SMFM Recap: Collaboration Essential to Advancing Care for Fetal, Prenatal Patients
Research from physicians at Cincinnati Children’s Fetal Care Center reveals the benefits that can be achieved on multiple levels when maternal-fetal medicine experts work closely with pediatric subspecialists.
At this year’s annual pregnancy meeting of the Society for Maternal-Fetal Medicine (SMFM), Mounira Habli, MD, was course chair of Pearls and Paradigms: Collaboration Between MFM and Subspecialties in Maternal Fetal Surgery presented jointly with the North American Fetal Therapy Network (NAFTNet). Habli is director of the Maternal-Fetal Medicine (MFM) program at Cincinnati Children’s Fetal Care Center.
David McKinney, MD, education and outreach director of Maternal-Fetal Medicine, and Beth Kline-Fath, MD, chief of Fetal and Neonatal Imaging, led a course on Advanced Fetal Imaging and Future Prospective: A Partnership Between Maternal-Fetal Medicine and Pediatric Radiology. This course was the most well attended during the meeting, which was held Feb. 10–14 in National Harbor, MD.
Cincinnati Children’s is proud to have served as a major participant.
Advanced Fetal Imaging
More than 125 people attended the all-day course on Advanced Fetal Imaging. Having pediatric radiologists in attendance with MFM experts was new and different and showed the thirst for knowledge among both specialties, McKinney says.
Habli developed the idea for the combined course on fetal magnetic resonance (MR) and ultrasound imaging. McKinney and Kline-Fath planned and pulled together speakers for each section.
Combining the knowledge that comes from fetal MR and ultrasound when evaluating congenital anomalies and prenatal conditions that affect the brain, chest, heart or skeleton provides information that helps care teams and parents determine the best treatment in the womb or after birth, Kline-Fath says.
Everyone learned from one another with many key takeaways. Attendees learned about:
- Advanced imaging techniques
- How to manage an advanced fetal imaging program with successful patient outcomes
- How prenatal anomalies can be more accurately diagnosed when both ultrasound and fetal MRI are utilized
Collaboration among SMFM and the Society for Pediatric Radiology makes a difference, especially when work overlaps.
“Together, we can change the outcome by understanding the pathology better, providing better counseling and planning better care,” Kline-Fath says.
This combined advanced imaging is becoming the standard of care for diagnosis and prenatal counseling. For providers who did not train at a fetal care center like Cincinnati Children’s, knowledge about the technique can be limited.
“This is the way we advance treatment,” Kline-Fath says. “We learn and innovate by collaborating and figuring out how to provide the best care and outcomes for these babies.”
Plans are underway for additional joint courses. Discussions during the February SMFM session led to questions about functional imaging and diffusion imaging, and how these techniques can be used in evaluating babies with growth restrictions or to assess placental pathology.
McKinney says he also wants to explore how first trimester ultrasound and MR imaging might complement one another.
Pearls & Paradigms
The overall goal of this course was to emphasize the importance of collaboration and careful risk-benefit analysis to ensure patients receive the best possible care, Habli says. Treatment often involves complex procedures that can affect both the mother and fetus. MFM specialists must work together with fetal radiologists, neonatologists, genetic counselors and pediatric surgeons.
Presenters wanted to equip general MFM specialists and trainees with the basic tools and an understanding of current advancements and multidisciplinary strategies.
Sessions highlighted collaborative research and clinical efforts in prenatal diagnosis managed with maternal-fetal surgery. Examples were shared from across the spectrum of specialties needed to optimize care for fetuses with a prenatal diagnosis of a congenital abnormality.
“Maternal-fetal surgery is rapidly expanding,” Habli says. “There is constant introduction of new prenatal diagnostic techniques, surgical interventions and postnatal care. Keeping track of these advances is challenging for the MFM specialist given the broad spectrum of knowledge required to care for pregnant persons.”
The paradigms highlighted include:
- Balancing act. The importance of carefully weighing the risks and benefits of maternal-fetal surgical procedures was discussed. Collaboration among MFM specialists and other subspecialties is crucial for ensuring that patients receive appropriate counseling and make informed decisions about their care.
- Fetal surgical learning curve. Experience and proficiency in performing complex fetal surgeries is important. MFS procedures require high levels of technical expertise, and experienced practitioners must work together to improve outcomes and minimize complications.
- Team approach. Working together involves close collaboration among different specialists to achieve successful outcomes.
Additional Posters and Presentations
Cincinnati Children’s researchers also presented posters and led presentations as part of other courses.
Habli presented “Fetal Growth Restriction (FGR) diagnosis and workup, between research and clinical practice” as part of the course Fetal Growth Restriction, Best Practices and Future Directions presented jointly with the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG).
Posters included:
- Proof-of-concept testing of vascular closure devices for use in fetal surgery, with Braxton Forde, MD, as primary and presenting author
- Impact of amnioinfusions on the ultrastructure of the amnion in a rodent model, with Forde as primary and presenting author
(Published April 2024)
