How surgical is MFM?

[OBUser77]

I was looking around the Ob/gyn forum and have a couple questions about maternal fetal medicine:

1. How much time do you spend in the OR?

2. Can MFM's perform fetal surgery? (with additional fellowship training)

3. How common is it for MFM's to do fetal intervention?

Thanks in advance for all replies.

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[anonperson]

I was looking around the Ob/gyn forum and have a couple questions about maternal fetal medicine:

1. How much time do you spend in the OR?

2. Can MFM's perform fetal surgery? (with additional fellowship training)

3. How common is it for MFM's to do fetal intervention?

Thanks in advance for all replies.

1. Depends. Generally MFM'S are doing C sections, cerclages (program dependent). They'll also do amniocentesis and CVS but with cell free DNA testing, that's becoming less. Some are doing fetal interventions, like laser ablation for TTTS. Some are trained to do D and Es on late second trimester pregnancies as well.

You'll get some OR time but the majority of MFM'S is prenatal diagnostics, consults, and management of complex pregnancy along with their labors (at times).

2. Yes. Other posters can comment to this more than me though. I am under the impression that the main thing is laser ablation in TTTS. I am unsure of how much an MFM'S is actually operating on a kid though. This field is rapidly evolving though.

3. Somewhat common. Usually in a large group setting, there will be one go to player since the volume is lower

 

[OBUser77]

Thanks.

I was also wondering how much pediatric surgeons do compared to MFM for fetal intervention?

 

[OBUser77]

bump

 

[HumbleMD]

I hope you arent' asking this because of Grey's anatomy. If you are, reconsider your career choice now.

This is a SUPER specialized question, many, many steps beyond a pre-med should know or care about. There aren't many fetal surgical centers. Lots of places do TTS cases and EXITs; they're usually done by an MFM. The Cards issues if anything just get a shunt with a big catheter done by the peds cards surgeons. I'd say the rarest and the hallmark of a good program is myelomeningocele repairs, done at CHOP and, UCSF. I can really only speak to CHOP where I've scrubbed in on some. The department is led and chaired by Dr. Scott Adzick, a pediatric surgeon. He invented the device to open the uterus and amniotic membrane. The MFM holds the US probe and directs where to cut. The peds surgeon enters the uterus and closes it. The peds neruosurgeon closes the MMC. The MFM cares for the pregnancy and does the Csection afterward. At UTSW the department is led by an MFM.

Resident and even fellow involvement is nonexistent to minimal. Get through your first 2 years of med school, see what your interests are, then start thinking about fetal surgery; the field could be vastly different then.