• Skip to main content
  • Skip to main content
Choose which site to search.
University of Arkansas for Medical Sciences Logo University of Arkansas for Medical Sciences
Institute for Digital Health & Innovation: High-Risk Pregnancy Program
  • UAMS Health
  • Jobs
  • Giving
  • Call Center
  • Contact Us
  • Guidelines For Providers
  • Providers
    • Suggested Provider Management for High-Risk Pregnancy Cases
    • Provider Education, Programs and Services
      • Teleconferences
      • Online Continuing Education
    • Printable Resources
      • Presentations
  • Outreach Services
    • Fetal Echocardiography
    • The Perinatal Outcomes Workgroup through Education Research (POWER)
      • Fetal Monitoring Courses
      • Neonatal Resuscitation Program
      • Obstetrics Emergency Drill Simulation
      • Sugar, Temperature, Airway, Blood pressure, Lab work, and Emotional (S.T.A.B.L.E)
    • Following Baby Back Home
    • Telenursery
    • Women’s Mental Health Program
  • Patients
    • Breastfeeding Education
    • Text4baby
    • Patient Education, Programs and Services
      • Web-Based Instruction on Nutrition (WIN)
      • Angel Eye Camera System
  • Annual Reports
    • High-Risk Pregnancy Program Annual Reports
    • High-Risk Pregnancy Program Evaluation
  1. University of Arkansas for Medical Sciences
  2. Institute for Digital Health & Innovation
  3. High-Risk Pregnancy Program
  4. Providers
  5. Suggested Provider Management for High-Risk Pregnancy Cases

Suggested Provider Management for High-Risk Pregnancy Cases

The UAMS High-Risk Pregnancy Program within the UAMS Institute for Digital Health & Innovation is a network of obstetricians, family practice physicians, maternal-fetal medicine specialists, pediatricians and neonatologists in Arkansas who collaborate to ensure high-risk pregnancy cases receive appropriate clinical care.

This innovative initiative is a joint program of UAMS and the Arkansas Department of Human Services.

The supplied table serves as a reference to identify:

  • high-risk situations in which primary care is appropriate and
  • high-risk situations in which the UAMS High-Risk Pregnancy Program can provide consultation, co-management, or assumption of care.

As part of our many services, the UAMS High-Risk Pregnancy Program provides guidelines for best practices in obstetrical and neonatal care, weekly educational teleconferences, facilitation of maternal transport, coordination of subspecialty care for fetal anomalies, and complete reporting and follow-up for referring physicians.
To access the guidelines, visit the Guidelines website to view, download or bookmark for easy access.

The UAMS High-Risk Pregnancy Program thrives on the input and participation of providers around the state of Arkansas. We appreciate your questions and suggestions. Please contact us at 866-273-3835 if we may further assist you.

Levels of Care

The suggested levels of clinical care were developed to aid health care providers in making decisions about appropriate care for high-risk pregnancy cases. The guidelines and suggested levels of care are not intended to dictate an exclusive course of treatment. The needs of the individual patient, resources available, and limitations unique to the institution or type of practice may warrant variations.

Suggested Provider Management (PDF version)Download

Past Medical History / Conditions

History or ConditionLevel of Care
Asthma  — Asymptomatic*Primary Provider
Asthma  — Symptomatic on medication*Primary Provider
*MFM consultation recommended. (After consultation, select patients may be co-managed.)
Asthma  — Severe (multiple hospitalizations)* MFM specialists should assume care
*MFM consultation recommended. (After consultation, select patients may be co-managed.)
Maternal cardiac disease — Cyanotic, prior MI, prosthetic valve*MFM specialists should assume care
*MFM consultation recommended. (After consultation, select patients may be co-managed.)
Maternal cardiac disease — NAHA Class > II, history of cardiac surgeryMFM specialists should assume care
Maternal cardiac disease — Congenital heart diseasePrimary Provider
Maternal cardiac disease — Pulmonary hypertensionMFM specialists should assume care
Maternal cardiac disease — Other valvular diseasePrimary Provider
Diabetes — Gestational Diabetes, managed by dietPrimary Provider
Diabetes — Gestational Diabetes, managed by medicationPrimary Provider
Diabetes — Type IIPrimary Provider
Diabetes — Type IPrimary Provider
Drug/alcohol use*Primary Provider
Epilepsy (on medication)Primary Provider
Family history of genetic problems (e.g., Down Syndrome, Tay Sachs)Primary Provider
Hemoglobinopathy (SS, SC, S-thal disease)MFM specialists should assume care
Hypertension — Chronic, with renal or heart diseaseMFM specialists should assume care
Hypertension — Chronic, on medication or diastolic < 90Primary Provider;
Consider MFM consultation
ObesityPrimary Provider
Psychiatric disease (significant)*
(e.g., psychoses, schizophrenia, manic-depressive, multiple prescriptions)
Consider MFM consultation;
MFM consultation recommended (After consultation, select patients may be co-managed);
Psychiatric disease (mild)*
(anxiety, depression)
Primary Provider
Pulmonary disease — Severe obstructive pulmonary disease, ARDSMFM specialists should assume care
Renal disease — Chronic, creatinine > 1.5 with or without hypertensionMFM specialists should assume care
Renal disease — Chronic, otherPrimary Provider
Autoimmune Disorders — SLEMFM specialists should assume care
Autoimmune Disorders — Controlled thyroid diseasePrimary Provider;
Consider MFM consultation
Autoimmune Disorders — Uncontrolled thyroid diseasePrimary Provider
Marfan’s syndrome or other major connective tissue diseaseMFM specialists should assume care
Hx of intracranial injury (e.g., stroke, A.V. malformation, aneurysm)MFM specialists should assume care
Maternal spina bifidaPrimary Provider
Gastric bypassPrimary Provider
Thrombophilias — Prior pulmonary embolus/deep vein thrombosisPrimary Provider
Thrombophilias — Hypercoagulable State (e.g. protein S/C def, ATIII deficiency)Primary Provider
Thrombophilias — Prolonged anticoagulation (therapeutic levels)MFM specialists should assume care

Other History / Conditions

History or ConditionLevel of Care
 Age > 35 at deliveryPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Cesarean delivery, prior classical or verticalPrimary Provider;
Consider MFM consultation
Cervical InsufficiencyPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior history of Preterm Delivery <34 weeksPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior fetal structural or chromosomal abnormalityPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior neonatal deathPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior stillbirthPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior preterm delivery or preterm PROMPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Prior low birthweight (< 2500 gm)Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Second trimester pregnancy lossPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Uterine leiomyomata or malformationPrimary Provider;
Consider MFM consultation

Examination / Laboratory Findings

Examination or Laboratory FindingLevel of Care
 Abnormal Quad Screen (low or high)Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Abnormal First Trimester ScreeningPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Abnormal NIPT/cffDNAPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Abnormal Pap smearPrimary Provider
Anemia (HCT < 28% unresponsive to iron therapy)Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Condylomata (extensive, covering labia/vagina)Primary Provider;
Consider MFM consultation
HIVMFM consultation recommended (After consultation, select patients may be co-managed)
Rh/other blood group isoimmunizations (excluding ABO, Lewis)Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)

Medical Conditions During Pregnancy

ConditionLevel of Care
 Drug/alcohol use*Primary Provider;
Consider MFM consultation
PyelonephritisPrimary Provider;
Consider MFM consultation
DVT/pulmonary embolusPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed)
Breast cancerMFM consultation recommended (After consultation, select patients may be co-managed)
Cancer, otherMFM consultation recommended (After consultation, select patients may be co-managed)

* Consider referral to Women’s Mental Health Provider

Current Obstetrical History / Conditions

History or ConditionLevel of Care
Proteinuria (>4gms by 24º urine collection)Primary Provider;
MFM specialists should assume care
Blood pressure elevation (diastolic > 90), no proteinuriaMFM consultation recommended (After consultation, select patients may be co-managed); 
Preeclampsia (mild)Consider MFM consultation
Preeclampsia (severe)MFM consultation recommended (After consultation, select patients may be co-managed); 
IUGR diagnosisMFM consultation recommended (After consultation, select patients may be co-managed); 
Fetal abnormality suspected by ultrasoundMFM consultation recommended (After consultation, select patients may be co-managed); 
Fetal demiseConsider MFM consultation
Gestational age 41 weeks (to be seen by 42 weeks)Primary Provider
Diabetes — Gestational DiabetesMFM consultation recommended (After consultation, select patients may be co-managed); 
Diabetes — Type IIMFM consultation recommended (After consultation, select patients may be co-managed); 
Diabetes — Type IPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed);
MFM specialists should assume care
Herpes, active lesions 36 weeksConsider MFM consultation
Polyhydramnios by ultrasound — Severe, < 34 weeksPrimary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed);
MFM specialists should assume care
Polyhydramnios by ultrasound — Severe, > 34 weeksConsider MFM consultation
Hyperemesis, persisting beyond first trimesterMFM consultation recommended (After consultation, select patients may be co-managed); 
Multiple gestation — >3Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed);
MFM specialists should assume care
Multiple gestation — Twins — MonoamnioticPrimary Provider;
MFM specialists should assume care
Multiple gestation — Twins — ConjoinedPrimary Provider;
MFM specialists should assume care
Multiple gestation — Twins — MonochorionicMFM consultation recommended (After consultation, select patients may be co-managed); 
Multiple gestation — Twins — Dichorionic, normal growthPrimary Provider
Multiple gestation — Twins — DiscordantMFM consultation recommended (After consultation, select patients may be co-managed); 
ObesityMFM consultation recommended (After consultation, select patients may be co-managed); 
Oligohydramnios by ultrasound  — <34 weeksMFM consultation recommended (After consultation, select patients may be co-managed); 
Oligohydramnios by ultrasound  — >34 weeksConsider MFM consultation
Preterm labor, threatened, < 34 weeksConsider MFM consultation
Preterm labor, threatened, < 34 weeks — Documented cervical changeMFM consultation recommended (After consultation, select patients may be co-managed); 
Prelabor Rupture of Membranes (PROM) — <34 weeksMFM consultation recommended (After consultation, select patients may be co-managed); 
Prelabor Rupture of Membranes (PROM) — >34 weeksPrimary Provider
Placenta accreta (diagnosed antepartum)Primary Provider;
MFM consultation recommended (After consultation, select patients may be co-managed);
MFM specialists should assume care
Placenta previaConsider MFM consultation
Institute for Digital Health & Innovation LogoInstitute for Digital Health & InnovationInstitute for Digital Health & Innovation
Mailing Address: 4301 West Markham Street, Little Rock, AR 72205
Phone: (501) 686-7000
  • Facebook
  • X
  • Instagram
  • YouTube
  • LinkedIn
  • Pinterest
  • Disclaimer
  • Terms of Use
  • Privacy Statement

© 2025 University of Arkansas for Medical Sciences