Women's and Children's Hospital, Adelaide

Maternal Fetal Medicine (MFM) Clinic

Women who should be referred for care with the Maternal Fetal Medicine Unit

Focussed MFM Care

  • Rhesus and other blood group incompatibilities (titre ≥ 1:16 or previously affected fetus)
  • Platelet incompatibilities
  • Previously affected fetus (as per 6.3.1 MWT)
  • Monochorionic / Monoamniotic Twin Pregnancy
  • Monochorionic / Diamniotic (MC/DA) Twin Pregnancy with Twin-Twin Transfusion Syndrome (TTTS) or discordant growth
  • Triplet and Quadruplet Pregnancy (and greater multiples)
  • Delayed interval deliveries
  • Fetal congenital malformation with deterioration or requiring intervention
  • Fetal ‘hospice’ care
  • Fetal cardiac arrhythmias
  • Fetal hydrops
  • Inherited fetal endocrine anomalies requiring transplacental therapy
  • Early onset intrauterine growth restriction (IUGR ≤ 24 weeks)
  • Referral based on ADACS involvement
  • Parvovirus seroconversion until patient out of window
  • Primary seroconversion with toxoplasmosis and cytomegalovirus
  • Previous ≥ 2 Perinatal deaths (IUFD, NND)
  • Previous ≥ 2 spontaneous non-iatrogenic pre-term births < 28 weeks gestation
  • Antiphospholipid syndrome with previous adverse obstetric event
  • Sickle Cell Anaemia or G6PD deficiency
  • Cardiac disease with pulmonary hypertension – (New York Heart Association Classification Grade III or IV)
  • Anti-Ro and/or Anti-La antibodies

"Shared Care" with Consultation

  • MC/DA Twins without TTTS or growth discordance
  • IUGR requiring doppler / cardiac function indices / biophysical assessment follow-up
  • Fetal congenital malformations without in utero deterioration -- very case dependent
  • Prophylactic cerclage
  • Maternal transplant

Other High Risk Consultations - Referrals

This list does not define the scope of practice of an MFM subspecialist unit, but outlines the types of cases that are rare and complex enough so that generalist obstetrician / gynaecologists have very limited exposure to them, or that require the particular “hands on” ultrasound and fetal intervention skills that subspecialty MFM training provides. The service also has close liaison with the Antenatal Diagnosis and Counselling Service, and benefits greatly from the continuity of care that the MFM unit midwives can offer to very high risk pregnant women. As may all specialists, some MFM subspecialists have particular interests in other disorders such as thrombophilias, HIV or hypertensive disorders of pregnancy which may be useful to generalist obstetrician / gynaecologists. The MFM unit is prepared to accept referrals for any high risk pregnancy, but not with any presumption of priority for other complex pregnancies exclusive to the other specialty units.

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last modified: 29 Jul 2014