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The New Age of Maternal Fetal Medicine – From Simulations to Precision Medicine

health & life text over pregnant woman - Maternal-Fetal Medicine

The U.S. is often believed to have the best healthcare in the world. But when it comes to maternal fetal medicine care, this is not necessarily the case. Among high risk deliveries today, mothers in the U.S. are three times more likely to die than mothers in Canada. This figure jumps to six times as high when compared to mothers in Scandinavia. According to the Centers for Disease Control, between nearly 900 maternal deaths occur annually in the U.S., and 60 percent could be prevented.  Fortunately, advances in maternal fetal medicine are helping change the current landscape for the better.

What Exactly is Maternal Fetal Medicine?

By definition, maternal fetal medicine is an advanced specialty of obstetrics and gynecology. For a physician to become a maternal fetal medicine specialist, he or she must complete 3 years of additional training. The added experience and training enable these specialists to accommodate the needs of high-risk pregnancy patients. Of course, pregnancies involve two patients…the mother and the fetus. And either patient could demand the services of a maternal fetal medicine specialist if a high risk for complications existed.

With this in mind, knowing what represents a high-risk pregnancy is important. Most pregnancies are low-risk in nature, meaning that routine prenatal care can be administered without problems likely occurring. High-risk pregnancies are just the opposite. In these instances, the mother may have a preexisting condition that increases the chance of problems. Common conditions might include unexpected bleeding, hypertension, and diabetes. Likewise, the fetus may be the one with problems, like a birth defect or poor growth. In these instances, a maternal fetal medicine specialist is typically involved in their care.

Improving Maternal Fetal Medicine Through Simulation Training

Maternal Fetal Medicine Doctor providing a prescription to Pregnant Woman Maternal Fetal Medicine
Maternal Fetal Medicine Doctor providing a prescription to Pregnant Woman Maternal Fetal Medicine

Of all states, California suffers the most from poor maternal fetal medicine outcomes. Why? Because 12 percent of all children are born in California. However, since 2006, the state has reduced maternal mortality rates by 55 percent. By investing in training simulations and pre-arranged toolkits in hospitals, the chance of poor maternal outcomes has fallen significantly. These simulation training program typically use highly sophisticated mannequins to teach health providers about proper care of high-risk pregnancy patients. These programs may also be combined with computer simulations to provide further guidance and education. Toolkits that contain IV lines, oxygen masks, and special balloons to stop bleeding have also helped. These toolkits alone have reduced maternal morbidity by 21 percent. With nearly 90 percent of hospitals adopting similar strategies in California, marked improvements in maternal fetal medicine outcomes have resulted.

Telehealth Impact on Maternal and Fetal Medicine  

Telehealth is also offering new strategies for maternal fetal medicine to enhance pregnancy-related outcomes. For low-risk pregnancies, telehealth offers a way to remotely perform prenatal monitoring. With proper guidance, pregnant mothers can monitor fetal heart rates, their own blood pressure, and fundal height with telehealth oversight. For high-risk pregnancies, telehealth provides rural providers with access to maternal fetal medicine specialists. In states like South Carolina and Arkansas, where over a third of the state is rural, telehealth is making a big impact. Results show significant reductions in premature births and neonatal and maternal mortality with the use of telehealth in these instances. Some facilities, like the Medical University of South Carolina, perform 50 to 60 telehealth maternal fetal medicine consults each week.

Maternal Fetal “Precision” Medicine

Current trends also show that maternal fetal precision medicine is moving toward a precision medicine model of care. Precision medicine, or personalized medicine, aligns care based on an individual’s genetics, medical history, environment and lifestyle. With this in mind, some businesses are working with maternal fetal medicine providers to facilitate care during pregnancy. For example, Babyscipts, a company based in Washington D.C., provides pregnant mothers with a smartphone app. The application then coordinates recording, documentation and communication of important data during the pregnancy. The company is currently raising capital for the development of wearable monitors worn during pregnancy. These devices would communicate to smartphone apps through Bluetooth technologies. Such precision medicine strategies can provide maternal fetal medicine specialists with real-time data to enhance better decision-making throughout the pregnancy.

The Future of Maternal Fetal Medicine Outcomes

Certainly, technological advances are already making an impact on maternal and fetal medicine care. In all probability, continued use of artificial intelligence, big data systems, and mobile data devices will encourage further progress in these areas. Likewise, increased accessibility to the proper care at the right time will hopefully reduce mortality rates and improve outcomes. And further advances in non-invasive prenatal testing will help even more. Based on current trends, the future for maternal fetal medicine certainly looks very exciting.

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