Perinatology, or maternal-fetal medicine, is the subspecialty of obstetrics and gynecology that focuses on the management of high-risk pregnancies and the assessment and treatment of the fetus. By the mid-1970s, knowledge regarding maternal and fetal physiology and disease had evolved to the point where many obstetrician/gynecologists confined their practice to these areas. In 1974, the American Board of Obstetrics and Gynecology began to offer an exam-based certification of special competency in this area. In 1977, the Society of Perinatal Obstetricians (now called the Society for Maternal-Fetal Medicine) was formed.

 

Modern maternal-fetal medicine specialists devote their professional practice to providing care for, and conducting research on, maternal medical disorders such as diabetes, premature labor, perinatal infectious disease, multiple gestation, and perinatal pharmacology. Additionally, they are actively involved in the assessment and treatment of the fetus. They assess fetal gestational age and growth; evaluate possible congenital anomalies; and assess the placenta and amniotic fluid and the adequacy of uteroplacental function. They employ a number of invasive techniques, such as amniocentesis, chorionic villus sampling, cordocentesis, and fetoscopy, to evaluate the fetus for genetic disorders and alloimmune disorders, evaluate fetal maturity, and treat the fetus with pharmacological agents or blood products.

1 -Experts at diagnosing and treating pain

2 -Restore maximum function lost through injury, illness or disabling conditions

3 -Treat the whole person, not just the problem area

4 -Lead a team of medical professionals

5 -Provide non-surgical treatments

6 -Explain your medical problems and treatment plan

Work not only on treatment but also prevention

Rehabilitation physicians are nerve, muscle, and bone experts who treat injuries or illnesses that affect how you move. Rehabilitation physicians have completed training in the medical specialty physical medicine and rehabilitation (PM&R).

Rehabilitation physicians treat a wide range of problems from sore shoulders to spinal cord injuries. Their goal is to decrease pain and enhance performance without surgery. Rehabilitation physicians take the time needed to accurately pinpoint the source of an ailment.

They then design a treatment plan that can be carried out by the patients themselves or with the help of the rehabilitation physician’s medical team.

This medical team might include other physicians and health professionals, such as neurologists, orthopedic surgeons, and physical therapists. By providing an appropriate treatment plan, rehabilitation physicians help patients stay as active as possible at any age. Their broad medical expertise allows them to treat disabling conditions throughout a person’s lifetime.

Physical medicine and rehabilitation involves the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement & activities modification, adaptive equipments and assistive device, orthotics (braces), prosthesis, and experiential training approaches.

Physical Medicine & Rehabilitation physicians may also perform electrodiagnostics which are used to provide nervous system functional information for diagnosis and / or prognosis for various neuromuscular disorders. The common electrodiagnostic tests performed by physiatrists are nerve conduction studies (NCS) and needle electromyographies (EMG). The nerve conduction study involves electrical stimulation to peripheral nerves and the nerves' responses are measured such as onset latency, amplitude and conduction velocity. Needle electromyography requires needle electrode insertion into the muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials such as fibrillation potential or positive sharp waves detected by EMG needles indicate the presence of muscle fibers that have abnormal nerve supplies.

Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskeletal pain syndromes such as low back pain, fibromyalgia and traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through multidisciplinary approach involving psychologists, physical therapists, occupational therapists, chiropractors, and interventional procedures when indicated. In addition to the previous methodology, stroke is often treated with the help of a speech therapist and recreational therapist when possible.