Maternal-Fetal Medicine

Maternal-fetal medicine (also known as perinatology) is a surgical sub-specialty of obstetrics and gynecology that focuses on the medical and surgical management of high-risk pregnancies. Management includes monitoring and treatment, including comprehensive ultrasound, chorionic villus sampling, genetic amniocentesis, and fetal surgery or treatment.

High-risk pregnancies may include patients who are older than 35 and younger than 17, patients who are underweight or overweight, pregnant with more than one fetus, patients who have gone into premature labor, babies with birth defects, and patients with high blood pressure, heart disease, diabetes, or other medical problems.

Obstetricians who practice maternal-fetal medicine are also known as perinatologists, perinatal surgeons, fetal surgeons, or maternal-fetal surgeons.

Notable Perinatologists

• Dr. Addison Montgomery (Director and Staff OB/GYN at Seaside Health and Wellness and Attending OB/GYN and Fetal-Neonatal Surgeon at St. Ambrose Hospital)
• Dr. Lucy Fields (former Maternal-Fetal Medicine Fellow at Seattle Grace Mercy West Hospital)
• Dr. Vanessa Hoyt (Attending Perinatologist and Neonatologist at St. Ambrose Hospital)
• Dr. Vivian Carlsmith (Attending Obstetrician-Gynecologist/Perinatologist at UCLA)
• Dr. Emma Marling (Head of Maternal-Fetal Medicine at Seattle Presbyterian Hospital)
• Dr. Nicole Herman (Head of Fetal Surgery at Grey Sloan Memorial Hospital)

Notable Cases

• Birth of Quintuplets (Much too Much, Owner of a Lonely Heart): Addison delivers a set of female quintuplets, four of the 5 each having their own medical problems, one having an omphalocele, hypoplastic left heart syndrome, hydrocephalus, and underdeveloped lungs.
• Ectopia Cordis (Piece of My Heart): Addison returns to Seattle Grace to deal with a pregnant women who's child is diagnosed with ectopia cordis - his heart has grown outside his body. Addison delivers the child, Hahn works to place the heart inside the chest and Sloan closes using a skin flap grown from the child's own skin.
• Twin to Twin Transfusion Syndrome (TTTS) (Raindrops Keep Falling On My Head): Addison works to separate fetal blood vessels in twins sharing a placenta using fetoscopic laser ablation (using a laser to sever the fetal blood vessels)
• Mirror Syndrome with a In-Utero Blood Transfusion (Ex-Life): While Addison is at Seattle Grace Hospital tending to her brother, Derek asks Addison to consult on his patient, who is showing signs of Mirror Syndrome, caused by the baby's anemia following a blood transfusion with the mother in surgery and causing congestive heart failure in both mother and child. Addison recommends delivering the baby, while Derek suggests a in-utero blood transfusion, despite the fact he knows nothing of the procedure and Addison is highly against the procedure, and the mother insists on the blood transfusion. Addison does successfully tranfuse blood into the baby, resolving the heart failure and anemia, not while berating Derek for cornering her into this.

Notes and Trivia

• Addison is considered the "Meryl Streep of Maternal-Fetal Medicine".
• Addison is one of 8 people in world who can perform maternal-fetal medicine on a world-class level.
• Dr. Vivian Carlsmith was a pioneer in maternal-fetal medicine.
• Since Addison's departure from Seattle Grace Hospital, Grey's Anatomy has hardly had any maternal-fetal cases; when it does, she is usually called in to consult, until Dr. Nicole Herman's introduction as Grey Sloan's head fetal surgeon.
• Fetal surgery is a sub-specialty of maternal-fetal medicine.

See Also

• Obstetrics and Gynecology
• Fetal Surgery