Having a high-risk pregnancy can be very stressful. Your ob-gyn may refer you to a maternal-fetal medicine expert. They offer advanced treatments, testing, and advice.
Maternal-fetal medicine experts are often called MFMs for short. These obstetricians (OBs) have extra training in diagnosing and treating problems in pregnant people. They care both for you and your growing baby.
Your MFM may be your primary doctor while you are pregnant. Or, they may see you only once or twice, advising your ob-gyn.
What Is a High-risk Pregnancy?
A high-risk pregnancy involves one or more problems that could affect the health of the pregnant person, the baby, or both. For instance, people with heart problems may need a high-risk OB. In other cases, the fetus may face health issues related to abnormal development.
Being pregnant requires a lot from the body. This means people’s chronic health problems can worsen while pregnant. Health problems in the pregnant person that may need an MFM’s care include:
- Autoimmune issues
- Mental health concerns
- Heart problems
- Kidney problems
- Lung problems
- Neurologic problems
- Endocrine problems
- Infectious diseases
An MFM can also help with health problems that arise while you are pregnant. These problems may start in the first trimester or just days before a due date. Health issues during pregnancy can threaten the pregnant person and the fetus.
- Cervical thinning or opening too early (cervical insufficiency).
- High blood sugar (gestational diabetes).
- High blood pressure due to the placenta (preeclampsia).
- If the placenta detaches from the uterus (placental abruption).
- Too much amniotic fluid.
On top of addressing health problems that occur in the pregnant person, MFMs also help with health diagnoses in the fetus. These include:
- Chromosomal and genetic changes, like Down syndrome.
- Fetal growth problems.
- Problems with the baby’s heart, kidney, lungs, or other organs.
- Spina bifida.
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How Do Maternal Fetal Medicine Doctors Help People With High-risk Pregnancies?
For health issues during pregnancy, your MFM will provide education and understanding and may suggest medicines and lifestyle changes. They will watch your health and the baby’s health as needed. MFMs have advanced training in what drugs are safe for pregnant people to take and which aren’t.
The MFM will provide extra tests and advice concerning the fetus’s health. They may suggest changes in activity, medicines, or stitching the cervix closed to reduce the risk of preterm birth.
MFMs can even advise about surgery in the womb or other treatments like blood transfusions to the fetus.
Advanced tests and treatments offered by maternal-fetal medicine specialists
MFMs offer advanced tests and treatments that regular OB clinics might not provide. MFMs may do these tests and treatments or refer you to another doctor. These include:
- Genetic testing and counseling.
- Chorionic villus sampling (CVS) of the placenta. The placental contains the fetal genetic material. CVS can confirm chromosomal problems or congenital disabilities. The MFM can do this test as early as 10 weeks, but it carries slightly more risks than amniocentesis.
- Amniocentesis. This test collects a small amount of amniotic fluid using a needle. Amniotic fluid contains fetal cells and chemicals that can signal problems with the fetus. This can be performed as early as week 16.
- More advanced ultrasounds, like 3D and 4D ultrasounds.
- Fetal echocardiogram. This test uses ultrasounds to see how the fetal heart beats.
- Fetal blood transfusions through the umbilical cord.
- Umbilical cord sampling or collecting a fetal blood sample to diagnose diseases.
- Therapeutic amniocentesis to take out extra amniotic fluid.
Can I See a Maternal Fetal Medicine Specialist Before I Get Pregnant?
If you have a chronic health issue, visiting an MFM before you get pregnant can help your planning. They can talk to you about how carrying a child might affect your health. They can also help you plan a strategy to stay healthy should you get pregnant.
For instance, they can tell you when to stop or start certain medicines and help you plan your diet and exercise.
You may see an MFM before you get pregnant if you’ve suffered a previous pregnancy loss, late miscarriage, or preterm birth. They can explore why complications happened and whether they might happen again. They can also suggest a plan for your next pregnancy.
If you’re worried about a congenital disability, MFMs can provide genetic testing and counseling. That way, you’ll know your risk of having another child with a genetic disorder. They can also help you explore options like egg or sperm donation or embryo selection.
Sometimes, an MFM will suggest treatments to improve your health before getting pregnant. This can reduce the risk that something will go wrong.
A Maternal Fetal Medicine Specialist Provides Extra Reassurance
An MFM helps to reduce the chance something will go wrong in your high-risk pregnancy. If a problem occurs, they make sure you and your child have the best outcome possible. You’ll be glad you have someone on your team with extra training in high-risk pregnancies.
American Medical Association. Maternal Fetal Medicine (OBG). Link
Colleen de Bellefonds. What is a maternal and fetal medicine specialist? BabyCenter. Link
Dr. Traci Johnson. What is an MFM specialist? WebMD. Link
Society for Maternal and Fetal Medicine. What we do. Link
Society for Maternal and Fetal Medicine. What makes a high risk pregnancy? Link
About UPMC Magee-Womens
Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.
Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.