Maternal-Fetal Medicine Treats Both Baby and Mother

“We have an ability to change the outcome drastically.” Kristin Coppage, M.D., and Sammy Tabbah, M.D., on the collaborative efforts of the Cincinnati Fetal Center.
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Photograph by Jeremy Kramer

Kristin Coppage, M.D.
Maternal-Fetal Medicine
Tri-State Maternal-Fetal Medicine Associates, Cincinnati Fetal Center

Sammy Tabbah, M.D.
Maternal-Fetal Medicine
UC Health, Cincinnati Fetal Center

Kristin Coppage (KC): A maternal-fetal medicine specialist is a fellowship specialist who deals with high-risk pregnancies. The Cincinnati Fetal Center is a collaboration between TriHealth, Cincinnati Children’s Hospital Medical Center, and UC Health; it’s been around for approximately 15 years.

Sammy Tabbah (ST): Cincinnati Children’s is essentially at the center of the program—that’s where most of the procedures take place, and where the multidisciplinary counseling and, most of the time, the initial consult takes place for patient families.

KC: The majority of patients, if they get referred to the Cincinnati Fetal Center, will receive a fetal echocardiogram, or ultrasound, of baby’s heart and will also undergo an MRI. Then they sit down with that imaging and, depending on what the finding is, have a team meeting with a maternal-fetal medical specialist, cardiac surgeons, neurosurgeons, geneticists, social workers, the neonatologist, or a high-risk pediatrician.

ST: We get all the specialists in one room together and talk about the baby’s diagnosis. We come up with a plan on how to take care of baby. Families really need to have as much time as they want with the providers who are helping them come to an understanding of what’s going on with their child [and] what their options are.

KC: Those team meetings and that education have really changed the experience for patients and their families. When you know what to expect, that peace and some decrease in anxiety goes such a long way.

KC: There are some cases where babies can actually have surgery during pregnancy. Two of the most common are spinal cord repairs and laser surgeries for pregnancies with twin-to-twin transfusion syndrome. Monochorionic twins—twins that share a placenta—can receive unequal blood flow that can lead to complications requiring interventions.

Photograph by Jeremy Kramer

ST: Before [the laser surgeries for twin-to-twin], there was little that could be done. A lot of these pregnancies ended up delivering early; a lot of times death would occur in utero because there really was no good intervention. [Now] the most common procedure we perform is laser for twin-to-twin; in any given year, we probably do about 100 of those surgeries. Probably the next most common major procedure we do is spina bifida surgery; we do roughly seven to 10 of those per year.

ST: We also have a new labor and delivery unit that’s been built at Children’s.

KC: The special delivery unit opened in July. Cincinnati Children’s is one of only a handful of centers across the country that offers full-service care—mom can have the surgery and then deliver at Children’s. Before this unit opened, at the time of delivery we would stabilize the infant and then transfer the infant to Children’s. Everyone involved, especially the family, kind of had a sense of despair because they were separated from their child.

ST: This labor and delivery [unit] is now there for healthy moms delivering high-risk babies, so they can stay together after birth.

KC: Pregnancy is usually an exciting and joyous time, but we know that pregnancy doesn’t always go smoothly, so to be able to help those patients and their families through the difficult time is a pretty amazing thing.

ST: We have an ability to change the outcome drastically. I think being part of that—there are really no words to describe how incredibly gratifying that is. —As told to Lisa Murtha

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