For more details, consult the Society for Maternal-fetal Medicine (SMFM) State of Pregnancy Monograph
What is Maternal-Fetal Medicine (MFM)?
MFM is the obstetric subspecialty that focuses on treating high-risk pregnancies and evaluating and treating problems with a fetus.
What is a high-risk pregnancy?
A high-risk pregnancy is one in which some condition puts the mother, the fetus or both at increased risk for complications during or after pregnancy and birth.
Who needs the services of Maternal-fetal specialist?
- “At risk” women, considering pregnancy or already pregnant, with diseases such as:
- Blood-clotting disorders
- Heart disease
- Infectious diseases, such as HIV or herpes
- Kidney or gastrointestinal disease
- Preeclampsia (toxemia)
- Seizure disorders
- Pregnant women who need diagnostic or therapeutic treatments, such as:
- Comprehensive ultrasound
- Chorionic villus sampling (CVS)
- Fetal surgery
- Healthy women whose pregnancies are potentially at risk because of:
- Abnormal blood test (1st or 2nd trimester screening tests, AFP – alpha fetoprotein)
- Multiple pregnancies (twins, triplets or more)
- Repeated pre-term labor and delivery in past pregnancies
- Recurrent pregnancy loss
- Fetus suspected of not growing enough
When should a woman consult an MFM?
- Before pregnancy – The MFM can help identify and prepare for the risks of pregnancy, especially if there is something in the woman’s medical history (a disease or prior poor pregnancy outcome) that increases the likelihood of a high-risk pregnancy.
- During pregnancy – The MFM can plan a course of action to address pre-existing conditions or conditions affecting the mother or fetus that develop during the course of the pregnancy. In some cases, the MFM may need to assume full responsibility for care if the case is beyond the expertise of the obstetric caregiver.
- After delivery – The MFM can assist with complications that may develop, such as postpartum hypertension, excessive bleeding, or resistant infection.
What are the most common fetal illnesses requiring an MFM?
- Birth defects
- Blood disorders
- Chromosomal abnormalities and genetic syndromes
- Congenital infections
- Intrauterine growth abnormalities
MFMs are trained to use diagnostic ultrasound to identify some of these complications. They are also skilled in planning and timing the delivery to optimize a healthy outcome.
Why is a maternal-fetal specialist the best physician to consult for a high-risk pregnancy?
The MFM specialist’s advanced training, mastery of complex technology and knowledge of the latest MFM medical advances makes him/her the best person to consult during a high-risk pregnancy.
If I consult a MFM specialist, how will he/she coordinate care with my primary care physician, obstetrician or nurse-midwife?
Many of these providers have the training and experience to manage high-risk pregnancies or to provide counseling before or during pregnancy. The MFM specialist will interact with you and your other medical providers as dictated by the seriousness of the case and specific local conditions. The MFM may also coordinate care with other medical and surgical subspecialists, neonatologists, anesthesiologists, and critical care teams if the specific case warrants. In some cases, the MFM may assume primary responsibility for care.