A focal point of the fellowship is our strong clinical training program that provides ample clinical and procedural training in ultrasound, inpatient and outpatient obstetric care for medically complicated and critically ill patients, genetics education, and ultrasound guided in-utero procedures.
Fellows will graduate as maternal fetal medicine experts and consultants. We expose our fellows to a variety of different practice settings, including outpatient clinic, ultrasound suite, intensive care unit, and labor and delivery. The clinical experience will enable a fellow to becoming extremely proficient at ultrasound, antenatal diagnosis of genetic and fetal anomalies and the management of medical and obstetrical complications of pregnancy.
OHSU performs approximately 2,400 deliveries annually of which about 700 are high-risk. The hospital accepts transfers from all of Oregon and parts of southern Washington, northern California, and western Idaho. In total, 8-10 cesarean hysterectomies and 40-50 forceps deliveries are performed each year. OHSU is the largest referral center in Oregon for women with placenta accreta. Cases are performed in a multidisciplinary fashion with MFM, GYN oncology, urogynecology, interventional radiology and anesthesia.
Fellows finish the program with experience in critical care obstetrics by:
- Rotating through the cardiovascular intensive care unit, which accepts all critically ill obstetric patients
- Participating in our multidisciplinary placenta accreta cases
- Providing MFM consultation and participating in multidisciplinary planning for critically ill obstetric patients
Fellows provide ½ to 1 day per month of generalist services (including staffing resident clinic). These opportunities are limited so as not to interfere with the fellowship clinical activities or master's degree coursework. Past fellows have collected cases and successfully sat for their oral board exam during fellowship without impacting their fellowship training.
Hands-on ultrasound training is provided by the MFM faculty and Women's Imaging Specialist group, including Drs. Karen Oh and Roya Sohaey who are diagnostic radiologists sub-specialized in women's imaging, specifically complex fetal anomalies and fetal MRI. Together they co-authored the most widely used obstetric ultrasound textbook, Diagnostic Imaging: Obstetrics.
Fellows also have the opportunity for additional training in fetal echocardiogram through the pediatric cardiology division. A substantial amount of elective time is available in the 3rd year of fellowship that can be used for additional ultrasound training.
As part of the fellowship training, fellows will work closely with five board certified genetic counselors and three board certified MFM/Genetics faculty that include Stephanie Dukhovny, M.D., Brian Shaffer, M.D., and Susan Tran, M.D.
Intensive care training
Fellows will finish the program with experience in critical care obstetrics by rotating through the cardiovascular intensive care unit, which accepts all critically ill obstetric patients. They have no MFM obligations during this rotation.
Fetal Therapy Program
Fetal Therapy Program fellows receive substantial fetal genetic and anomaly training through this multidisciplinary program that involves MFM, genetic counseling, women's imaging specialists, neonatology, ethicists, and pediatric subspecialists to provide fetal diagnostic and therapeutic services, including in-utero procedures.
Program Director Brian Shaffer, M.D. spearheads the program, and in conjunction with Doernbecher Children's Hospital, provide coordinated care to women with complex fetal anomalies throughout Oregon and Southwest Washington. The program provides:
- Advanced prenatal diagnostic imaging including ultrasound, echocardiography and fetal MRI
- MFM consultation
- In-utero procedure training and practice as well as thoracentesis, vesicocentesis, thoraco-amniotic and bladder shunt placement, and intrauterine transfusions
- Genetic counseling and testing
- Fetal cardiology
- Pediatric subspecialty consultation (i.e. cardiology, peds surgery, peds CT surgery. urology, neurology, neurosurgery, ENT, endocrine, nephrology, hematology, gastroenterology, orthopedics, palliative care, etc.)
- Coordination of complex deliveries
- Family planning
- Support and counseling services for patients, siblings and families
- Postnatal follow-up and testing
- Opportunity for fetal anomaly clinical outcomes based research
- A multidisciplinary conference is held weekly to review imaging, diagnostic testing, plan of care and coordinate ongoing antenatal, intrapartum, and postnatal care.
- Program volume annually ranges from 350-400 new patients
- Fellows meet quarterly with Brian Shaffer, M.D. to practice ultrasound based procedures to improve procedure related communication practice for amniocentesis, thoracentesis, and shunt placement.
MFM/Adult Congenital Heart Disease Program
Fellows play an integral role in this new multidisciplinary program staffed by director Emmanuelle Pare, M.D. (MFM), Kathleen Brookfield, M.D., Ph.D. (MFM) and Abigail Khan, M.D. (Adult congenital heart disease cardiologist). Its goal is to provide care for the increasing volume of women referred to OHSU with complex congenital heart disease. The program includes:
- A multidisciplinary clinic at the Center for Women's Health including MFM, adult congenital heart disease cardiologists, cardiac disease geneticists and anesthesiologists
- A twice monthly multidisciplinary conference to coordinate antenatal, intrapartum, and postnatal care.
Diabetes and Pregnancy Program (DAPP)
This is an interdisciplinary program under the direction of Amy M. Valent, DO (MFM), consisting of maternal fetal medicine specialists, trainees at all stages, dietitians and physician assistants to provide patients with comprehensive diabetes care. We provide care to women with pregnancies complicated by all diabetes classifications and other metabolic conditions. Our mission is to educate providers, patients and their families on the benefits of high quality nutrition, health lifestyle behaviors and wellness. In order to improve the health and wellbeing of our patients and their offspring, our program includes:
- Medical nutritional therapy
- Mindfulness-based therapy courses
- Comprehensive glycemic monitoring and optimization
- Expertise in insulin pump therapy and continuous glucose monitoring systems