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 conditions.
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.
How to prepare for, and what to expect during, Maternal-Fetal Medicine Consultation in our office:
- Obtain all medical records and tests that pertain to your current health problems, previous serious health problem, and previous obstetrical complications.
- 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.
- Your visit may entail a full physical exam and ultrasound of your pregnancy.
- The length of your visit will vary between 40 and 90 minutes depending on the complexity and number of problems you have.