A Maternal-Fetal Medicine Specialist: The High-Risk Pregnancy Expert
Medical care for babies can start in the womb.
Do you want to start a family but you’re considered “high risk?” Or have you just learned that you’re expecting triplets and your pregnancy needs to be closely monitored? You may be referred to see a maternal-fetal medicine (MFM) specialist. What does this mean?
Maternal-fetal medicine as a subspecialty began in the 1960's with the introduction of technological advances like ultrasound and fetoscopy, which allows a view into the womb. Additional fetal therapies soon followed that dramatically improved the health of infants at delivery.
Maternal-fetal medicine specialists undergo two to three additional years of specialized training after completing their four-year residency in obstetrics and gynecology. Since the body reacts and adapts differently to diseases in pregnancy, maternal-fetal medicine physicians are specifically trained in the management of the “unroutine” pregnancy. The goal of maternal-fetal medicine is to prevent unfortunate outcomes by helping to maximize the health of mother and baby.
Today, women are referred to maternal-fetal specialists for three primary reasons:
- To optimize their health before pregnancy
- To treat medical conditions and pregnancy complications that occur during the pregnancy
- To evaluate and treat fetuses who are at higher risk of being born in critical condition or not surviving in late pregnancy
The best time to prevent a high-risk pregnancy is before ever becoming pregnant and in the first 14 weeks of pregnancy. Maternal-fetal medicine physicians are specially trained to prevent birth defects and developmental delays by identifying and treating at-risk women with special diets, medications or supplements, like folic acid.
When to see a maternal-fetal specialist
Women who see maternal-fetal medicine specialists before pregnancy are primarily women with chronic illnesses such as diabetes, kidney disease and severe high blood pressure, or have a history of pregnancy complications, like pre-term or still-birth delivery. When pregnant women are identified as high risk, either before or early in pregnancy, there are interventions to reduce their risk of delivering preterm by 30-45 percent. Women may also turn to a maternal-fetal specialist for help and guidance if there is a family history of genetic diseases that may affect their future children. Otherwise healthy patients who may develop complications during the pregnancy, such as pregnancy-induced high blood pressure and diabetes, may also see a maternal-fetal specialist.
Women in multiple gestation pregnancies, such as twins and triplets, are almost always referred to MFM practices. Over the past forty years, there have been incredible advancements in treating fetuses before delivery, which prevents death or severe disability. With MFM, blood can be transfused into a severely anemic fetus, fetal heart failure can be treated and some fetal anomalies can be repaired before birth, such as spina bifida, obstructed bladders and some heart defects.
Dr. John Allbert has practiced maternal-fetal medicine in Charlotte for more than 25 years. He is past president of the North Carolina Obstetrical and Gynecologic Society and is currently the American College of Obstetrics and Gynecology Section chair for North Carolina. Learn more about Novant Health Maternal-Fetal Medicine.