Maternal-Fetal Medicine physicians, also called perinatologists, are obstetricians who specialize in the diagnosis, treatment, and ongoing care of expectant mothers and their unborn babies, who may be at high risk for special health problems.
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Resident Education in Maternal Fetal Medicine
Tulane Lakeside Hospital
The majority of basic as well as advanced obstetric diagnosis and management is encountered during this hospital rotation which involves inpatient labor and deliver, ob emergency room, antenatal admissions, and postpartum complications as well as outpatient high risk and low risk clinics, fetal ultrasonography, and antenatal outpatient testing.
The goals of the inpatient aspect of the rotation are to teach the resident
- Intrapartum management of normal term labor.
- Understanding of normal physiology of pregnancy.
- Indications for maternal transport.
- Cervical ripening and induction of labor.
- Knowledge of fetal heart rate patterns, uterine contractility and states of fetal wellbeing.
- Management of abnormalities of fetal-well being.
- Management of intrapartum complications, including hemorrhage, fetal distress, failure to progress, and chorioamnionitis.
- Management of preterm labor; understanding pharmacology and use of tocolytics.
- Diagnosis and management of abruptio placenta and placenta previa.
- Diagnosis and management of preterm rupture membranes.
- Diagnosis and management of preeclampsia/eclampsia.
- Diagnosis, management, and understanding of pathophysiology of medical problems in pregnancy including hypertension, diabetes, heart disease, asthma, anemia, pyelonephritis, other renal disorders, seizure disorders.
- Coordination of medical care with use of consultants.
- Understanding, diagnosis, and management of obstetric infections and their influence on maternal and fetal outcomes.
- Performance of operative techniques including vacuum extraction, forcep delivery, cesarean section, postpartum tubal ligation, cerclage, external cephalic version.
- Operative and medical management of obstetric hemorrhage, including cesarean hysterectomy, uterine and hypogastric artery ligation. Maternal and fetal effects of anesthesia.
The goals of the outpatient clinics involve prenatal care of the low and high risk obstetric patient. Specifically, to teach the resident:
- Management of the normal prenatal patient.
- The importance and techniques of education of the pregnant woman.
- Identification of complications in the normal patient.
- Diagnosis and management of common obstetrical problems including IUGR, multiple gestation, fetal demise, post dates, pregnancy loss, placenta previa, vaginal bleeding.
- Management of medical problems in pregnancy as outlined in inpatient goals.
- Basis and advanced ultrasonography, genetic amniocentesis, CVS
- Indications and techniques of antenatal testing, including NST, OCT, biophysical profiles, and amniotic fluid indices.