Maternal-Fetal Medicine

A maternal fetal medicine (MFM) doctor is an obstetrician/gynecologist who specializes in caring for a woman and her unborn child (the fetus) during high-risk pregnancy. High-risk pregnancy is a term used to describe any pregnancy in which a mother and baby need specialized monitoring and medical care. The types of risks vary and can include maternal age, since older women have a higher risk of having a child with Down Syndrome or other genetic problem. Other high risk pregnancies include women with medical conditions like diabetes, high blood pressure, or seizure disorders that can affect her baby’s development. Or the risk may simply refer to a woman carrying “multiples” (twins, triplets or more), or who has a history of preterm labor (contractions beginning too early in pregnancy) or past complications with pregnancy or delivery.

MFM specialists have advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and are dedicated to providing the most recent approaches to the diagnosis and treatment of obstetrical problems. Oftentimes the MFM doctor works with family physicians, obstetricians and mid-wives in the co-management or direct care of complicated patients before and during pregnancy.

The Division of Maternal Fetal Medicine is a national leader, specializing in many rare obstetrical complications. The division, comprised of seven MFM doctors, nurses, sonographers and genetic counselors, offers cutting edge clinical management and research in high-risk obstetrics including higher-resolution ultrasound and safer, less-invasive prenatal testing.

Who needs to see an MFM?

The following patients are in need of MFM expertise:

Patients undergoing diagnostic or therapeutic procedures during pregnancy, such as:

  • Comprehensive ultrasound
  • Chorionic villus sampling
  • Genetic amniocentesis, fetal surgery or treatment

Women with medical or surgical disorders, such as:

  • Heart disease
  • High blood pressure
  • Preeclampsia (toxemia)
  • Diabetes or other endocrine disorders
  • Kidney or gastrointestinal disease
  • Infectious diseases such as HIV

Healthy women whose pregnancy is at markedly increased risk for adverse outcome such as:

  • Abnormal AFT (alpha fetoprotein) blood test
  • Twins, triplets or more
  • Recurrent pre-term labor and delivery
  • Premature rupture of membranes
  • Recurrent pregnancy loss
  • Suspected fetal growth restriction (baby is not growing enough)

Services

For Fetal Therapy services, click here.

The Division offers prenatal consultations, genetic counseling, ante partum fetal surveillance, and a full spectrum of screening and diagnostic tests. Potential risks, benefits and potential fetal conditions are fully discussed prior to testing.

Tests for fetal well-being include:

Ultrasound is used to estimate the age or size of a baby, to look for birth defects or observe a baby’s activity, environment  and well-being:

  1. Multiple parameter fetal biometrics determine if the fetus is growing normally
  2. Biophysical profile (BPP) measures fetal heart rate, muscle tone, movement, breathing, and amniotic fluid levels
  3. Doppler flow studies assess blood flow in the umbilical blood vein and arteries, fetal brain and heart
  4. Fetal echocardiography evaluates the baby’s heart

Screening for chromosomal abnormalities using sonographic evaluation of the nuchal translucency and biochemical markers:

  1. A combination of first trimester and second trimester screening is offered through sequential and integrated screening. For example, a blood test called the quad screen looks for biochemical markers of Down Syndrome. Maternal serum AFT measures a protein called alpha-fetoprotein in the mother’s blood and screens for neural tube defects, like spina bifida, where the spinal cord and brain fail to develop.

    A Nuchal Scan helps identify higher risks of Down Syndrome in fetuses, particularly for older mothers who have higher risks of such pregnancies. The scan assesses the amount of fluid behind the neck of the fetus; babies with Down Syndrom risks tend to have a higher amount of fluid around the neck. The test may also help confirm both the accuracy of the pregnancy dates and fetal well-being, as well as detect other less common chromosomal abnormalities.

Evaluations of the placenta, uterus and cervix:

  1. Amniocentesis is done in the second trimester (16 to 22 weeks). This procedure takes a sample of amniotic fluid, which contains cells excreted by the fetus, to be analyzed for chromosome abnormalities like Down Syndrome or spina bifida or other genetic diseases.
  2. Chorionic villus sampling (CVS) is used to confirm a suspected genetic problem after initial screening. A more invasive procedure, CVS takes a few cells from the placenta to be analyzed. Past risks of CVS have been reduced by conducting the procedure later in the pregnancy, at least 10 weeks.
  3. Percutaneous umbilical cord blood sampling (PUBS), or fetal blood sampling, is a procedure in which a blood sample is withdrawn from the umbilical cord while the fetus is still in the uterus. It is used mainly for rapid chromosome analysis or to evaluate fetuses at risk for certain blood disorders.

The division also offers amniofusion (the insertion of amniotic fluid into the protective sac surrounding the fetus), fetal intrauterine blood transfusions and fetal therapies. Fetal therapies have been found to help many abnormalities once considered untreatable or only treatable after birth, such as spina bifida and tumors.


Our faculty also collaborates with the Divisions of Neonatology and Pediatric Cardiology to provide multidisciplinary care.


Additionally, our maternal fetal medicine specialists are the sole providers of care under the Regional Perinatal Intensive Care Center (RPICC) program at Jackson Memorial Hospital, a state program that promotes access to high-risk obstetrical and neonatal intensive care services to women. The division also has the largest perinatal HIV clinical practice in the United States.

For more information on maternal fetal medicine visit:

Where We Practice

Maternal Fetal Medicine Services are provided at: