What We Offer

OC Maternal-Fetal Medicine

Prevention of preterm birth and Management of cervical insufficiency

oc maternal fetal medicine

Prevention of preterm birth

Preterm birth continues to be the leading cause of perinatal morbidity and mortality in the U.S. At OCMFM, we are passionate about prevention of preterm delivery. Within the specialty of Maternal-Fetal Medicine, Dr. Kurtzman is widely known for his expertise in this area. In addition to numerous publications related to this, Dr. Kurtzman has served as the Chairman for the Prematurity Scientific Forum for the Society for Maternal-Fetal Medicine, including presentations and collaboration with other leading researchers in this specific area around the world. While Dr. Kurtzman has performed thousands of deliveries over the years, he spends almost all of his time these days keeping babies in!

At OCMFM, we provide high level surveillance and state-of-the-art techniques to help maximize the likelihood of carrying your pregnancy to term. By the time a patient develops symptomatic preterm labor, it can be challenging to stop the labor effectively. At OCMFM, we have special expertise in cervical length assessment which enables early detection of changes in the cervix weeks before the patient ever develops symptoms of preterm labor. This in turn enables the use of early intervention techniques which are not only effective but can also help to prevent the need for eventual hospitalization. As we like to say, it’s easier (and more effective) to prevent a fire than to have to put one out!

While even patients with no risk factors can benefit from preterm birth prevention strategies, the patients who are in greatest need of this level of surveillance include the following:

  1. Patients with multiple gestations (eg. twins and triplets)
  2. Patients with a prior preterm birth
  3. Patients with a prior loss in the 2nd or 3rd trimester
  4. Patients with a known cervical abnormality or prior cervical surgery
  5. Patients with a known uterine anomaly (specifically, a uterus with an abnormal shape such as a bicornuate uterus)

Management of cervical insufficiency

In addition to prevention of preterm birth, Dr. Kurtzman is widely known within the specialty of Maternal-Fetal Medicine for his expertise in the management of cervical dysfunction (including cervical insufficiency). In addition to numerous publications related to this, Dr. Kurtzman has served as the Chairman for the Prematurity Scientific Forum for the Society for Maternal-Fetal Medicine, including presentations and collaboration with other leading researchers in this specific area around the world.

If you have had a prior pregnancy loss in the 2nd or 3rd trimester, you need to be followed very closely to maximize the likelihood of carrying your next pregnancy to term. Dr. Kurtzman will carefully review your history with your to determine the best strategy for you have a favorable outcome. If your prior loss was felt to be due to cervical insufficiency (previously known as cervical incompetence), the treatment for the next pregnancy will likely include the placement of a cerclage (a pursestring stitch woven around the cervix to keep it closed). When a patient has a “classic” history for cervical insufficiency, the cerclage is placed prophylactically at 13-14 weeks’ gestation. In some cases where the cause of the prior loss is less clear, the cervix may be followed by ultrasound, and the cerclage may then be placed at any point prior to 24 weeks’ if early shortening is noted to occur. Dr. Kurtzman has extensive experience and expertise in the placement of cerclage in patients who are determined to have this need. Cerclage placement is performed in the OR and is generally performed on an outpatient basis.