The practice of maternal–fetal medicine (MFM) in the Philippines originated within the broader scope of obstetrics and gynecology. The specialty started to emerge to address the need for specialized care for high‑risk pregnancies and the management of fetal complications. Over the years, the development of MFM as a distinct subspecialty has evolved through advancements in medical technology, training programs, and the increasing complexity of pregnancy management. The Philippine Society of MFM (PSMFM), established in 1996, is the primary organization representing MFM specialists in the country. It is dedicated to advancing the field through education, training, service, and research. PSMFM provides its members a platform to enhance their knowledge, improve their skills, foster collaboration, and share expertise.
Perinatology ; Pregnancy, High-Risk

OBJECTIVE: To assess the application value of copy number variation sequencing (CNV-seq) for women with a high risk for fetal anomalies. METHODS: Based on the results of non-invasive prenatal testing (NIPT), 271 high-risk pregnant women were divided into NIPT positive group (n = 83) and other anomaly group (advanced age, high risk by serological screening, repeated NIPT failure, adverse pregnancy history, abnormal ultrasound finding, and abnormal phenotype) (n = 188). CNV-seq was carried out to detect copy number variations (CNVs) in amniocytic DNA from the two groups of pregnant women, and karyotyping analysis of the amniotic cells was carried out for verification and comparison. RESULTS: The amniocytes from 271 pregnant women were detected. The detection rate was 20.66% (56/271) for pathogenic CNVs by CNV-seq and 19.19% (52/271) for pathogenic karyotypes by karyotyping analysis. The difference was statistically significant (P < 0.05). CNV-seq had shown that, compared with NIPT positive group, the detection rates for likely pathogenic CNVs and variants of unknown significance (VUS) in other abnormality group were significantly higher [2.41%(2/83) vs. 5.32%(10/188)](P < 0.05). CONCLUSION CNV-seq can well suit the first-tier diagnosis for pregnant women suspected for fetal abnormality. In prenatal diagnosis settings, CNV-seq can identify additional and clinically significant cytogenetic abnormalities. In those with other abnormalities, the detection rates for likely pathogenic CNVs and VUS are higher than with the NIPT positive cases.
Female ; Pregnancy ; Humans ; DNA Copy Number Variations ; Pregnancy, High-Risk ; Prenatal Diagnosis/methods* ; Chromosome Aberrations ; Chromosome Disorders/genetics*

OBJECTIVES: The objectives of this study were to investigate the correlations of the temperament and character, depression, anxiety, and maternal-fetal attachment and the mediating effects of the depression, anxiety on the relationship between temperament and character and maternal-fetal attachment.METHODS: A hundred and eleven high-risk pregnant women were recruited in this study. All subjects were administered a sociodemographic and obstetric questionnaire, Temperament and Character Inventory, Beck Depression Inventory-II, State Trait Anxiety Inventory-State, and Maternal-Fetal Attachment Scale.RESULTS: The results of this study were as follows. Higher scores on the reward dependence, persistence, cooperativeness, and self-transcendence scale were associated with higher scores on maternal-fetal attachment scale. Higher scores on the harm avoidance scale and lower scores on the self-directedness scale were associated with higher depression scores. Higher scores on the harm avoidance scale and lower scores on the persistence, self-directedness, and cooperativeness scale were associated with higher anxiety scores. Higher anxiety scores were associated with higher scores on maternal-fetal attachment scale. The anxiety was found to have a partial mediating effect on the relationship between persistence and the maternal-fetal attachment. It was also found to have a partial mediating effect on the relationship between cooperativeness and the maternal-fetal attachment.CONCLUSION: In this study, we found that the anxiety has partial mediating effect on the relationship between temperament and character and maternal-fetal attachment. Based on these findings, it is suggested that examining temperament and character and screening vulnerable pregnant women can help to prevent negative results for high-risk pregnant women.
Anxiety ; Depression ; Female ; Humans ; Mass Screening ; Negotiating ; Pregnancy, High-Risk ; Pregnant Women ; Reward ; Temperament

OBJECTIVES: In this study, we compared anxiety, depression, and maternal-fetal attachment between high-risk pregnant women and normal pregnant women, and investigated whether there was a correlation between anxiety, depression, and maternal-fetal attachment in each group.METHODS: Two hundred and eleven pregnant women(118 high-risk pregnant women, 93 normal pregnant women) were recruited. All subjects were administered a sociodemographic and obstetric questionnaire, Stait Trait Anxiety Inventory-State(STAI-S), Beck Depression Inventory- II(BDI-II), and Maternal-Fetal Attachment Scale(MFAS).RESULTS: Total score of STAI-S in high-risk pregnant women was 13.704 point higher than that in normal pregnant women(95% CI=10.449–16.959, p<0.001). Also, total BDI-II score in high-risk pregnant women was 5.325 higher than that in normal pregnant women(95% CI=1.850–3.711, p<0.001). There was no significant difference between total MFAS score of normal pregnant women and that of high-risk pregnant women(t=1.594, p=0.112). There was a significant positive correlation between anxiety and depression in both normal(r=0.529, p<0.001) and high-risk(r=0.582, p<0.001) groups. In normal pregnant women, there was a significant negative correlation between anxiety and maternal-fetal attachment(r=−0.284, p=0.006).CONCLUSION: High-risk pregnant women experienced more anxiety and depression than normal pregnant women, and the maternal-fetal attachment was not significantly different between the two groups. The higher the level of anxiety of the pregnant women, the lower the degree of maternal-fetal attachment. Psychological support for dealing with the emotional problems of high-risk pregnant women and promoting maternal-fetal attachment is needed.
Anxiety ; Depression ; Female ; Humans ; Pregnancy, High-Risk ; Pregnant Women

The Mother and Child Act is the most important law set up to maintain and improve maternal-child healthcare. This act was established in 1973 and was revised to improve maternal-child healthcare. This act includes the establishment and management of a maternal-child healthcare center in the district, a maternal-child regional healthcare center in the province, and a national maternal-child medical center. In the baby boom era, maternal-child healthcare centers provided maternity care and delivery services as well as emergency obstetrical management, but those centers stopped providing maternity care in the low birth-rate era. The last revised act included the establishment of a national maternal-child medical center to care for the increase in the number of high-risk pregnancies. This review briefly evaluates the goals and roles of a maternal-child healthcare center and a national maternal-child medical center according to the Mother and Child Act, and integrates high risk pregnancies with a neonatal care center to renovate the maternity healthcare system.
Child ; Delivery of Health Care ; Emergencies ; Humans ; Jurisprudence ; Mothers ; Population Growth ; Pregnancy ; Pregnancy, High-Risk

Several studies have reported adequate patient transfer to higher level hospitals according to the risk for improving perinatal outcomes. According to these reports, countries across the world divide the levels of maternal care on the basis of the assessment of hospital facilities and medical services as well as the assessment of high-risk pregnancies while evaluating the cases of and risks associated with maternal care that can be addressed by these hospitals at each level. Because the level of and policies on maternal care vary across countries, we aimed to evaluate risk assessments and introduction of treatment facility classifications in different countries. In Korea, birth rate is declining and the number of elderly pregnant women is increasing, whereas the number of hospitals that can deliver a baby and care for mothers at high risk is decreasing. We, therefore, need to establish an infrastructure for medically vulnerable areas, a localization center, and a medical personnel supplement. Moreover, establishing detailed guidelines and criteria for different levels of maternal care is necessary. The new guidelines will also need to supplement the policies on the requirement of well-trained obstetricians and of low medical insurance fee.
Aged ; Birth Rate ; Classification ; Fees and Charges ; Female ; Humans ; Insurance ; Korea ; Maternal-Child Health Services ; Mothers ; Patient Transfer ; Pregnancy, High-Risk ; Pregnant Women ; Prenatal Care ; Risk Assessment

PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.
Critical Care ; Education ; Fetus ; Gynecology ; Humans ; Intensive Care Units ; Lectures ; Mothers ; Nursing ; Nursing Care ; Obstetrics ; Pregnancy, High-Risk ; Program Development

No abstract available.
Cervical Length Measurement ; Female ; Incidence ; Obstetric Labor, Premature* ; Parturition* ; Pregnancy ; Pregnancy, High-Risk ; Reproductive History

PURPOSE: This study examined the effect on uterine contraction frequency (UCF), blood pressure (BP), heart rate (HR), fetal heart rate (FHR) patterns and psychophysical symptoms (physical discomfort, anxiety, and depression) of structured bed exercise (SBE) in hospitalized high-risk pregnant women prescribed bed rest. METHODS: Forty-five hospitalized high risk pregnant women at >24 weeks of pregnancy prescribed bed rest were randomly assigned to the experimental or control group. From January to May 2014, data were collected using electronic fetal monitoring and patient monitoring of UCF, BP, HR and FHR patterns, and psychophysical symptoms were measured using the antenatal physical discomfort scale, state-trait anxiety scale, and Edinburgh postnatal depression scale. RESULTS: UCF, BP, HR, and FHR patterns (rate, variability, acceleration, and deceleration) did not differ significantly between the experimental and control groups. The experimental group showed a significant increase in baseline FHR after SBE within the normal range, and after SBE, it reduced to the FHR before SBE. The variability, acceleration and deceleration of FHR before and after SBE did not differ significantly between two groups. Moreover, there was no statistically significant difference before and after SBE in the experimental group. Also, the experimental group showed statistically significant decreases in physical discomfort score. However, there were no significant differences in depression and anxiety score between two groups. CONCLUSIONS: SBE in hospitalized high-risk pregnant women under bed rest did not increase the risk to the fetus, and relieved physical discomfort and anxiety. Therefore, SBE should be considered as a nursing intervention in hospitalized high-risk pregnant women.
Acceleration ; Anxiety ; Bed Rest ; Blood Pressure ; Cardiotocography ; Deceleration ; Depression ; Depression, Postpartum ; Female ; Fetal Heart* ; Fetus ; Heart Rate ; Heart Rate, Fetal* ; Humans ; Monitoring, Physiologic ; Nursing ; Pregnancy ; Pregnancy, High-Risk ; Pregnant Women* ; Reference Values ; Uterine Contraction*

It has been demonstrated that risk-appropriate perinatal and obstetric care can improve perinatal morbidity and mortality. Recently, various studies focus on the importance of evaluation for maternal conditions and allocation of high risk pregnant women to highly qualified facilities. Therefore, it is necessary to develop the conceptualized framework for levels of obstetric care and establish the guidelines for the situations that should be cared in each level of facility. In this review article, we reviewed several classifications of obstetric care in eastern and western countries, and conditions in which transfer should be recommended depending on the risk and capacity of centers.
Classification ; Female ; Humans ; Mortality ; Pregnancy, High-Risk ; Pregnant Women ; Referral and Consultation