This is a little more information on who we are and what we do here at PERINATAL ASSOCIATES, LLC.


Diabetes Information from Perinatal Associates

Lisa Emond, Nurse Practitioner/Perinatal Clinical Nurse Specialist has more than thirteen years’ experience in the field of Maternal Fetal Medicine. Prior to MFM, she had a decade of experience working in the labor and delivery department.    She has specialty training in the management of gestational diabetes and can provide care to patients in our newly established diabetes in pregnancy center.  Services include: 

  • Nutritional consultation and diet management in pregnancy 
  • Clinical Diabetic education and consultation 
  • Education on the use of glucometer and glycemic target goals according to ACOG guidelines 
  • Weekly evaluation via e-mail, Telehealth and face-to-face consultations  
  • Management of both oral hypoglycemic medications and Insulin initiation, if needed  

She will be collaborating with Dr. Langer to ensure that your patients are receiving exceptional care.  She will be providing consultative services such as: 

  • Preconception consultation for a wide variety of clinical indications 
  • Consultation for both acute and chronic maternal illness in pregnancy. Common indications include types 1 and type II diabetes, hypertension, thyroid disease, and poor obstetric history 
  • Serum screening for fetal aneuploidy including dating scans and nuchal translucency  
  • Fetal surveillance including fetal growth, biophysical profile and non-stress testing

Here is a brief list of conditions that indicate referral to our specialist office:

The goal of Perinatal Associates LLC. is to help patients with chronic health conditions, challenging pregnancies, and complex fertility issues and to have successful, healthy pregnancies. Women feel relaxed and comfortable in the care of our all-female team.

We offer specialized services in both clinical genetics and maternal-fetal medicine. Maternal-fetal medicine is the treatment and care for patients with pregnancies that, for any reason, have needs and conditions that extend beyond routine obstetric care. Some of our patients have  chronic health conditions and need to be monitored and treated for both  mommy and baby. Some pregnancies are complicated by growth problems or by abnormalities that require extra monitoring and support throughout gestation. Patients are referred by their midwives and obstetricians for better pregnancy outcomes.

● Advanced maternal age (defined as a mother aged 35 or older at the expected date of delivery)
● Diabetes, including Type I/II and gestational diabetes
● Hypertensive disorders, including both pregnancy-related pre-eclampsia and pre-existing hypertension
● Seizure disorders
● Lupus, rheumatoid arthritis, and other autoimmune diseases
● Prior preterm birth
● Multiple gestation (twins, triplets, etc.)
● Fetal abnormalities
● Cervical insufficiency
● Thrombophilia and related blood disorders

● Familial genetic disorders
● Omphalocele and gastroschisis
● Intrauterine growth restriction (IUGR)
● Discordant twins
● Twin-twin transfusion syndrome
● Preterm ruptured membranes
● Cancer in pregnancy
● Recurrent pregnancy loss
● Hypo- and hyperthyroidism
● Cleft lip and palate
● Oligo- and polyhydramnios
● Excessive fetal growth (macrosomia)


Obstetrical Scans

First Trimester Down Syndrome Screening
This is an ultrasound examination performed between 11 and 14 weeks gestation. A measurement of the clear space in the tissue at the back of the baby’s neck is obtained. The presence or absence of the fetal nasal bone is also documented (absent nasal bone may be associated with an increased risk for chromosomal abnormalities). These results are combined with your age and a special blood test to determine if your pregnancy is at increased risk for certain chromosomal abnormalities such as Down Syndrome. This ultrasound can also detect some (not all) birth defects such as whether or not your baby is at an increased risk for heart abnormalities.

Second Trimester Scans
Anatomy: This ultrasound is most often performed between 19 and 22 weeks. Your baby’s anatomy is evaluated for possible birth defects. It is important to note that all birth defects cannot be identified while you are pregnant.


Viability/Dating Scans

This is an ultrasound examination which is most often performed in the first trimester (prior to 14 weeks gestation). It determines if the pregnancy is growing properly within your uterus. It also checks to make sure your ovaries are healthy. A first trimester Viability/Dating ultrasound is the best time to establish your due date.


Cervical Length Studies

A cervical length ultrasound measures the length of your cervix. You may need this test if you are having symptoms of preterm labor such as contractions or pressure or if you have a previous history of preterm labor and or preterm delivery.


Placental Check

Ultrasound may be used to identify the location of your placenta. Your doctor may order this test if you have a history of vaginal bleeding or if your placenta looks like it may be near your cervix.


Biophysical Profiles (BPP)

This is an ultrasound examination which is most often performed in the second and third  trimester. It is used to check on your baby’s well being. During a biophysical profile, your baby’s heart rate, breathing, movement, muscle tone, and amniotic fluid level are evaluated and given a score.


Fetal Echo

This is a special ultrasound of the baby’s heart. This test may be needed if you have a family history of congenital heart defects or if it is difficult to visualize all of the parts of the heart at the time of routine anatomical screening.

3D Ultrasound may be utilized to better visualize certain anatomical parts of your baby. Likewise, it may be utilized if a birth defect is suspected.


Multiple Gestation Imaging

For the most part, the ultrasound examinations for patients with twins, triplets, and higher-order multiples are the same as for patients who are pregnant with one baby. Nonetheless, patients with multiples often undergo more ultrasounds due to the fact that they may need to be monitored for signs and symptoms of preterm labor and delivery as well as growth discordance among twins.


Doppler Studies

Doppler studies are a special ultrasound of the maternal, placental, or fetal vessels. They are utilized to determine if your pregnancy is at risk for problems or to determine the health of your baby in utero. These tests are only obtained if you or the baby has a condition necessitating them.


Diagnostic Tests

Amniocentesis is a medical procedure, used in prenatal diagnosis of chromosomal abnormalities and fetal infections. This procedure may detect genetic abnormalities that cause problems for your growing baby.

Chorionic Villous Sampling
Chorionic villus sampling (CVS) is a prenatal test in which a sample of chorionic villi is removed for testing. This test can be used to diagnose certain birth defects and genetic abnormalities in your baby.  These genetic changes can cause health problems for your baby.