Caution: Baby on Board
What is a maternal fetal medicine specialist?
Maternal fetal medicine specialists are OB-GYNs who do an additional three years of training to become a maternal fetal medicine specialist. We specialize in high risk pregnancies—which could be because of a condition that the mother has or a condition that the fetus has.
Why might I be referred to a material fetal medicine specialist?
On the maternal side, you might come to me for something as simple as your age—once you reach 35, you are considered advanced maternal age, so that puts you at slightly increased risk. We see a lot of patients with high blood pressure or diabetes. Perhaps your last pregnancy you developed pre-eclampsia or went into preterm labor.
On the fetal side, perhaps your doctor saw something on the 20-week ultrasound that seemed a little different or odd, and they want us to check that out. Thankfully, the vast majority of those turn out okay, but we still need to evaluate them because we will sometimes find certain birth defects or genetic issues that need to be handled during pregnancy.
What services can I expect?
You're going to get a higher level of ultrasound, and by that I mean we really look in detail at the fetal anatomy. We really try to evaluate the heart and the brain at a little bit more detailed level than what you might get for your just routine screening.
We offer genetic counseling for conditions like sickle cell anemia, cystic fibrosis or Down syndrome.
We offer some blood tests looking for genetic abnormalities, such as Down syndrome, Trisomy 18 or Trisomy 13. We can do screening to see whether you're a carrier for certain genetic issues.
We offer amniocentesis, where we remove a small amount of fluid from around the baby and send that off to get a picture of the baby's DNA.
How often will I need to see the maternal fetal medicine specialist?
Most of the time, we only need to see you once. For example, if you’re referred to us because of high blood pressure, we will do a targeted ultrasound and make sure that your baby looks good, then we’ll come up with a plan for your physician to follow. Our goal is for your doctor to manage your pregnancy and you not have to come back to see us.
But depending on what we see, we may need to follow you. For example, let’s say you’re sent to us for your blood pressure and unfortunately, we find a birth defect, growth restriction or something like that. At that point, we are going to continue to follow you alongside your doctor. You still go to your doctor for routine prenatal care, but you'll also see us so that we can keep tracking you.
Your doctor can possibly still deliver your baby at your home hospital. Sometimes babies need to be delivered at the NMMC Women’s Hospital because of our excellent Neonatal Intensive Care Unit. Occasionally, babies will need to be delivered at an even larger hospital that offers advanced procedures like pediatric neurosurgery, pediatric general surgery or pediatric heart surgery.
What is pre-conception counseling?
A lot of times we'll see parents that are not pregnant yet, but they want to be and perhaps their last pregnancy had a bad outcome. They want to know what they can do to decrease their risk of that happening again. Some have a genetic issue that they're worried about their baby having. Some just want to know what they can do to maximize their chances of good outcome. If you’re interested in pre-conception counseling, ask your doctor for a referral.
In closing, nobody wants to go to the high-risk obstetrician. I totally get it. It sounds terrible. It sounds scary. Just understand that we're just here to help and thankfully, the vast majority of people that see us are going to do great. Lord forbid, if we do see some issues, we're going to do everything that we can do to help you have as healthy a pregnancy and as good an outcome as we possibly can.
In a high-risk pregnancy, both mother and child need a special kind of care.
