Maternal-Fetal Medicine Consultations
Maternal-Fetal Medicine consultation is needed whenever a pregnancy
is complicated by medical, obstetric, or genetic conditions, ultrasound
abnormalities, or teratogen exposure.
Medical complications of pregnancy include any medical condition
that has potential of being active or is active during the pregnancy.
Examples include Diabetes, Hypertension (high blood pressure), heart
diseases, thyroid diseases (Grave's disease, hypothyroidism, etc.),
Connective tissue disorders (Lupus, arthritis, scleroderma, etc.),
asthma, pneumonia, kidney stones, kidney infections, hepatitis,
infections (HIV, syphilis, etc.), cancer, and many other possible
The concerns that may arise from a medical complication include:
worsening of the medical problem because of pregnancy, poor pregnancy
outcome because of the medical condition, the effect of medications
used on the pregnancy, and the effect of the pregnancy on medications
used. All these concerns require careful evaluation by specialists
skilled in the care of high-risk pregnancies with medical complications.
A team approach that includes your Obstetrician, your Internist,
and a Maternal-Fetal Medicine specialist is necessary in many circumstances.
At times, your Obstetrician and the Maternal-Fetal Medicine specialist
suffice. As a general rule, it is always best to obtain prepregnancy
counseling with a Maternal-Fetal Medicine specialist two to three
months prior to conception to maximize your pregnancy outcome and
avoid deterioration in your medical condition. However, should you
find yourself unexpectedly pregnant, seek consultation with a Maternal-Fetal
Medicine specialist as soon as a fetal heart beat is documented
by your Obstetrician, at around 6 weeks from the first day of your
last menstrual cycle, or 4 weeks from the day of conception, if
you know that date.
During the course of a pregnancy, many obstetrical complications
may arise such as vaginal bleeding, early rupture of the sac of
pregnancy (membranes), poor fetal growth, hypertension of pregnancy,
or diabetes of pregnancy. These complications require careful follow
up of your health and the fetal health. Here again, a team approach
that includes your Obstetrician and a Maternal-Fetal Medicine specialist
can improve your pregnancy and personal health outcome immensely.
When to get help regarding a pregnancy
If your family has a known genetic problem, then it is important
to obtain prepregnancy counseling with a Geneticist and a Maternal-Fetal
Medicine specialist in order to understand your potential pregnancy
risks and to plan your future pregnancy. If you do not have known
history of genetic problems in your family however, it does not
mean that your likelihood of having a baby with a genetic condition
is zero. The most common type of Down syndrome, Trisomy 21 for example,
does not run in families and is simply a chance occurrence. Furthermore,
genetic problems are not always expressed in families that carry
potential for having them. Examples of such genetic problems include
Cystic Fibrosis, Tay-Sachs, thalasemia, Sickle-cell anemia, and
many others. Though many of the latter genetic conditions are more
prevalent in certain ethnicities, for example Tay-Sachs in Ashkenazi-Jews,
Cystic Fibrosis in northern Europeans, and Sickle-cell anemia in
Africans, no ethnicity is immune to these conditions. Therefore,
it is important that you and your partner seek genetic advice prior
to conception, or very soon after conception. It is important to
understand that many genetic problems arise newly in a family, such
as the common type of Dwarfism.
Dealing with abnormalities
If on ultrasound your fetus (baby) shows an abnormality, it is
very important to obtain consultation with a geneticist and a Maternal-Fetal
Medicine specialist. The need for proper evaluation of the abnormality
by ultrasound, genetic testing on the parents, fetus, and placenta,
careful follow up of the pregnancy, careful evaluation of the aborted
fetus (should that be the couple's choice), and careful evaluation
of the newborn is imperative for maximizing the current and any
future pregnancy outcome. Hasty decisions regarding an abnormal
finding on ultrasound of the fetus may seem at the time emotionally
appropriate, but unfortunately may cause more anguish in the future.
It is important to obtain the appropriate emotional support through
known organizations with experience in helping families in crisis.
During conception and pregnancy, there is a high potential for
exposure to teratogens. Teratogens are substances that have potential
to cause fetal defects and poor pregnancy outcome. Examples of such
substances include Tobacco, Alcohol, Retin-A, some Chemotherapy
agents, high dose X-ray, certain Chinese Herbs, diet pills, certain
vitamins, and so on. It is very important that prior to conception
you consult with a Maternal-Fetal Medicine specialist regarding
all prescription medications, over-the-counter pills, herbs, vitamin
supplements, herbs, and recreational drugs that you or your partner
are using. Please do not stop prescription medications without consultation
with a Maternal-Fetal Medicine consultant, as many times you are
wrongly advised to do so by your Internist. Many medications are
not only considered safe for use during pregnancy, but are considered
essential to a safe pregnancy outcome for you and your baby.
Our office is skilled in the care of a wide range of Maternal and
Fetal complications. Call for an appointment with one of our Maternal-Fetal
Medicine specialists prior to conception, after conception, or any
other time during your pregnancy should a medical, obstetric, genetic,
fetal, or other problem arise.
Obtain all medical records and tests that pertain to your
current health problems, previous serious health problem, and previous
Request records from doctors and hospitals to be faxed to
our office prior to your appointment with us so that we may review
them in advance.
You will require 15-20 minutes to fill out paper work in our
office prior to being evaluated by a physician.
How to prepare for, and what to expect during, Maternal-Fetal Medicine
Consultation in our office:
Your visit may entail a full physical exam and ultrasound of
The length of your visit will vary between 40 and 90 minutes
depending on the complexity and number of problems you have.