What Is Maternal–fetal medicine (MFM)?
It is an emerging branch of medicine which focuses on managing health concerns of the mother and fetus before pregnancy, during pregnancy, and shortly after delivery. It is a subspecialisation within the field of obstetrics. These maternal and fetal medicine specialists (also known as High risk pregnancy specialist and Perinatologists) are dedicated in optimising outcomes in mothers with complex medical and surgical diseases as well as those with major obstetrical problems. They also help improve outcomes and provide guidance and counselling in cases of fetal diseases and anomalies.
To whom does it help?
This branch of medicine helps take care of expectant mothers who have chronic conditions e.g. heart, kidney or liver disease, gastrointestinal conditions e.g. Inflammatory bowel disease, hypertension, diabetes, neurological disorders e.g. seizure disorder, migraine, psychiatric conditions e.g. depression, blood disorders e.g. sickle cell disease, thalassemia and various thromboembolic conditions e.g. thrombophilias.
They also take care of pregnant women who are at risk for pregnancy-related complications (e.g. preterm labor, pre-eclampsia, and twin or triplet pregnancies) and wherever possible take preventive measures to reduce adverse maternal and fetal outcomes.
Also, they deal with expecting mothers who have underlying disorders like autoimmune conditions e.g. SLE (Systemic Lupus Erythematosus), musculoskeletal disorders e.g. kyphoscoliosis, those who conceived via ART (Artificial Reproductive Techniques), those with neoplastic diseases prior to or during pregnancy and women with disabilities.
They also deal with mothers whose fetuses may be at risk due to chromosomal or congenital abnormalities, maternal disease, infections, genetic diseases and growth restriction. They also deal with Rh isoimmunised pregnancies and help improve fetal outcomes.
To whom it can help?
Maternal fetal medicine specialists help workup of women with recurrent pregnancy loss and those with history of previous stillbirth. They also help in work up of women prior to pregnancy, do a detailed pre pregnancy counselling for different medical conditions or bad obstetric history so as to optimise the health of the woman before pregnancy and improve future pregnancy outcomes. They provide comprehensive care in association with other specialists and care providers. During pregnancy they monitor both the mother and fetus, make a pregnancy plan, timely birth plan and manage labour and delivery so as to provide the optimum outcome for the mother and the baby.
They are also well trained in obstetric ultrasound and perform detailed nuchal scan, anomaly scan, growth scan, doppler studies and various other obstetric scans. They can perform invasive prenatal diagnosis using amniocentesis and chorionic villus sampling for detecting Trisomies eg Downs syndrome or various other genetic conditions. Overall these specialists strive to improve maternal and child outcomes by prevention, diagnosis and treatment of various health conditions of women prior to, during and after pregnancy.
By Dr Prathima Prabhu
Assistant Professor, Department of OBG
MBBS, MS OBG, FNB Maternal and Fetal medicine (High risk pregnancy and Perinatology)
Father Muller Medical College Hospital, Kankanady, Mangalore
