What is Maternal-Fetal Medicine or MFM

Maternal-Fetal Medicine (MFM) is a branch of obstetrics that is focused on managing health concerns of the mother and fetus before, during, and shortly after pregnancy. Therefore, it is also associated with the term ‘Perinatology’ (‘peri’ and ‘natology’ meaning ‘around’ + ‘birth’). An MFM physician is required to complete an additional 3 years of education and training, also known as an MFM Fellowship, following 4-5 years of training as an obstetrician and gynecologist. MFM training is involved in all aspects of maternal health care during pregnancy, as well as fetal development and wellbeing. It encompasses knowledge from internal medicine, surgery, radiology, genetics, and of course, obstetrics. An MFM specialist utilizes all armamentarium available to obstetricians and heavily relies on the utilization of high-precision ultrasound analysis (2D conventional, color, pulsed, and power Doppler, 3D/4D) of fetal anatomy, wellbeing, and placental function.

A high-risk pregnancy threatens the health or life of the mother and/or her fetus. Common preexisting maternal disorders considered for high-risk pregnancy are, for example, diabetes, hypertension, thyroid disorders, cancer, autoimmune disorders, asthma, kidney disease, and mental health disorders. Common fetal disorders are fetal malformations, chromosomal aberrations, growth deficiency, and similar. There are also a multitude of obstetrical complications that elevate normal pregnancies to high-risk ones such as multifetal pregnancy, preterm labor, and weak cervix predisposing to preterm labor, diabetes in pregnancy, thrombocytopenia of pregnancy, and other hematologic disorders.

Poor obstetrical history is a significant risk factor especially if it had been associated with placental malfunction, abruption (premature separation), placenta previa, multiple cesarean deliveries, or fetal demise (stillbirth) in prior pregnancies. Multiple maternal personal and family conditions, current and in the past, such as maternal obesity with BMI >35, pregnant patients <16 years of age or with advanced maternal age (>35 years of age), conception via IVF assisted technology, smoking, alcohol use or drug substance dependency during the pregnancy are also considered risk factor(s) for ongoing pregnancy. Family history, for example, of deep vein thrombosis (DVT) in father or mother increases patient risk of inherited thrombophilia that can be a contributing factor to maternal postpartum DVT or even catastrophic PE (pulmonary embolus).

Collaboration between your Obstetrician and MFM physician, even when pregnancy is considered low risk, is very prudent and beneficial as an MFM specialist is trained to detect and uncover many subtle risk factors in pregnancy. MFM specialists can optimize current pregnancy and reduce the risk of adverse events during pregnancy and postpartum, for both - mother and her fetus/neonate. In addition, an MFM specialist is trained, and Board Certified to provide the most adequate pregnancy and fetal assessment via sonogram (ultrasound) that surpasses the ability of a Radiologist or general obstetrician.

Mariposa Perinatal is a consultative practice that is patient-focused by providing detailed assessments and personal attention to you and your health care provider (referring doctor, midwife, or nurse practitioner), of your maternal and fetal status when pregnancy complications exist, or pregnancy is at risk of adverse outcome.

Our expertise is summarized into services related to:

Maternal medical or obstetrical conditions:

Office and hospital consultations,
High-risk pregnancy co-management,
Genetic counseling,
Facilitation of antepartum care transfer to a highly specialized clinic or hospital if the maternal or fetal condition requires.

Fetal conditions:

Routine and high-resolution ultrasound (performed on the most advanced ultrasound machines with certified ultrasound technicians),
Targeted ultrasound such as a fetal echocardiogram,
Antepartum testing (also known as fetal surveillance),
Non-invasive and invasive fetal testing (genetic amniocentesis, Chorionic Villus Sampling or CVS, fetal umbilical cord blood sampling, or intrauterine blood transfusion).