| |
 |
Heading Here |
|
 |
|
 |
 |
Heading here |
|
 |
|
|
|
What is “Maternal-Fetal
Medicine”(MFM)?
Maternal-Fetal Medicine (MFM) is a subspecialty of
Obstetrics&Gynecology. MFM focuses on taking care of women
who plan to get pregnant or who are already pregnant and who
may have some complications. MFM specialists have an
additional 3 year fellowship in maternal-fetal medicine
after having completed a general 4-year ObGyn residency,
Please read here more about Maternal-Fetal Medicine.
What is a high-risk pregnancy?
Many obstetricians are also qualified by training and
experience to manage complicated pregnancies. Maternal-Fetal
Medicine specialists are complementary to obstetricians in
providing consultations, co-management or direct care for
complicated patients both before (preconceptional
counseling) and during pregnancy. The relationship between
the obstetrician and the Maternal-Fetal Medicine specialist
will depend on the acuity of the condition and the local
circumstances.
The discipline of Maternal-Fetal Medicine involves four
major subgroups of patients:
A. Patients undergoing diagnostic or therapeutic procedures,
including but not limited to:
Abdominal cerclage
Chorionic villus sampling
Comprehensive ultrasound
Fetal gene therapy
Fetal blood sampling
Fetal transfusion
Fetal muscle/organ biopsy
Fetal reduction
Fetal skin sampling
Fetoscopy/embryoscopy
Genetic amniocentesis
Other diagnostic/therapeutic procedures
B. Patients with medical and surgical disorders, such as:
Antiphosphoipid Antibodies
Chronic renal disease
Chronic Hypertension
Neurologic diseases:
- Seizure disorders
- Multiple sclerosis
- AV malformation
- Berry aneurysm
- Prolactinoma
- Pseudotumor cerebri
- Myasthenia gravis
- Paraplegia/quadriplegia
SLE/Other collagen vascular disease
Congenital disorders with potential untoward maternal
outcomes
- Cystic fibrosis
- Marfan's syndrome
- Protein S, C, AT-III deficiency
- Factor 5 Leiden
- Prothrombin mutation
Endocrinologic disorders
- Addison's Disease
- Diabetes, insulin-requiring/dependent
- Thyroid disease
- Parathyroid disease
- Pheochromocytoma
Gastrointestinal Disease
- Hepatitis
- Acute fatty liver of pregnancy
- Portal hypertension
- Hyperemesis, unresponsive to conservative therapy
- Ulcerative colitis
- Crohn's disease
- Cholecystitis/cholelithiasis
- Pancreatitis
Cardio-pulmonary diseases
- Cardiac disease (Clark's Group II, III, any valve
replacement)
- Pulmonary hypertension
- Restrictive lung disease
- Asthma requiring frequent medications
Hematologic diseases
- Sickle cell disease/other hemoglobinopathies
- Allo- and autoimmune thrombocytopenia
- Thromboembolic disease, past or current
- Thrombotic thrombocytopenia purpura/hemolytic uremic
syndrome
Infectious diseases
- HIV
- CMV
- Toxoplasmosis
- Rubella
- Parvovirus
- Varicella
- Herpes (primary)
- Septicemia
- Coccidiomycosis
- Any life-threatening infection
Maternal malignant disease
Myasthenia gravis
Paraplegia/quadriplegia
Pulmonary hypertension
Eating disorders
Severe preeclampsia/eclampsia HELLP syndrome
Substance abuse
Transplants
C. Healthy pregnant women with fetuses at markedly increased
risk of adverse outcome, such as:
IVF pregnancies
Women who are "older"
Twins
Abdominal pregnancy
Abnormal maternal serum testing
Fetal hydrops; immune, nonimmune
Fetal anomaly or cytogenetic abnormality
Fetal supraventricular tachycardia or congenital heart block
Incompetent cervix
Red cell alloimmunization
Mullerian abnormalities
Multifetal pregnancies
Recurrent prior to preterm deliveries
Nonobstetric abdominal surgery in the current pregnancy
Oligohydramnios at <37 weeks gestation
Placenta accreta, increta, percreta
Polyhydramnios
Premature rupture of membranes <34 weeks gestation
Preterm labor <34 weeks gestation
Prior second trimester fetal loss
Prior intrauterine fetal demise
Recurrent pregnancy loss
Significant 2nd or 3rd trimester bleeding
Suspected intrauterine growth restriction
Twin-to-twin transfusion syndrome
D. Any antepartum patient admitted for "other than delivery"
and patients with postpartum complications such as severe
hemorrhage, refractory infections, complicated preeclampsia,
eclampsia and difficult post cesarean complications
|
|
 |
|
|
 |
