Presentations
- Amniotic fluid volume changes, including:
- anhydramnios
- oligohydramnios
- polyhydramnios
- Anatomical structural anomalies
- Antepartum haemorrhage
- Diabetes in pregnancy
- Disorders of growth, such as:
- fetal growth restriction
- macrosomia
- Factors affecting breastfeeding and the production of breast milk
- Hydrops fetalis
- Hypertensive disorders in pregnancy
- Maternal mental health, including:
- anxiety
- attention deficit hyperactivity disorder (ADHD)
- bipolar disorder
- depression
- post-traumatic stress disorder (PTSD)
- Maternal thyroid disease
- Multiple pregnancies
- Preterm labour
- Preterm prelabour rupture of membranes
- Significant maternal medical and surgical conditions
- Substance use
Conditions
- Anatomical structural malformations, including:
- congenital cardiac lesions
- congenital diaphragmatic hernia
- congenital pulmonary airway malformation
- developmental and acquired brain malformations
- multicystic dysplastic kidneys
- renal agenesis
- renal pyelectasis
- Chromosomal and genetic abnormalities, including:
- Cleft palate
- Congenital infection
- Discordant growth
- Hypoplastic lung
- Shared placental physiology
- Tracheoesophageal fistula or intestinal atresia
- Twin anaemia polycythaemia sequence
- Twin-to-twin transfusion syndrome
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when
developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate
preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and
management
Presentations
- Echogenic bowel
- Fetal anaemia
Conditions
- Agenesis of the corpus callosum
- Cerebellar hypoplasia
- Cystic hygroma
- Fetomaternal alloimmune thrombocytopaenia
- Neural tube defects, such as:
- Neurological presentations, such as:
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when
developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate
preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and
management
- Knowledge of the basic sciences relevant to maternal and fetal medicine
Embryology
- Absent and reverse diastolic flow significance in antenatal ultrasound scanning
- Factors involved in initiation of labour
- Fetal adaptions to stress
- Fetal origins of disease and factors relevant to providing a healthy start, such as:
- folate
- iodine
- mental health
- minimising risks
- substance use
- supportive environments
- Normal fetal and placental physiology and pathology
- Pathophysiology of pregnancy complications related to high-risk / premature births
- Role of magnesium sulphate for neuroprotection
- Role of steroids in predicted premature birth
- Understand fetal cardiological, endocrinological, and respiratory responses to birth
- Umbilical cord pathology, including abnormal and normal variants
- Umbilical gas significance:
- Understanding of the placenta and the role it plays in fetal wellbeing
Investigations
- Amniocentesis
- Antenatal infection tests:
- Carrier screening
- Chorionic villus sampling (CVS)
- Fetal:
- echocardiogram
- MRI
- ultrasound
- First trimester combined ultrasound and serum screening test
- Genetic testing, such as:
- karyotype
- microarray
- whole exome sequencing
- whole genome sequencing
- Maternal serum screening first trimester (MSS1)
- Non-invasive prenatal testing (NIPT)
- Routine pregnancy screening tests and monitoring
Procedures – know about but not perform
- Cerebral doppler studies
- Intrauterine fetal surgery
- Laser ablation for twin-to-twin transfusion syndrome
- Umbilical doppler monitoring
- Impacts of climate and environmental hazards on fetal, maternal, and neonatal health:
- changing epidemiology of infectious diseases and pollution-related disorders, including
impact on fetal brain and lung development
- heat-related risk of neonatal mortality, stillbirth, and preterm birth
- impact of displacement / reduced health care access due to natural disasters
- psychological effects of climate hazards, such as:
- acute and chronic heat stress
- natural disasters
- Knowledge and application of antenatal counselling
- Management of periviable births
- Parental expectation and planning for birth
- Role of maternal fetal medicine specialists
