Referral to maternal fetal medicine?

breezyweezer · October 2014

I am 9w4d and I have had one OB visit. He didn't even mention a MFM referral, I actually found out about them on here and in Dr. Luke's book. My question is, do I just tell my Dr. that I want a referral? I have had miscarriages and I know that twins are usually already considered high risk, so it seems like he should have at least mentioned a referral.

PeaceofKia · October 2014

I didn't get referred to my mfm until our anatomy scan. Now I see her every two weeks.

zazu13 · November 2014

I conceived with ivf after losses. My RE suggested seeing a specialist. You can ask your OB though. Some mfm deliver and others just monitor in addition to your OB visits. Not all OB's agree that twins automatically pose a risk but I was glad for the extra care.

RayRay007 · November 2014

It just so happens that the OB I was referred to (didn't have one before) is a MFM, but if she weren't, I don't know that it's standard practice to see a MFM if you have a low risk twin pg (eg. di/di with no other conditions).

minirella · November 2014

I don't see an MFM nor was I referred to one.

pillowass · November 2014

I saw an MFM exclusively. I think it's important to be at least monitored by one, even if it's in addition to your regular OB. As we see so often on this board, everything is "normal" and low-risk until it's not. Someone who specializes in twin pregnancy is way more versed in the potential complications and latest research. Many OB's will just put twin moms through the singleton pregnancy protocols. For instance, I remember one twin mom who was seeing an OB and not getting growth u/s in her 3rd tri, which is an important part of monitoring twins in late pregnancy.

twinmom1121 · November 2014

I don't know if I saw an MFM but I was told to go to a different office that specialized in twin ultrasounds. They had better equipment for the anatomy scan. I went there for the scan at 18 weeks and then every two weeks until 25 weeks for cervix checks and then after that went back to my regular OBs office. I didn't know what an MFM was until I saw everyone had one on here too. I had di/di twins and a very uneventful pregnancy so that's probably why I wasn't referred to one. Doesn't hurt to ask though!

Mrs.McIrish · November 2014

I chose to go to a MFM who delivers since I'm AMA, twins, on lovenox and it took 8 rounds of IVF to get these babies. I wanted a higher level of care. I didn't need a referral with my insurance and "qualified" as high risk with the MFM's office to refer myself (I don't see a regular OB at all)

PeaceofKia · November 2014

I also wanted to add that I was referred because my twins are mono/di and more high risk than di/di. We get growth u/s every two weeks now to monitor for ttts.

diz1313 · November 2014

I didn't get referred to my MFM until the anatomy scan. Also, at this point I see my OB more often as they have me on a two week cycle and the MFM is keeping me on a three week cycle since I am "doing so well". My MFM will also stop doing cervical checks after my next visit which will be 34 weeks cuz they said after that it isn't anything they need to know. Heh In any case I would ask about seeing one if it would make you feel better. It is nice to get a look at what is going on in there with a place that has top of the line equipment. It's also nice to know that someone is keeping an eye on how the kids are developing and that the cords and placentas are all doing their jobs.

breezyweezer · November 2014

Thanks for the replies! Seems like I can possibly wait, but I think I definitely do want to eventually be seen by one. I was told at the first ultrasound that they are identical, so I think that makes them a little higher risk? I just feel like my OB was so blase about the whole thing. I have had three miscarriages in the past as well.

carrotcake06 · November 2014

I saw an MFM but only bc my OB doesn't do u/s in-house at all. So I went to the hospital I would be delivering at for u/s and growth scans and saw the rotating MFM there.

A twin pregnancy is similar to a singleton for the first trimester plus. W IDs, the increase in monitoring tends to start a bit sooner than w di/di. Around 16w usually.

lilydolce · November 2014

When I found out it was twins I asked my OB to refer me to MFM at hospital. She was quiet offended and basically said she can handle twins, but she would only see me once a month so I talked to her office manager and requested to be sent to MFM and I am glad I did. My MFM sees me every two weeks with 1 hour ultrasounds and checkup at every appointment. I felt more secure, I am 31 weeks pregnant and I will give birth at the same hospital. Please go see an MFM they are more experienced in twins and high risk.

MrsF0831 · November 2014

My office as soon as they found out twins they referred me to MFM. Im still early in my pregnancy and they are thinking fraternal and said so far everytthing looks good. But I am glad I was referred to them

Mrs.McIrish · November 2014

breezyweezer said:

Thanks for the replies! Seems like I can possibly wait, but I think I definitely do want to eventually be seen by one. I was told at the first ultrasound that they are identical, so I think that makes them a little higher risk? I just feel like my OB was so blase about the whole thing. I have had three miscarriages in the past as well.

Yes, if your twins are mono/mono or mono/di, they are higher risk than di/di.

breezyweezer · November 2014

Thanks again for the replies. My next appointment is Nov. 11th and I will be just a couple days shy of being in the second trimester; I am definitely going to request the referral then. I have found one that accepts Medicaid but it is 3 hours away. I am going to see if they know of one closer, because there doesn't seem to be many around where I live. (Rural southern Oklahoma)

PinkinProvence · November 2014

I would just seek out an MFM and not wait for a referral. Research the closest hospital with a Level 3 NICU and look up their high risk doctor practice. I was seen by one exclusively. In my opinion, it is very important, especially since yours are identical.

MissEm15 · November 2014

I started out going to a regular OB, who my RE recommended. They weren't doing anything different w/ me at all. In fact they didn't even take growth measurements at 12w or 16w. I know they have delivered plenty of twins, but I didn't feel comfortable. Now I see an MFM exclusively & feel so much better about my level of care. I'd just make sure you feel comfortable w/ how you are being monitored.

cls78 · November 2014

My OB referred me to one after my first OB appt at 9 weeks. I have seen both throughout this pregnancy and my MFM does all my U/S's.

CNYBride05 · November 2014

I was referred to an MFM early because my midwife and OB were suspected that we were having mono mono twins (we had mono di, but the membrane wasn't visible until about 12w). Not all twin pregnancies require MFM involvement. If you have di di twins and your OB feels comfortable managing your pregnancy, that's great!

Bigboneded · November 2014

I asked about, but didnt see MFM until a/s at 18 weeks. My OB will address concerns at his office, I had viability scan early when he didnt find HBs, mine are di/di- so far no probs :-)

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