Maternal Fetal Specialist


Special Care for Mother and Baby For expectant mothers, the prospect of having a baby is both a joyous and exciting one, and most pregnancies proceed smoothly. But for a number of reasons, some women need to be watched more closely during pregnancy. In this case, the woman’s obstetrician may suggest she consult with a Maternal-Fetal Medicine specialist. Maternal-Fetal Medicine physicians, also called perinatologists, are obstetricians who specialize in the diagnosis, treatment, and ongoing care of expectant mothers and their unborn babies, who may be at high risk for special health problems.

Women are generally referred to a Maternal-Fetal Medicine specialist by their obstetrician or by an infertility specialist because he or she sees a potential for a pregnancy-related health concern or because a problem develops during the course of the pregnancy. Some women choose to see a Maternal-Fetal Medicine specialist on their own, without a referral from their obstetrician.

Referral to a Maternal-Fetal Medicine specialist should not cause undue alarm for expectant mothers. It does not necessarily mean the pregnancy will be a difficult one. Nor does it mean the baby will have health problems. Most often, it is simply a precautionary measure designed to protect both mother and baby, while putting the expectant parents’ minds at ease.

The Maternal-Fetal Medicine specialist works hand-in-hand with the woman’s obstetrician to develop a plan of care tailored to her personal needs and medical history. Though a woman may see a Maternal-Fetal Medicine specialist several times throughout her pregnancy, her own obstetrician will continue to manage the pregnancy and will deliver the baby. The Maternal-Fetal Medicine specialist is usually not present at the birth, but may consult with a neonatologist—a pediatrician who specializes in care for newborns with special medical needs—before the delivery to make sure all necessary services are in place.

Services provided by Maternal-Fetal Medicine physicians include maternal and fetal medical care, monitoring, ultrasound examinations, genetic counseling, diabetes education, state-of-the-art diagnostic tests, tests of fetal well being, and more. As the due date approaches, the Maternal-Fetal Medicine physician remains in close contact with the obstetrician who will deliver the baby and, if needed, the neonatologist who will oversee the baby’s care after birth. Smooth teamwork and good communication between the Maternal-Fetal Medicine specialist, obstetrician, and neonatologist ensure both mother and baby receive the best possible care, leading to success in most cases, despite problems that can be severe.

Why might a patient wish to be referred to a Maternal-Fetal Medicine sub-specialist?

Most women seek consultation from or care by a Maternal-Fetal Medicine (MFM) sub-specialist because they “at risk” and considering becoming pregnant or because they are pregnant and “high risk”, “complicated”, or otherwise worried about their pregnancy.

What are examples of types of patients seen by Maternal-Fetal Medicine sub-specialists?

Patients undergoing diagnostic or therapeutic procedures during pregnancy, such as:

  • Comprehensive ultrasound
  • Chorionic villus sampling
  • Genetic amniocentesis, fetal surgery or treatment

Women with medical or surgical disorders, such as:

  • Heart disease
  • High blood pressure
  • Preeclampsia (toxemia)
  • Diabetes or other endocrine disorders
  • Kidney or gastrointestinal disease
  • Infectious diseases

Healthy women whose pregnancy is at markedly increased risk for adverse outcome, such as:

  • Abnormal AFP (alpha fetoprotein) blood test
  • Twins, triplets or more
  • Recurrent pre-term labor and delivery
  • Premature rupture of membranes
  • Recurrent pregnancy loss
  • Suspected fetal growth restriction (baby not growing enough)

Why is an MFM sub-specialist ideally suited/trained/prepared to care for women with these issues/pregnancy complications?

A Maternal-Fetal Medicine sub-specialist is an individual who has completed two to three years of Maternal-Fetal Medicine fellowship after completing four years of Obstetrics and Gynecology residency upon graduation from Medical School. Fellowship training provides additional education and practical experience to gain special competence in various obstetrical, medical, and surgical complications of pregnancy. By virtue of this training and technical proficiency, the MFM sub-specialist provides care or consultation for both mother and fetus (unborn baby) in a complicated pregnancy. In addition, he/she provides education and research concerning the most recent approaches to the diagnosis and treatment of obstetrical problems. He/she thus promotes awareness of the diagnostic and therapeutic techniques for optimal management of these complicated pregnancies.

How is care coordinated between your provider and an MFM sub-specialist?

It is recognized that many obstetricians-gynecologist are also qualified by training and experience to manage complicated pregnancies. Maternal-Fetal Medicine sub-specialists are complementary to obstetricians in providing consultations, co-management, or direct care for a complicated patients both before (pre-conceptional counseling) and during pregnancy. Maternal-Fetal Medicine sub-specialists also function in collaboration with family physicians and certified nurse-midwives. The relationship between your provider and the Maternal-Fetal Medicine sub-specialist will depend upon the acuity of the condition and local circumstances.