Commonly Asked Questions
What does MFM mean in pregnancy?
For mothers-to-be whose pregnancies aren't routine, the obstetrician may make a referral to a Maternal-Fetal Medicine (MFM) specialist for extra specialized care.
What is MFM?
A Maternal-Fetal Medicine specialist is a doctor who helps take care of women having complicated or high-risk pregnancy. The complications can be maternal or fetal. Some women start pregnancy with medical conditions that need special follow up and monitoring while other women may develop a medical condition as a result of being pregnant. An MFM also watches and monitors the fetus during pregnancy to be sure the baby is growing and developing normally. Some fetuses have structural differences or conditions that need to be followed closely throughout the pregnancy.
How is an MFM different from an OB physician?
MFM physician is a physician who did extra training after their OB/GYN residency to become a subspecialist in high risk pregnancy care and fetal imaging. Their training typically includes a four-year residency in obstetrics and gynecology followed by a three-year fellowship in MFM. They perform high detail prenatal ultrasounds and may provide treatments or offer tests to be sure your unborn baby is healthy.
What training did Dr. Stephenson complete?
Dr. Stephenson, after medical school, completed a four year residency at New York-Presbyterian Brooklyn Methodist Hospital and a three year Fellowship at New York University (NYU). After which she sought out additional training, while working full time in Charlotte as an MFM, in fetal surgery at the Cincinnati Children’s Hospital Medical Center for additional three years.
Dr. Stephenson is an expert in Maternal-Fetal Medicine and fetal intervention. She has over 16 years of experience.
Why would I be referred to a MFM for an ultrasound?
MFM physicians have specialized training in fetal ultrasound and are able to image fetal structure in tremendous detail. The imaging requirements of an MFM ultrasound (level III) are highly meticulous and differ from that an ultrasound with your Obstetrician. This detailed scan may be necessary when there is a clinical concern that needs clarification. MFM physicians are also able to perform ultrasound tests for fetal wellbeing and interpret blood flow studies to be certain the fetus is healthy and not in distress.
What can I expect at my first appointment?
The first appointment is a consultation appointment which includes an ultrasound assessment of your pregnancy. Your MFM physician will review any medical records, surgical history, medications or environmental exposures, and prenatal labs or screening tests that may have been done. A family history is also important to mention, if you have any concerns, so that the physician can have a complete picture of your health. Our MFM practice has the latest state of the art ultrasound imaging equipment, GE Voluson E10, and will provide you with tremendous detail regarding your pregnancy and fetal condition.
If I am sent to an MFM for care, does this mean my baby has a problem?
Most patients are routinely referred to an MFM for evaluation and reassurance. Many patients are in a “high risk category” due to their age, prior history, family history, or a medical condition and need a higher level of care or imaging of their baby, but are ultimately reassured that “everything is ok”. Just because a patient is referred to an MFM doesn’t mean there is a “problem”, most of the time patients leave feeling confident “everything is ok”.
Sometimes your obstetrician finds a concern and would like clarification and therefore sends the patient to an expert in maternal-fetal care for consultation and assistance. We work collaboratively with your obstetrician to provide excellent care during your pregnancy.
If we do find a concern, we are here to support you all the way through your pregnancy.
What is genetic counseling?
Genetic counseling is a consultative meeting that may be recommended for women with a significant medical or pregnancy history of birth differences or family conditions which may have a genetic predisposition.
Our physicians and nurses believe in non-judgmental and non-directive counseling. You can expect to receive objective information about the benefits, limitations, and/or potential risks of all of the screening options and/or procedures if offered. All decisions made by the patient are respected and patients are directly involved and participate in their care plan.
What are genetic disorders?
Genetic disorders are the result of changes in a person’s genes or chromosomes—these changes can be spontaneous or inherited.
There are two main categories. The first is aneuploidy. Aneuploidy is a condition where there are missing or extra chromosomes or pieces of chromosomes. Trisomy is when there is an extra chromosome and monosomy is a missing chromosome.
The second category is inherited disorders, such as sickle cell disease, cystic fibrosis, Tay-Sachs disease and many others. These disorders are caused by mutations in genes. In most cases, both parents must carry the same gene for it to affect the child. Parents can be screened for these disorders through their DNA in pan-ethnic screening panels.
When do I get an ultrasound?
Ultrasounds are performed at any time during pregnancy. MFM appointments are generally scheduled with an ultrasound, as the imaging results can affect the counseling and pregnancy care. The earliest point at which fetal structures or gender can be imaged is during the late first trimester, between 11- 13 weeks 6 days. With the appropriate medical indication, such as advanced maternal age, it is highly recommended that you have a late first trimester ultrasound to evaluate the fetal anatomy.
Who should have a late first trimester (11 0/7 - 13 6/7 weeks) anatomical ultrasound*?
- Previous child with congenital, genetic, or chromosomal anomaly
- Known or suspected fetal anomaly in current pregnancy
- Fetus at increased risk for congenital anomaly based on the following:
- 35 years of age or older
- Maternal pre-gestational diabetes
- Increased early HbA1c
- Conceived by IVF
- Multifetal gestation
- Medication use during pregnancy
- Medication exposure after 6 weeks of pregnancy/ teratogen exposure
- Increased NT
- Positive cell free DNA screen or aneuploidy screening by serum/ combined screen
- Other conditions possibly affecting the pregnancy/ fetus
- Maternal BMI > 30 mg/kg2
- Placental implantation covering internal cervical os or under cesarean section scar
*J Ultrasound Med 2020. AIUM Practice Parameter for the Performance of Detailed Diagnostic Obstetric Ultrasound Examination
Who should have a Targeted Anatomical Survey
- Previous fetus or child with congenital, genetic, or chromosomal abnormality
- Known or suspected fetal anomaly in the current pregnancy
- Known fetal growth disorder in the current pregnancy
- Fetus at increased risk for a congenital anomaly
- Fetus at risk for genetic or chromosomal abnormality (maternal age > 35 years old at delivery)
- Other conditions affecting the fetus (low or high amniotic fluid, concern for fetal infection or anemia)
- Second opinion or uncertain ultrasound findings
- Concern for placental abnormalities