked pediatric specialties. This network of excellence from throughout our health system comes together to provide an elite level of care. Together, a comprehensive care plan is devised for pregnant patients and their developing babies who require specialized medical and surgical care while in the womb or expected interventions after birth. Our expert physicians and surgeons have ensured successful births for thousands of babies who needed specialized care. As leaders in complex in-utero surgery, we are proud to be the first in Connecticut and the region to perform in utero myelomeningocele repair. Myelomeningocele is a condition in which the baby’s backbone and spinal canal do not close before birth. The condition, a type of spina bifida , is a congenital defect of the spine and spinal cord. The surgery is performed before the baby is born (prior to 26 weeks gestation) as this provides the best outcomes. Provided world-class fetal therapy services at Yale New Haven Health for more than 40 years Pioneered the nation’s first Neonatal Intensive Care Unit at Yale New Haven Health Yale New Haven Health is one of only a few hospitals in the country to offer couplet care, where mothers and their babies are cared for together in the same room Many procedures available to women with high-risk pregnancies were first developed at Yale School of Medicine’s Department of Obstetrics, Gynecology and Reproductive Sciences , including noninvasive fetal anemia assessment, percutaneous umbilical blood sampling (PUBS), in utero fetal blood transfusion, and therapies such as fetoscopy and fetal surgery Physicians are leading researchers in the field of fetal medicine A fetal therapy coordinator is available to help patients through the process. The coordinator is there throughout the patient’s care journey, from pregnancy through delivery, and often beyond. They guide patients through testing, meeting with specialists, scheduling appointments, and coordinating the elements of the care plan based on the patient’s needs. For more information or to request an appointment, please call 855-433-8252 , or submit a Fetal Care Center Information Request . Someone is available to answer your call from Monday through Friday, 8am – 4:30pm. Read our list of frequently asked questions about the Fetal Care Center . Here are some of the common conditions we treat at the Fetal Care Center: Cleft lip/palate Congenital heart defects Fetal anemias Gastroschisis Hydrocephalus Intra-abdominal masses Spina Bifida Twin-to-twin transfusion syndrome View the full list of conditions . Advanced Prenatal Genetic Testing and Counseling Genetic counseling and prenatal testing are among the most valuable tools to help prospective parents make important decisions regarding a current or future pregnancy. Many things

Our uncompromising faculty and staff are dedicated to the welfare of children and adolescents. One of two major pediatric centers in Connecticut, Yale offers an extensive range of services for patients through our 14 specialties. In addition, we have several interdisciplinary centers and programs that involve collaborations with multiple departments throughout Yale Medicine and Yale New Haven Children’s Hospital. Thanks to our reputation for comprehensive pediatric care, we serve as a regional and national center for referral and consultation. Many of our physicians are internationally recognized for their innovative approaches to the diagnosis and treatment of conditions including arrhythmias, diabetes, cystic fibrosis, childhood cancers, juvenile diabetes, dyslexia, blood disorders, infectious diseases, and complications of premature birth, as well as many other disorders. We are leaders in the global pediatric community, advocates for childhood health and development, and innovators in research. We rank among the top pediatric centers in the country with respect to National Institutes of Health support for research. Neonatal and pediatric ICUs that serve our most vulnerable patients with the highest level of care 24/7 subspecialty telephone consultation service for primary care clinicians with expected response time of three minutes More than 20 years of experience with neonatal and pediatric Extracorporeal Membrane Oxygenation, a sophisticated machine that acts as an artificial heart and lungs, crucial for some seriously ill infants One-call center that provides centralized appointment scheduling for all pediatric specialties Close collaboration with other Yale departments to provide such services as molecular and genetic diagnostic services, state-of-the art management of high-risk fetuses and newborns, bone marrow transplantation, and management of complex malignancies

The Cardiovascular Disease and Pregnancy Program at Yale offers comprehensive and individualized support before, during, and after pregnancy for people with heart conditions. Our mission is to improve outcomes in pregnancy for patients with either pre-existing or newly diagnosed heart disease and ensure that pregnant patients receive appropriate and specialized risk assessment, treatment, and support. Cardiovascular disease is the number one cause of maternal mortality in the United States. While most people with pre-existing cardiovascular conditions can safely and successfully become pregnant, carry a baby to term, and breastfeed, patients with cardiovascular conditions are at higher risk of complications during pregnancy and after delivery. Pregnancy can also reveal or cause previously undiagnosed heart problems, and certain pregnancy complications can put patients at a higher risk for future cardiovascular disease. Yale’s Cardiovascular Disease and Pregnancy Program brings together cardiologists, maternal-fetal medicine specialists , nutritionists, pharmacists, lactation consultants , social workers, and family planning specialists who utilize their unique expertise to provide comprehensive patient care. Our multidisciplinary team meets regularly to create individualized care plans for each pregnant patient with heart disease. We provide care to: People with known heart disease, including congenital heart disease and acquired heart diseases, such as abnormal heart rhythms (arrhythmias), heart failure, and ischemic heart disease (coronary artery disease) People who develop cardiovascular disease or are newly diagnosed with heart disease during pregnancy (for example, peripartum cardiomyopathy) People who develop pregnancy-specific complications (including preeclampsia and related hypertensive disorders or gestational diabetes) that put them at higher risk for future cardiovascular disease Before pregnancy Contraception counseling: We provide individualized contraception counseling to patients with cardiovascular conditions to help determine the best and most reliable form of contraception for them based on a variety of factors, including specific heart conditions, interaction with other medications, and personal preferences. Comprehensive risk assessment: We provide a comprehensive risk assessment for patients with heart conditions who wish to become pregnant. We coordinate care to ensure they receive updated imaging and diagnostic studies and are on pregnancy-safe medications before they conceive. We also work closely with patients to provide nutrition and exercise guidance. Preconception counseling: We provide consultations to explore and discuss a potential pregnancy and family building. During this visit, we will answer all patient questions and develop care recommendations to support patients prior to, during, and after pregnancy. We also introduce members of the care team. During pregnancy Prenatal care management: We work wi

We provide ongoing care and management for women with a history of pregnancy risks, or current medical complications. Our providers follow patients closely from the point of referral to delivery and beyond. Patients receive individualized attention, and continuity of care is guaranteed throughout the pregnancy. We are often able to co-manage problems with our patients’ primary obstetrician. However, our High-Risk Pregnancy Program provides the full spectrum of prenatal, delivery, and postpartum care for women with high-risk pregnancies. We offer the following specialty programs: Diabetes in Pregnancy Program. This provides comprehensive services for women with diabetes before, during, and after pregnancy. Our expert team of physicians, diabetic educators, and advanced practice nurses helps initiate and manage oral hypoglycemic and insulin therapies to ensure optimal glycemic control in pregnant patients with diabetes. Our team approach has resulted in significant decreases in our patients' A1C levels, rates of fetal macrosomia (high birth weight), and incidence of pregnancy complications. Hemostasis and Thrombosis Services. Our specialists provide pregnancy management for women who suffer from thrombosis, including regular consultations and treatment with blood thinners. In addition, we provide screening and primary care, as well as treatment for other blood conditions such as hemophilia. Recurrent Pregnancy Loss Program. This is offered in conjunction with Yale’s Reproductive Endocrinology and Infertility Section. Our multidisciplinary team of pathologists, geneticists, and perinatologists uses a whole-patient approach to help couples with recurrent miscarriages and/or pregnancy losses. Women & Children’s Blood Disorders Program. This program strives to improve the quality of women and children's health by addressing disorders of blood coagulation and thrombosis during the reproductive, menopausal, fetal, neonatal, and geriatric periods of life. The program also provides patient care and management for pregnant women with preeclampsia (high blood pressure, swelling, protein in the urine).