Maternal and fetal medicine (also called perinatology) is the specialty devoted to caring for pregnant women and their unborn babies during a pregnancy where there are complications. The goal of this specialty is to reduce stress for the mother and to increase the chances of safely delivering a healthy baby.
In most cases, pregnancy takes place without any problems. There are a few cases, however, where health problems require extra monitoring, testing, and more training than a regular ob/gyn might have. These specialized ob/gyns are perinatologists.
There are many different issues that might cause a patient to be referred to a maternal and fetal medicine specialist. Some of the issues include:
Advanced maternal age (over 35)
Premature rupture of membranes, or “water breaking” too early
Congenital disorders that may impact birth
Multiples (twins, triplets, or higher)
Health issues in the mother, including chronic illness (diabetes, kidney disease, heart disease, etc.) and infectious disease (hepatitis, HIV)
Services offered by maternal and fetal medicine specialists vary depending on the nature of the concern, but they may include prenatal testing, ultrasound, or diagnostic screening. It is common for a patient to see a perinatologist several times during their pregnancy but for their own obstetrician to deliver the baby. Perinatologists typically do not deliver babies, although they are available for consult if needed.
What is Vascular & Interventional Radiology?
Vascular and interventional radiology, sometimes just called interventional radiology or abbreviated “VIR,” is a type of minimally invasive treatment done using only needles or catheters (tubes) and very tiny incisions in the body. Imaging, such as x-rays or ultrasound, is done from outside the body and used to guide the surgeon. Because the incisions are so small, this type of surgery offers less risk, less pain, and a faster recovery time to the patient.
Interventional radiology was first developed in the 1960s to treat blocked arteries, as an alternative to open bypass surgery. The technique was originally used only on blood vessels, which is where the word ‘vascular’ in the name comes from. These days it is still often used to treat blood vessel disorders, but also many other types of problems. Interventional radiology may be used to perform, among others:
Vascular treatments, such as the placement of stents or balloon angioplasty
Minimally invasive cancer treatments, such as biopsies, tumor ablation, or chemoembolization (delivering chemotherapy directly to a tumor via a catheter)
Uterine fibroid embolization
Varicose vein ablation
The device used for imaging during the surgery may be x-ray, ultrasound, fluoroscopy, or CT scan. Imaging allows the surgeon to see exactly what is happening without having to cut into a patient. Not only is recovery easier without major surgery, but outcomes are better with the precise detail that modern imaging can offer.
What is Nuclear Medicine?
Nuclear medicine is specialized medical care that uses tiny amounts of radioactive material to diagnose or treat disease. Most commonly, the radioactive material is used to produce images of the inside of the body.
When nuclear medicine is used for imaging, tiny amounts of radioactive material are mixed into medicine that is injected, swallowed or inhaled. These medications are called radiopharmaceuticals or radiotracers. The medication goes to the part of the body that is being examined, where it emits a kind of invisible energy called gamma waves. Special cameras can take photographs or video of those gamma waves, so they also take an image of the body part where the medication is. Videos can show how the medicine is being processed by the body.
What makes nuclear medicine so useful is that it is extremely accurate. The images taken with nuclear medicine are incredibly precise, providing images down to the molecular level, so they can show disease at its earliest stages. Nuclear medicine can also show the function of body parts instead of just their structure: it can be used to see how well a heart is beating or how much oxygen lungs are holding. It is a way for doctors to see inside the body without the risks of surgery.
The word “radioactive” can make some patients uneasy, but nuclear medicine is very safe. The amount of radiation used is very small, less than a person usually receives from simply standing outside during a normal year. It has been used successfully for more than sixty years, and is painless.
Sometimes nuclear medicine can be used not just to diagnose disease, but also to treat it. Hyperthyroidism is sometimes treated with radioactive iodine, and certain cancers are sometimes treated with targeted radiation or radioactive medications.
Nuclear medicine provides an enormous amount of information that is not available any other way. It helps patients avoid exploratory surgeries or unnecessary treatments, and it helps physicians quickly decide on the best care.