Concerns about the strength and safety of a newborn in the womb are challenges that every new mother faces, especially those with high-risk pregnancies who require special care. Today, we spoke with Dr. Adisorn Aksonpusitpong, a maternal-fetal medicine specialist at Phyathai 3 Hospital, to clarify what a “high-risk pregnancy” means, who an MFM doctor is, and how they can help boost a pregnant mother’s confidence.
What is a High-Risk Pregnancy?
A high-risk pregnancy refers to a pregnancy with conditions or factors that could adversely affect the mother and fetus, potentially leading to health issues or even death during pregnancy, childbirth, or after delivery.
Who is an MFM Doctor?
Dr. Adisorn explains that an MFM doctor, or Maternal-Fetal Medicine specialist, is a physician who has completed additional training in maternal-fetal medicine after finishing their obstetrics and gynecology residency. They are responsible for caring for pregnant women with high-risk pregnancies, focusing on both the mother and the fetus, identifying potential risks, and providing prevention or treatment to ensure the health and safety of both mother and baby.
Main Responsibilities of an MFM Specialist
1. Consultation and Care: Provide consultation, monitor the pregnancy, and manage deliveries.
- High-Risk Pregnancy Management: Oversee pregnancies with high-risk factors or complications for the mother and/or fetus from pre-pregnancy through to delivery and post-delivery.
- Management of Pre-existing Conditions: Care for pregnant women with chronic diseases such as diabetes, hypertension, and autoimmune disorders (e.g., SLE, APS).
- Complication Management: Address complications such as gestational hypertension, risk of preterm birth, threatened miscarriage, recurrent miscarriage, and low-lying placenta.
- Fetal Health Monitoring: Care for fetuses with disabilities, intrauterine growth restriction (IUGR), or in cases of multiple pregnancies, especially identical twins, which carry unique risks like twin-to-twin transfusion syndrome or unequal growth.
2. Detailed Fetal Assessments: Conduct thorough examinations to detect fetal abnormalities, particularly in high-risk pregnancies that require close monitoring.
- Ultrasound Assessments: Perform anomaly scans to detect fetal defects and growth scans to assess fetal health and well-being.
- Genetic Testing: Screen for genetic disorders via amniocentesis, cord blood sampling, or chorionic villus sampling, and evaluate risks for conditions like Down syndrome or hereditary blood disorders such as thalassemia.
3. Management of Short Cervix: Monitor and treat conditions that may lead to premature birth, including cervical cerclage and medications.
- Fetal Therapy: Address complications or abnormalities of the fetus while in utero, such as hydrops, arrhythmias, twin transfusion syndrome, or some forms of fetal tumors, including invasive procedures for diagnostic sampling.
- Termination of Pregnancy: Perform pregnancy termination as indicated for medical reasons.
Helping Abnormal Fetuses Before Birth
Dr. Adisorn explains that MFM doctors can treat fetuses with abnormalities that can be addressed while still in the womb before birth. Examples include administering blood transfusions via the umbilical cord for fetuses with severe anemia, providing medications for fetuses with arrhythmias, and performing laser ablation of placental tumors that divert blood from the fetus.
It is essential for mothers with a high-risk pregnancy to undergo screening to confirm the safety of their pregnancy with a specialized physician from the very beginning. Many conditions can be managed while the fetus is still in utero. Therefore, mothers should not lose hope and are encouraged to seek detailed consultations with their doctors. This proactive approach can help ensure that their little ones continue to thrive.
Dr. Adisorn Aksonpusitpong
Maternal-Fetal Medicine Specialist
Women’s Health Center, Phyathai 3 Hospital
