Obstetrics & Gynecology

MSC 10 5580
1 University of New Mexico
Albuquerque, NM 87131

Maternal Fetal Medicine

Welcome to the Division of Maternal-Fetal Medicine (MFM) at the University of New Mexico Department of Obstetrics and Gynecology.  MFM offers outstanding clinical care, trains medical students, residents and has one of 78 ABOG accredited MFM fellowship programs in the nation, and conducts important research.

National Recognition

Nationally recognized research in:

  • diabetes in pregnancy
  • induction of labor
  • evaluative education
  • illicit drug use in pregnancy
  • fetal alcohol syndrome
  • human chorionic gonadotropin levels predicting pregnancy outcomes
  • omega-3 fatty acids and pregnancy outcomes
  • labor induction
  • non-invasive prenatal diagnosis
  • physician workforce issues

Multidisciplinary Partners

Neonatology, pediatric surgery, family medicine, anesthesiology, emergency medicine, pathology, biochemistry, Los Alamos National Laboratories, Sandia National Laboratories

Link to Our Faculty

Areas of Special Interest

Clinical

  • History of unfavorable pregnancy outcomes
  • Medical complications of pregnancy
  • Prenatal diagnosis/genetics
  • Trauma in pregnancy
  • Fetal echocardiography
  • First trimester screening
  • Rh iso-immunization
  • Preterm labor/ruptured membranes
  • Illicit drug use and pregnancy

Research 

  • Emerging technologies and preterm birth
  • Diabetes during pregnancy
  • Induction of labor
  • Substance abuse in pregnancy
  • Proteomics for Preeclampsia and Preterm Labor
  • Human Chorionic gonadotropin levels and prenatal outcomes
  • Ultrasound predictors of fetal alcohol syndrome
  • Omega-3 fatty acids and pregnancy outcomes

Maternal Fetal Medicine Fellowship Program

To Apply

The Maternal Fetal Medicine (MFM) Fellowship accepts
applications only through the "Electronic
Residency Application Service" (ERAS)

For more information, please contact Susan Quintana.

The University of New Mexico's Perinatal Program is committed to the care of women and their newborns throughout the state. We believe that universal access to quality health care should be a right and not a privilege.  We are committed to providing the highest level of care for the underserved mothers in our state.

This 3-year ACGME-accredited program consists of one fellow per year.  It is one of the oldest programs nationally, established more than 30 years ago.

How the Program Functions

MFM Fellows work in a complementary manner and in a supervisory role with residents in Labor and Delivery, ultrasound and genetics, antepartum ward and clinics, and the special or intensive care units.  Clinical responsibilities of fellows are distinct from those of residents and like those of junior faculty.  The residents enjoy the teaching and supervision of the MFM fellows and faculty.  High complexity procedures are performed by the fellow; specifically, fellows perform genetic amniocenteses, therapeutic amnioreductions, cordocenteses, chorionic villous samplings, cervical cerclages, fetal echocardiography examinations, and Doppler evaluations.  Essentially all of the highly complex invasive procedures in the State of New Mexico are performed at UNM Hospital by our fellows and faculty.  Under the supervision of MFM faculty, fellows assigned to clinical rotations act as consultants to the obstetrics and gynecology residents, midwives, and family medicine residents/faculty on complicated obstetrical patients.  MFM fellows share with the OB/GYN residents in the preparation and presentation of didactic lectures and in active discussions during the bi-monthly obstetrical M&M conferences, weekly Residents' School, quarterly MFM Journal Club, and weekly departmental grand rounds.  Weekly didactic sessions directed primarily at the MFM fellows are given in general maternal and fetal medicine and ultrasound, and there is a weekly multidisciplinary case review of all current fetal anomalies and selected fetal complications, selected maternal complications, and neonatal outcomes including a didactic presentation by a neonatal or MFM fellow.

Facilities and Infrastructure for Research

The UNM Clinical and Translational Science Center offers fellows access to expertise in study design, biostatistics, internal funding and data management through consultations with biostatistics faculty.  The OB/GYN Department provides support through a research operations manager.  Our fellows work with a variety of basic scientist in several settings, particularly in the area of fetal alcohol disorders.  We offer excellent coursework to ensure sufficient training to develop skills in clinical and laboratory research.  By the end of their fellowship, the average fellow research experience includes 4-6 projects with most being presented at national scientific meetings and published in peer reviewed medical journals.

Clinical Experience

The medical school provides professional development for "fellows as teachers' in the outpatient, inpatient, and didactic settings, emphasizing the fellows' role as educators.  MFM Fellows are actively engaged in the daily bedside and didactic teaching of residents.  The clinical responsibilities of the fellows and residents are well defined and distinct.  Residents are aware of specifically designated fellow procedures and fellows are aware of their primary educational role with the residents.  For complex obstetrical surgical cases such as placenta accretas, an alternating algorithm ensures that both residents and fellows have ample access to these cases.  As the major tertiary referral center for the state, UNM cares for the vast majority of the highly complex maternal and fetal cases in New Mexico, and all patients on the service are cared for by the fellows.  The Division provides outreach services to many areas in rural New Mexico and fellows participate in this program as much as possible.

Inpatient care is given in the Richardson Pavilion, a modern 500,000 square foot facility with state-of-the-art labor and delivery, antepartum, neonatal, and postpartum units as well as a variety of medical, surgical, cardiac, and neurologic intensive care units.  As the only Level I trauma center in New Mexico, UNM Hospital supports the most advanced technology not only in obstetrical care, but also in surgical and medical subspecialty care, and subspecialists are available 24 hours a day for consultation.  Outpatient care is given in the University Hospital Clinics as well as in the UNM Women's Care Clinic on Eubank, a brand new 22,000 square foot facility with state-of-the-art ultrasound and telemedicine capabilities.  In addition, the Division serves multiple outreach clinics in rural New Mexico that enable the fellows to experience the unique rewards and challenges of caring for a wide variety of divers patient populations.

Consultative Roles

Under the guidance of the MFM faculty, MFM fellows provide consultative services to generalist obstetricians, family physicians, and midwives on Labor and Delivery, the antepartum and postpartum wards and in the ultrasound unit and clinics within the UNM Hospital system.  Under the supervision of the MFM attending faculty, fellows complete and MFM consult on every complex patient who is admitted to the University of New Mexico Hospital MFM service.  In addition, the fellows share call responsibility with our MFM faculty to provide telephone consultations to care providers across New Mexico, Northern Arizona, and Southern Colorado, through the Physician Access Line Services (PALS) line.  this line used in both to provide advices and to facilitate transports of patient with pregnancy complications to the University of New Mexico Hospital.

Systems-Based Practice

The fellows are involved in caring for patients in a wide variety of settings throughout the University of New Mexico's large, integrated health care system, as well as at secondary teaching sites.  They receive instruction and feedback during active patient care encounters in each clinical setting.  The fellows work on the inpatient service as well as outpatient clinics.  They also perform surgeries in the operating room and procedures on the Labor & Delivery unit.  Ultrasounds and ultrasound-guided procedures are performed by the fellows in our Women's Imaging suite.  Fellows receive additional instruction from our affiliated clinical faculty at our secondary community-based clinical teaching sites, Pinon Perinatal and Lovelace women' Hospital.  Additionally, each fellow has his/her own continuity clinic in which they care primarily for patients.

In addition to primarily managing patients in their continuity clinic, fellows are usually the point person for any inpatient of ambulatory patient transfers.  They learn to evaluate the risks and benefits or transporting the patient to our facility, as well as the cost to the patient, the hospital, and society in doing so.

Continuity of Patient Care

On the outpatient side, each fellow has a weekly continuity clinic at which she/he personally takes care of a cohort of patients throughout their pregnancy and during the postpartum period.  They help coordinate care for their patients with various adult and pediatric subspecialist.  This continuity of care is further augmented when patients are admitted to the inpatient MFM service (both antepartum and intrapartum) where they are shared by the fellows.  When appropriate the fellows also participate in their delivery when the fellow's schedule allows.  After delivery, these patients are admitted to the MFM service and are cared for by the MFM fellow before they are discharged home.  When possible, these patients return to the MFM clinic to see the same fellow for their outpatient postpartum follow-up.

Curriculum for Fellows' Scholarly Activities

Curriculum for fellow's scholarly activities includes Institutional Review Board training, grant writing, learning about study design, manuscript preparation, and thesis preparation and defense.  Much of Institutional Review Board (IRB) training is with the faculty member assigned to the fellow's specific research project(s) and with the IRB staff member assigned to the project.  Our IRB is user-friendly and quick to address the fellow's needs.  in addition, the UNM IRB has a Research Design Curriculum, which focuses on skills and education needed at the fellowship level of training.  Study design, ethics in research, and conflict of interest constitute a significant part of the curriculum.  Grant writing:  By the end of their training, each MFM fellow has gained experience from their own research projects and from collaborations with faculty, who are funded.  The Department's research division, under the direction of the Department of Obstetrics and Gynecology's Vice Chair for Research, has a curriculum dedicated to grants preparation and submission for all faculty and fellows.  in addition, the UNM Grant Training Center at the Clinical and Translational Science Center (CTSC) offers twice annually an intensive three-day grant proposal workshop.  MFM fellows attending the workshop learn how to comprehend the diversity of the grant funding community, identify potential funding sources, create the right fit with the funding agency, address the guidelines of proposals, identify and effectively write the key elements of a proposal, integrate each component of the grant into the final product, develop focused and realistic budgets, and package professional grant submissions.  Each fellow in the past has been assigned to attend the Excellence Course in Clinical research which includes lectures pertaining to research methodology.

Thesis presentation/defense:  Progress on the thesis is reviewed with the MFM fellowship program director on a regular basis beginning at least in the second year.  the thesis project is presented orally by the fellow either at the end of their second year or third year at our Annual Women's Health Research Symposium.  The project is submitted in abstract form at the beginning of the third year and customarily presented at the beginning of the third year and customarily presented at the Society for Maternal Fetal Medicine (SMFM), American Institute of Ultrasound in Medicine (AIUM) or Society for Reproductive Investigation (SRI) annual scientific meeting.  We comply with the thesis guidelines written in the "Guide to Learning in Maternal-Fetal Medicine" published by ABOG.  The thesis is to be defended each May of the MFM fellows' third year.  By then, the manuscript will have already been completed and either submitted before or after the thesis presentation.

Curriculum for the fellows' scholarly activities is divided into statistical analysis, structured didactic instruction, basic science techniques, abstract preparation and presentation, training in academic careers, and preparation to become an independent investigator.  Statistical analysis:  Our School of Medicine's Clinical and Translational Science Center (CTSC), sponsored by the National Institute of Health, provides statistical analyses to every MFM fellow at no cost.  Each project is assigned to a statistician whose responsibility is complete, from assistance in study design to response to reviewers upon any acceptance of the manuscript.  A course of formal training in statistical analysis is available through the UNM Cancer Center.  Structured didactic instruction in epidemiology is taught in our Fellow Didactic Session.  Fellows receive instruction in basic science techniques both through didactic instruction in the fellow's lecture series and through hands on experience in the lab.  We are fortunate to have forged relationships in the Department of Neuroscience, College of Pharmacy, and Neonatology.  These relationships afford our fellows the opportunity to work on funded basic and translational science projects.  Multiple opportunities exist for training in grant writing, thesis preparation, and didactic and hands-on experiences in clinical teaching.  Fellows are prepared to become independent investigators through instruction in research design, grant writing, statistics, laboratory methodology, and completion of the thesis project.  There are opportunities in our institution for graduates of the program to join the MFM faculty and to receive further research and career development mentorship.

Fellow thesis projects:

2018: Nathan Blue, MD:

Effect of acetaminophen on postpartum blood pressure control in preeclampsia with severe features: RCT comparing ibuprofen and acetaminophen for postpartum pain in women with preeclampsia with sever features.  Clinicaltrialsgove ID: NCT02911701

2017 Brad Holbrook, MD:

Effects of prenatal alcohol use on the expression of placental protiens.  Comparative study of placental protein expression in women exposed and non-exposed to alcohol use during pregnancy.

2016: Pranita Nirgudkar, MD:

Nirgudkar P, Taylor D, Yangawa Y, Valenzuela CF.  Ethanol exposure during development reduces GABAergic/glycinergic neuron numbers and lobule volumes in the mouse cerebellar vermis.  Neuroscience Letters. 2016 Oct 6; 632:86-91. PMID 27565053

Summary of fellowship block schedule:

Inpatient/clinical service: 12 months

Combined clinical and ultrasound training: 6 months

Protected research: 12 months

1 month each of NICU and MICU

L&D: 2 months

Elective: 2 months

MFM PHYSICIAN FACULTY ROSTER

William Rayburn, MD (Professor and Program Director)

Jacquelyn Blackstone, DO (Associate Professor)

Conrad Chao, MD (Professor and Division Chief)

Ben Curet, MD (Professor Emeritus)

Danielle Esters, MD (Assistant Professor, MFM and Medical Genetics)

Luis Izquierdo, MD (Professor)

Kathy Morris, MSSW, LCGC (Genectics Counselor)

Ellen Mozurkewich, MD (Associate Professor, Assistant Program Director)

Evan Taber, MD (Assitant Professor)

Steffen Brown, MD (Clinical Assistant Professor)

Timothy Hurley, MD (Clinical Assistant Professor)

Valerie Rappaport, MD (Clinical Associate Professor)

Current Fellows

First Year

Vivek Katukuri
Vivek
Katukuri, MD

Second Year

Nathan Blue
Nathan
Blue, MD

Third Year

Brad Holbrook
Brad
Holbrook, MD

High Risk Clinics at UNM Hospital

This clinic cares for all women with complicated pregnancies due to maternal or fetal conditions.  Clinics are available weekly, and each is staffed by a Maternal-Fetal Medicine sub-specialist. Care is coordinated with all other consulting medical services to provide integrated, multi-specialty consultations. Private patient consultations with attending Maternal-Fetal Medicine consultants are available.

For appointments call (505) 272-1821

Fetal Testing Center

The Fetal Testing Center (FTC) is an integral part of the Maternal Fetal Medicine Division, providing antenatal surveillance to high risk obstetrical patients in an outpatient setting. Once or twice weekly testing (NST and AFI) usually begins at 28-32 weeks gestation. Indications for testing are diabetes, chronic hypertension, renal disease, cardiac disease, pulmonary disease including active asthma, collagen vascular disease, severe anemia intrauterine growth restriction, decreased fetal movement, discordant twins, preeclampsia, premature rupture of membranes, abruption, oligohydramnios, prior intrauterine fetal demise, cholestasis, Rh isoimmunization and any pregnancy reaching 41 weeks gestation. Other procedures that are done in the FTC are confirmation of viability, fetal presentation, amniocentesis for Fetal lung Maturity (prior arrangement with MFM required)

The FTC sees patients by appointment only. Patients are scheduled every 30 minutes, allowing important one on one time with the nurse. Besides testing this time is used for patient education, addressing questions and concerns and giving support to help the mother cope with a high risk pregnancy.

Perinatal Outreach

The Division of Maternal-Fetal Medicine maintains an active perinatal outreach program to remote and underserved communities in New Mexico.

Prenatal Diagnosis and Genetic Counseling Service

The Prenatal Diagnosis Service offers genetic counseling, genetic testing and screening to individuals and couples who are already pregnant or considering a pregnancy. The procedures offered through our service include:

  • Chorionic villi sampling
  • Amniocentesis
  • Structural ultrasounds screening or fetal anomalies
  • Nuchal translucency and first trimester biochemical testing.
  • Fetal echocardiography
  • Non-invasive prenatal testing (NIPT)

Families who have a history of a genetic disorder, a previous child with a birth defect, or chromosome alteration and couples who have experienced three miscarriages, or women over the age of 35 are encouraged to make an appointment with our clinic. For more information, or to schedule an appointment, please contact the prenatal diagnosis office at (505) 272-6611.

Preconception Counseling

An assessment of a woman’s current health is essential before conception by your physician, midwife, or nurse practitioner. This assessment should include checking the status of her immunity to certain infections and the need for immunization, the presence and status of any medical conditions, reproductive and family history, nutrition status, and risk of genetic disease:

  • Testing is recommended for immunity to rubella and varicella, and those not immune should be vaccinated.
  • Many examples exist for counseling about certain medical conditions and additional risks for both mother and fetus before conception.
  • Nonjudgmental and indirect questioning of patients is recommended to determine their use of drugs or abuse in order to provide education, contraceptive counseling, and referral for treatment.
  • Nutrition and weight gain are to be emphasized before conception.
  • 400 mg of Folic acid should be taken daily if planning a pregnancy.

Maternal Fetal Medicine Clinics

Women's Health Clinic, Women's Imaging Center

University of New Mexico Hospital
4th Floor, Ambulatory Care Center
2211 Lomas Blvd. NE (directions)
Albuquerque, NM 87106
For appointments: (505) 272-2245

Women's Imaging/Prenatal Diagnosis

Monday-Friday
8:00am - 5:00pm
(505) 272-6611 (genetics)
(505) 272-8913 (ultrasound)

Northwest Valley Clinic

1231 Candelaria NW (directions)
Albuquerque, NM 87107
Phone: (505) 272-2158
Fax: (505) 272-8653
Tuesdays 8:00am - 5:00pm

Women's Faculty and Midwife Clinic

801 Encinco Place NE, Suite E-1 (directions)
Albuquerque, NM 87102
Main Appt. Line: (505) 925-4940

Administrative Office Information

Department of Obstetrics & Gynecology 
University of New Mexico Department of Obstetrics & Gynecology
MSC 10 5580
1 University of New Mexico
Albuquerque NM 87131-0001
Phone (505) 272-6387
Fax (505) 272-6385