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OBGYN.net Interview with David Augustus Nagey, MD, OBGYN.net Editorial Advisor, Pregnancy & Birth
Dr. David Nagey: A perinatologist, or maternal-fetal medicine specialist, can play a number of roles in the care of the complicated obstetric patient - from performing imaging and prenatal diagnosis to consultation concerning vexing or unusual medical or obstetric problems. My job (and I think I've got the best job in the world) involves traveling around Maryland on a set schedule seeing patients referred by other obstetricians, writing up a consult such as that attached, and then presenting the patient(s) back to the referring physicians at a conference for which they get an hour of CME credit through the state medical society. I also carry an 800-number pager to answer quick consults. Last year I did over 400 in-person consults away from Hopkins (I don't count the consults there), answered over 600 telephone/pager consults and provided over 1000 person-hours of CME/CEU credit - and I'm having a blast because I'm learning all the time!
OBGYN.net:What types of cases require a perinatologist to be consulted?
Dr. David Nagey: Any time the obstetrician wants another opinion, or thinks the patient needs to hear it another time, or wants to speak with someone who is used to dealing with unusual obstetric situations, the maternal-fetal medicine specialist can be useful.
OBGYN.net:Do you usually work with the patient directly or with her physician?
Dr. David Nagey: Whatever the referring physician prefers - usually with the patient FOR the referring physician for difficult problems.
OBGYN.net: Does the woman/patient continue care with the Perinatologist or with her OB/GYN?
Dr. David Nagey: Almost always with the referring OB/Gyn. An exception would be the patient requiring neonatal surgery soon after delivery. In those cases we often co-manage but delivery takes place where the pediatric surgeons are. (for us Johns Hopkins)
OBGYN.net:Once a women has had a difficult pregnancy does she always need special care when pregnant in the future?
Dr. David Nagey: Everyone deserves special care, and the woman with a prior poor outcome more so - but most women can get that care from their own OB - who might then choose to consult a maternal-fetal medicine specialist (or not).
OBGYN.net:This is an area most women know Nothing about and as you so well know, are very frightened to find themselves in a non-normal pregnancy. I think this will help them understand so much about what is happening and what to expect while in the care of their OB/GYN and their Perinatologist.
Thank you so much Dr. Nagey for sending this presentation to us. I see a wonderful service for many women coming out of publishing this article/interview.