Maternal–fetal medicine referral guidance for clinicians

Direct answer

Refer to maternal–fetal medicine when a focused subspecialist opinion could change diagnosis, surveillance, treatment, genetic investigation, delivery timing, delivery location, or multidisciplinary preparation. State the clinical question clearly, indicate urgency, and send the original evidence needed to answer it.

A referral that says only “high risk” is difficult to triage. A useful request identifies gestational age and dating method, maternal and obstetric history, the current concern, relevant trend, what has already been discussed, and the decision that needs specialist input.

Findings that may need urgent specialist discussion

Examples include severe early fetal growth restriction, absent or reversed umbilical artery end-diastolic flow, hydrops, suspected major fetal abnormality, complicated monochorionic twins, severe pre-eclampsia at an early gestation, possible placenta accreta spectrum, fetal anaemia risk, or a high-chance chromosomal screen with abnormal ultrasound findings. Urgency depends on gestational age, stability, symptoms, fetal testing, and local capacity.

Emergency symptoms or maternal/fetal instability should go through the appropriate emergency or direct hospital pathway rather than a routine electronic referral queue.

Appropriate planned referrals

Planned review can be valuable for previous fetal abnormality, stillbirth, early severe pre-eclampsia, severe growth restriction, very preterm birth, significant maternal disease, complex medication, twins, increased nuchal translucency, abnormal screening, detailed fetal assessment, suspected placental disease, or pre-pregnancy planning.

Records that improve the consultation

Please include:

• estimated date of delivery and the evidence used for dating;
• complete obstetric and relevant medical history;
• medication and allergy list;
• laboratory and screening results;
• original ultrasound images and reports, not only a typed summary;
• blood group and antibody information where relevant;
• family history or prior genetic reports;
• current symptoms, blood pressure, fetal movement, and stability when urgency is possible;
• direct clinician contact details for time-sensitive discussion.

Closing the referral loop

The MFM response should identify the working diagnosis, uncertainty, tests or surveillance proposed, urgency, escalation triggers, delivery implications, and responsibility for follow-up. Complex cases benefit from named communication between teams and early confirmation that the proposed delivery hospital has the maternal, fetal, neonatal, anaesthetic, surgical, and blood-bank capabilities the case may require.

Use the secure referral route on Fetus.ae. Never place patient names, diagnoses, reports, or other health information in analytics parameters or unsecured URLs.