The in-patient facilities at the University of Maryland Medical Systems (UMMS) occupy two floors of the south inpatient tower. A total of twenty antepartum and postpartum beds, as well as three LDRPs are currently located on the sixth floor in our Mother-Baby (MBU) Unit. A three-bed intermediate care unit is under construction within the MIC at this time and should be completed by October 2002. The Center for Advance Fetal Care (CAFCa), neonatal intensive care unit and term nursery are on this floor as well. Immediately above this unit, on the seventh floor, is theLabor & Delivery (L&D) unit.
L&D consists of three traditional labor rooms, four LDRPs, three operating/cesarean delivery rooms, a three bay recovery room, and a 2-bed early labor area, which is also used for triage. All labor beds have automated equipment for monitoring maternal vital signs and electronic fetal monitors. There are two ultrasound machines physically 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. Maternal and fetal blood gas analysis is performed in a satellite laboratory run by the Department of Pathology immediately adjacent to the NICU. This service is available 24 hours a day. Amniotic fluid testing for fetal lung maturity, infection, and chemistry tests is available 24 hours a day as well.
The outpatient facilities in which the Maternal-Fetal Medicine Fellows work are located both on and off the UMMS campus. Each location is described separately.
On-campus facilities for the care of high risk pregnancies consist of the following: The University of Maryland Women's Health Center at Penn Street is located one block south of the UMMS, 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 two half days per week. Fellow training is based on the principle of progressive responsibility. During the first year, the Fellow will spend one session per week in the high-risk pregnancy clinic immediately alongside a faculty perinatologist. In the second year, and third year a faculty member is present in the clinic, to provide close supervision of and consultation to the Fellow, while at the same time allowing the Fellow to direct the clinical activities of the residents. 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 shall attend the High Risk Clinic during research months throughout their first, second and third years. This clinic experience serves as a continuity clinic for the Fellows.
The Antenatal Testing Unit is located on the sixth floor of the UMMS, adjacent to the CAFCa The unit consists of two-bed NST unit in which electronic fetal heart rate monitoring is performed.
The Maryland Center for Advanced Fetal Care (CAFCa) is loctated on the sixth floor of the north nursing tower. The CAFCa provides a multi-disciplinary team approach for the diagnosis and management of the families with fetal structural, growth, infectious or medical abnormalities. It consists of a waiting room, a reception area, a report area, three ultrasound/procedure rooms, and and several consult rooms and offices and a data/image management area.
All anomaly scans, targeted imaging, basic echocardiography, invasive fetal, and a significant percentage of genetic testing are performed in the CAFCa. It is here that the fellow will undergo the bulk of the ultrasound training.
The CAFCa serves patients from throughout the State of Maryland and National Capital Region. The Center is staffed by perinatologists, sonographers, genetics counselors, and dedicated nurses. Consultations with pediatricians, neonatologists, pediatric surgeons, social work and chaplaincy services are coordinated through the CAFCa, and often take place within the CAFCa to maximize patient convenience.
The Division of Maternal Fetal Medicine maintains a private MFM practice immediately off campus and sees MFM Consults at several outreach sites in the Baltimore Metropolitan Area. The fellow, while on clinical rotations, may accompany a member of the MFM division to these consult clinics and see a full spectrum of patients referred from local practitioners for consultation, ultrasound evaluation amniocentesis etc. with visits up to once a week depending on the site. The Fellows participation at all sites will be under the direct supervision of MFM faculty. This clinical experience is designed to prepare the Fellow to function as an expert consultant in MFM by exposing the Fellow to a different type of patient population from that seen in an inner city hospital and not to generate income for the Fellow or the division.