The in-patient Obstetric facilities at the University of Maryland Medical Center (UMMC) occupy two floors of the south in-patient tower. A total of 22 antepartum and postpartum beds are currently located on the sixth floor in our Mother-Baby Unit (MBU). The term nursery is located on this floor as well. A new state-of-the-art 50-bed neonatal intensive care unit is located on the fourth floor.
Immediately above the MBU, on the seventh floor, is Labor & Delivery (L&D). L&D consists of seven labor and delivery rooms, three operating/cesarean delivery rooms, a four-bay recovery room and a two-bed triage area. All labor rooms have upgraded automated equipment for central monitoring of maternal vital signs and electronic fetal monitoring. Two portable ultrasound machines with Doppler capabilities are permanently located on L&D. Invasive maternal physiologic monitoring equipment is portable and can be used in any of the labor rooms. The obstetrical anesthesia service maintains offices on L&D and is on-site 24 hours a day.
Adjacent to L&D is a five-bed maternal intermediate care unit. The Intermediate Care Unit (IMC) is used for initial evaluation of high-risk antepartum patients who need close observation for maternal and/or fetal problems, but are not yet ready for induction and/or labor and delivery.
Planning is complete and construction has begun on a new state-of-the-art Labor and Delivery Suite.
The out-patient facilities in which the Maternal-Fetal Medicine fellows work are located both on and off the UMMC campus.
The Center for Advanced Fetal Care (CAFC), a 6,380 square-foot unit, utilizes a multi-disciplinary team approach for the diagnosis and management of families with fetal structural, growth, infectious or maternal medical abnormalities. Our facility has a capacious waiting room and reception area. A report and data/image management area is equipped with a GE Viewpoint reporting and image processing system. Our nine ultrasound/procedure rooms are each equipped with a GE Voluson ultrasound. There is a conference/research room with teleconference capabilities and three research computer work stations, two genetic counseling consult rooms, two physicians’ consult rooms/offices and a lab area for specimen handling. The Antenatal Testing Unit is an integral part of the CAFC, consisting of a five-bed unit in which biophysical and electronic fetal heart rate monitoring is performed. The antenatal testing unit is equipped with three GE Logicbook ultrasounds.
The CAFC serves patients from throughout the State of Maryland, and from adjacent parts of Delaware, Pennsylvania, Virginia, West Virginia and beyond. It is at this site that most antepartum and genetic testing is performed. Anomaly scans, targeted imaging, fetal echocardiograms, nuchal translucency, fetal therapy procedures and genetic testing are performed in the CAFC. It is here that the fellows undergo the bulk of their ultrasound training. More invasive procedures such as fetal blood sampling and transfusion, or laser treatment of TTTS are performed in the labor and delivery suite.
The CAFC is staffed by maternal-fetal medicine subspecialists, RDMS-certified sonographers, ABGC-certified genetics counselors and dedicated nurses. Consultations with pediatricians, neonatologists, pediatric surgeons as well as social work and chaplaincy services are coordinated through the CAFC, and may take place within the CAFC to maximize patient convenience.
The Department of Obstetrics and Gynecology at Mercy Medical Center, chaired by MFM division member Robert O. Atlas, MD, is fully integrated with our Department at UM-SOM. Under his direction the Center for Advanced Fetal Care at Mercy Medical Center (CAFC @MMC), serves an additional training site for the fellow. The CAFC @MMC provides the same spectrum of care as the university-hospital-based CAFC with the exception of invasive fetal therapy procedures. The fellows spend two months in the CAFC @MMC during the second year to gain an additional training in an outpatient maternal-fetal medicine practice setting. Training opportunities include targeted sonography, amniocentesis, CVS, PUBS, transabdominal cerclage, maternal-fetal medicine consultation (outpatient and inpatient) genetic and preconception consultation. This 4,500 square-foot facility consists of a spacious waiting room, a reception area, a report and data/image management area, three physician consultation rooms, a genetic counselors office and separate consultation room, five ultrasound/procedure rooms and five exam rooms in which biophysical and electronic fetal heart rate monitoring are performed.
The University of Maryland Women’s Health Center at Western-Penn is located one block south of UMMC, and it is here that the High-Risk Pregnancy Clinic meets. The space consists of a large waiting room, clerical and administrative spaces, four consultation rooms and eight exam rooms. The High-Risk Pregnancy Clinic is in session three half days per week. For two of these clinics, the fellow leads a team of residents and medical students take part in all sessions. The fellow spends one session per week in the High-Risk Pregnancy Clinic and sees patients under the supervision of a faculty perinatologist. The faculty member is present in the clinic at all times to provide close supervision of and consultation to the fellow. The goal of this organized clinical experience is to allow the fellow progressively more responsibility in evaluating and managing complex antepartum patients, while at the same time assuring close supervision and availability of faculty. Fellows attend the High-Risk Pregnancy Clinic during research months throughout their first, second and third years.