Maternal Fetal Medicine Specialists (Perinatologist) – What Are They & When to See One?

Pregnancy is a delicate affair. While some fortunate women may have a smooth pregnancy, others may not. If you fall in the latter category of women or know someone who has a high-risk pregnancy or is facing complications while pregnant, you know it well that special care and constant monitoring is a must in such a case. A mention of high-risk in pregnancy can get any woman worked up, no doubt, but one need not lose hope because at the end of the tunnel there’s light whom we call a perinatologist. A perinatologist comes as a blessing in the life of a woman who has a high-risk pregnancy.

If you’ve never heard of a perinatologist (also known as maternal-fetal medicine specialist) before, you’re bound to have certain questions. Let’s try to answer some common questions that pregnant women have regarding an MFM.

Who Is a Maternal-Fetal Medicine Specialist (MFM)?

A perinatologist or maternal-fetal specialist is an obstetrician-gynaecologist with a specialized degree and knowledge to manage high-risk pregnancies. An MFM doctor is an OB/GYN but along with these specializations, the doctor also undertakes three years of fellowship to understand and work on various complications associated with pregnancy, which can affect both the mother and the foetus. These specialists usually work alongside OB/GYNs or midwives to monitor any fetal complications and maternal diseases. A maternal-fetal medicine specialist is often consulted by a pregnant woman in case of complications in her pregnancy or on the occurrence of any kind of accidents or mishaps.

When to See a Perinatologist

A woman whose pregnancy isn’t a routine or regular pregnancy may be referred to a perinatologist or a high-risk doctor for pregnancy for the added care and monitoring. The prime focus of maternal-fetal medicine doctor is to take the utmost care of the mother and her baby during various phases of pregnancy, which includes before, during, and after delivery. Following are some conditions when you may be required to see a perinatologist:

Before Pregnancy

In most cases, a woman may be required to see a perinatologist during pregnancy but some women may require the assistance and guidance of a maternal-fetal medicine doctor even before getting pregnant because of some complications. A woman may need to visit an MFM specialist:

• If she has had a miscarriage before, if her previous pregnancy was a high-risk pregnancy, or if she had faced other complications in pregnancy.
• If she has any medical condition that may create problems during pregnancy, such as lupus, high blood pressure, diabetes, or other chronic conditions that may include your blood vessels, kidneys, heart, lungs, digestive system, immune system, etc.
• If the woman is obese or severely overweight.
• If there are any genetic abnormalities or conditions present in the family such as sickle cell or Tay-Sachs, cystic fibrosis, etc.

During Pregnancy

Sometimes a pregnant woman may experience complications during her pregnancy that may become risky for her or her unborn baby. Following are the cases when the pregnant woman may have to visit an MFM specialist.

• If the pregnant woman gains excessive weight during pregnancy, she may develop health risks such as gestational diabetes, preeclampsia, stillbirths, and other such complications. In the case of these complications, she might have to visit an MFM specialist.
• If the pregnant woman suffers from any kind of injury during pregnancy that may have affected her and her unborn baby.
• If there are any birth defects, genetic abnormalities, growth issues, and other kinds of complications that may get discovered during pregnancy. The doctor may conduct advanced tests to establish the condition, work with the paediatrician to treat the condition after or in some cases before the birth of the baby. The doctor may sometime prepare the parents to expect a baby with special needs.
• If the mother is carrying twins, triplets, or multiple babies, this may increase the associated risks that include early delivery amongst others. The doctor will closely monitor the growth of such babies and if any medical issue crops up the measures may be taken to cure them before birth only.
• If the mother experiences medical conditions where the amniotic fluid starts reducing or her immune system starts harming her unborn baby’s tissues and other such conditions.

After Delivery

A woman may require specialist care and services of a perinatologist after delivering her baby too in some of the below-mentioned conditions:

• If the woman experiences any kind of excessive or heavy bleeding post-childbirth.
• If some kind of infection develops that requires immediate care and medical intervention.

A woman may have to visit a perinatologist because of the above-mentioned or other complications. Based on the severity of the risk and condition, the doctor may chalk a special care plan after checking with the woman’s OB/GYN or midwife. This plan may include various kinds of blood tests, screenings, fetal screenings, etc and in some cases chorionic villus sampling, amniocentesis, etc. Apart from monitoring the physical well-being, the doctor may also help the woman deal with any kind of emotional stress.

How to Choose the Best Maternal-Fetal Medicine Doctor

When it comes to choosing a maternal-fetal medicine doctor or maternal and fetal specialist, here are some things that one should consider:

1. Check the doctor’s experience.

Since most people don’t know about an MFM specialist, so if you have to visit a perinatologist, you must consider one who has enough experience in dealing with pregnant women who have had high-risk pregnancies.  Therefore, you must select a high-risk perinatologist who sees a high volume of patients on a regular basis. You can always take references from family or friends who may have availed the facilities of such specialists.

2. Look for a doctor who has specialized in the condition you’re affected with.

Choose a perinatologist who has specialized in the condition you are affected with. Although most specialists can deal and treat multiple health complications, you should go for the one who has already dealt with complications that you might be experiencing.

3. Check if the MFM specialist works closely with the other associated specialists.

You should go for a perinatologist who also works closely with other doctors who can manage, treat and monitor the condition of the patients. Therefore, when you choose a maternal-fetal medicine specialist for yourself, you are not only choosing one doctor but you are opting for a network of doctors who usually have connections with the multidisciplinary team of specialists. The team together may make efforts in ensuring the best medical support for the expectant mother and her unborn baby.

4. Choose the one who coordinates with the associated care.

In most cases, it is the OB/GYN who takes care of a woman during your pregnancy. It is only when there are severe complications, a maternal-fetal medicine specialist is consulted. However, there are many perinatologists who work closely with OB/GYNs and monitor the health and well-being of their patients before and during pregnancy and in some cases even post-delivery. Such a perinatologist acts as single contact in helping a woman sail smoothly through pregnancy and delivery. If you’re pregnant, you should look for a perinatologist who works with your gynaecologist and is well-informed about your condition.

It is normal for a pregnant woman to feel overwhelmed if she is asked to see a maternal-fetal medicine specialist. But one should panic, as consulting a perinatologist may be the best in case of a high-risk pregnancy. Sometimes, a gynaecologist may suggest a pregnant woman visit an MFM specialist just to take an expert opinion on some pregnancy-related complications but that does not mean that the woman has a high-risk pregnancy. Taking an expert’s opinion is wise during pregnancy, whether there is any complication or not.

Also Read: Foetal Echocardiography