If you saw a MFM Dr for high risk the first pregnancy...

[Anonymous]

And you’ve had a second or pregnant with baby #2- at what point in your second pregnancy did you’d begin seeing the maternal fetal medicine high risk Dr? I need to call my OB dr on Monday because I forgot to ask them but looking for others experiences.


First time I had gestational diabetes, high blood pressure and was borderline pre eclampsia towards then end and I had my water break spontaneously break at 35 weeks and gave birth that same night. Should I have my initial Ultrasound at my OB or with MFM that I had previously saw?

Thanks!

[Anonymous]

I saw the MFM as soon as I got pregnant

[Anonymous]

Anonymous wrote:I saw the MFM as soon as I got pregnant

Thank you for your reply! If you don’t mind my asking - what were you seeing the MFM for?
OP

[Anonymous]

After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

[Anonymous]

I saw MFM my entire first and second pregnancy. I had a pulmonary embolism in my 20s unrelated to pregnancy but was on blood thinner for my pregnancy both times. So monthly appointment with the MFM and all ultrasounds with them. First they thought was growth restricted towards end (she was not) and so second measured small and they wanted me to be seen a few more times to monitor that and partial placental prévia (which resolved). My practice worked with a MFM group so I would see the MFM wait 20 min and then see the OB and the office would already have the MFM scans and reports.

[Anonymous]

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

[Anonymous]

Anonymous wrote:

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

+1. I had gd with my first and borderline with my second. Never went on insulin with either. No regular testing with the second either.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

+1. I had gd with my first and borderline with my second. Never went on insulin with either. No regular testing with the second either.

Well yeah, if you got through the first with gd and no insulin (must have been very mild or you didn’t go to a good MFM, because insulin is standard of care in the US), and you didn’t even technically have gd the second, then your situation isn’t really what people think about when they say they had gd and went to a MFM for it.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

+1. I had gd with my first and borderline with my second. Never went on insulin with either. No regular testing with the second either.

Well yeah, if you got through the first with gd and no insulin (must have been very mild or you didn’t go to a good MFM, because insulin is standard of care in the US), and you didn’t even technically have gd the second, then your situation isn’t really what people think about when they say they had gd and went to a MFM for it.

Most GD is managed by diet and exercise. I saw an endo during both of my pregnancies, GD was diet-controlled, but pre-e was managed by the MFM.

[Anonymous]

First pregnancy: I had an emergency c section by an MFM at 32 weeks for HELLP syndrome. (And baby had an unrelated heart defect discovered in the NICU.) I started seeing an MFM only a week before delivery when complications first arose. This was at Georgetown. I asked about a second pregnancy at a follow up and they said I’d see a regular OB from the beginning (but probably do a consult with an MFM in second trimester) but not switch over unless I actually started having complications.

Second pregnancy: 25 weeks with #2 and I’m now living in New York but what Gtown said is holding true here. I’m seeing a regular OB and even with some potential red flags on my cfDNA and my first child’s heart condition I’ve only consulted with MFMs and will continue seeing a regular OB until this pregnancy actually presents its own complications.

I’d recommend just booking an appt with your previous OB—but if you’re switching practices then look for one that has MFMs in-house to make the transition easier. I’m intentionally with a large practice this time and planning to deliver at a big city hospital (even though we have lovely suburban hospitals nearby) because I want easy access to high risk docs and a top level NICU like I did at Georgetown.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

+1. I had gd with my first and borderline with my second. Never went on insulin with either. No regular testing with the second either.

Well yeah, if you got through the first with gd and no insulin (must have been very mild or you didn’t go to a good MFM, because insulin is standard of care in the US), and you didn’t even technically have gd the second, then your situation isn’t really what people think about when they say they had gd and went to a MFM for it.

Most GD is managed by diet and exercise. I saw an endo during both of my pregnancies, GD was diet-controlled, but pre-e was managed by the MFM.

This was my experience, too. My blood sugar tested 190 on the one hour test, and I managed to keep a strict diet and have normal blood sugar readings.

[Anonymous]

My OB sent me to a MFM with my first pregnancy because I was 35 at the time. Had all ultrasounds with the MFM and they monitored a placenta previa that resolved at 32 weeks. I'm even older with my second pregnancy, obviously, and I'm back with the MFM. I have another previa and gestational diabetes this time (managed by diet and exercise). My understanding from the diabetes educator was that you're moved to insulin or other medications if your blood sugar levels aren't manageable by diet/exercise alone.

[Anonymous]

My first pregnancy ended with pre-e and HELLP and an IUGR baby. At GT.

For #2 they had me see the regular OBs but do a consult with the MFM team around 8-10 weeks to go over taking aspiring and basically a, ok the MFM know you're pregnant now and will be keeping an eye on things but you don't need to see them regularly until something comes up that necessitates it.

I switched to another state around 7 months (moved). In that state there is only one high risk group and they assumed my care entirely. I never saw a regular OB after I moved. But the end is where things get exciting for me. They saw me every week but I had a pretty uneventful pregnancy with #2.

Currently pregnant with #3 and back with the MFMs. I will see them like regular OBs for my whole pregnancy but have to go in more than other people and get way more ultrasounds than other poeple.

[Anonymous]

I think it depends on why you’re considered high risk. I was referred right after my first appointment at 8 weeks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:After gd they will want you on insulin all along. Unless you test your own blood after every single meal, in which case they want copies to protect themselves.

This was not my experience.

+1. I had gd with my first and borderline with my second. Never went on insulin with either. No regular testing with the second either.

+1 I had GD with my second pregnancy and was told if I had another pregnancy I would be referred for early testing and monitoring...plus with GD with my second pregnancy, I tested my own blood daily as well and was totally under control with my diet, never took any medication.