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Maternal-Fetal Medicine Qualifying Exam Preparation


The content of the Qualifying Examination will be based on the blueprint for Maternal-Fetal Medicine. The major categories and subcategories are shown below indicating the percentages of the categories. The questions will be in a multiple-choice, one best answer form.


Medical Disorders

  • Evaluate, diagnose, and manage medical disorders
  • Provide preconception, post-delivery counseling (including contraception) for patients with medical disorders
  • Counsel patients about maternal physiology, fetal and neonatal implications of their medical condition(s)
  • Counsel patients on impact of medical disorders on delivery timing
  • Counsel patients with medical disorders regarding drugs and biologics
  • Manage antenatal care for patients with medical disorders
  • Manage intrapartum and postpartum care for patients with medical disorders

Critical Care

  • Evaluate and diagnose critical care conditions
  • Manage critical care conditions and interpret hemodynamic monitoring
  • Identify critically-ill patients and facilitate transfer to higher level of care
  • Manage antenatal care and delivery timing for critically-ill patients
  • Manage intrapartum and postpartum care for critically-ill patients
  • Counsel critically-ill patients regarding drugs and biologics
  • Manage massive obstetrics hemorrhage
  • Manage obstetric coagulopathy

Preterm Labor and Preterm Premature Rupture of Membranes (PPROM)

  • Identify risk factors for preterm birth
  • Counsel patients on risk-reduction strategies for preterm birth
  • Counsel patients on limits of viability, prognosis, and management
  • Manage PPROM
  • Manage preterm labor and delivery
  • Manage cervical insufficiency

Hypertensive Disorders

  • Manage hypertensive disease in pregnancy
  • Manage preeclampsia
  • Manage eclampsia

Multiple Gestation

  • Counsel and manage patients on associated complications and pregnancy outcomes based on chorionicity for twin gestations
  • Counsel and manage high-order multiple gestations
  • Counsel patients on indications and risks associated with fetal reduction

Fetal Demise

  • Provide preconception counseling for recurrent pregnancy loss
  • Evaluate and manage patients with a fetal demise and/or recurrent pregnancy loss
  • Evaluate and manage patient for bereavement and/or postpartum depression

Procedures Relating to Obstetrical Complications

  • Amniocentesis and amnioreduction for fetal lung maturation
  • External cephalic version
  • Peripartum hysterectomy
  • Cervical cerclage
  • Chorionic villus sampling
  • Cordocentesis and fetal transfusion

Obstetric Anesthesia

  • Counsel medically-complicated patients regarding the different anesthetic options including benefits, risks, and contraindications (e.g. systemic analgesia and sedation, general anesthesia, regional anesthesia); for example, cardiac arrest, respiratory arrest, aspiration pneumonitis, hypotension, high spinal or total spinal, convulsions, neuropathy, headaches, hypothermia
  • Identify, diagnose, and co-manage anesthetic complications (e.g. cardiac arrest, respiratory arrest, aspiration pneumonitis, hypotension, high spinal or total spinal, convulsions, neuropathy, headaches, hypothermia)

Management of Obstetrical Complications

  • Amniotic fluid embolism (AFE)
  • Acute fatty liver of pregnancy (AFLP)
  • Placental abruption
  • Abnormal placentation (e.g. acceta, increta, percreta, vasa previa and placenta previa)
  • Gestational trophoblastic disease
  • Ruptured uterus
  • Cholestasis of pregnancy
  • Uterine anomalies
  • Ovarian masses
  • Dermatologic conditions (e.g. PUPPS, herpes gestationis)
  • Fetomaternal hemorrhage
  • Trauma
  • Abnormally-implanted pregnancies (abdominal, cervical, and c-section scar)


  • Perform and interpret 1st trimester ultrasound for singleton and multiple gestations
  • Perform and interpret 2nd and 3rd trimester ultrasound
  • Recognize normal and abnormal maternal, fetal, and placental anatomy
  • Apply knowledge of the limitations of ultrasound to determine need for additional imaging modalities
  • Determine indication for and perform Doppler studies (umbilical artery and MCA, color, m-mode)
  • Determine indication for and perform 3D and 4D ultrasound
  • Perform and interpret cervical length assessment
  • Manage disorders of amniotic fluid volume
  • Perform and interpret fetal echocardiography
  • Perform ultrasound assessment of chorionicity

Evaluation, Management, and Diagnosis of Fetal Complications

  • Fetal structural abnormalities
  • Fetal growth restriction
  • Genetic disorders (e.g. chromosomal abnormalities, DiGeorge's, skeletal dysplasia, syndromes)
  • Fetal hydrops
  • Isoimmunization
  • Alloimmune thrombocytopenia
  • Fetal Infections

  • Obtain a genetic history and perform a three-generation pedigree, perform preconception genetic counseling, and counsel patients on Mendelian patterns of inheritance (e.g. autosomal dominant, autosomal recessive, co-dominant, X-linked recessive, X-linked dominant) and non-Mendelian patterns of inheritance (e.g. trinucleotide repeat disorders, imprinting, uniparental disomy, mitochrondrial inheritance, germline mosaicism, multifactorial and polygenic inheritance)
  • Counsel patients on benefits and limitations of PGS/PGD (preimplantation genetic diagnosis)
  • Counsel patients on and perform expanded and ethnicity-based carrier screening
  • Counsel patients on different methods of aneuploidy screening and interpret results
  • Counsel patients on prenatal testing (e.g. fetal karyotype, chromosomal microarray, biochemical and molecular tests, whole exome sequencing)

Ethics and Professionalism

  • Systematically engage in practice review to identify health disparities
  • When engaged in shared clinical decision making, incorporate patient, family, and cultural considerations in making treatment recommendations
  • When providing care for patients, consider psychological, sexual, and social implications of various treatment options

Patient Safety

  • Systematically analyze the practice for safety improvements (e.g. root cause analysis)
  • Systematically engage in practice reviews for safety improvements (e.g. root cause analysis)
  • Incorporate the standard use of procedural briefings, "time outs", and debriefings in clinical practice
  • Participate in the review of sentinel events, reportable events, and near misses
  • Implement universal protocols (e.g. bundles, checklists) to help ensure patient safety

Interpersonal and Communication Skills

  • Communicate to patient and family regarding adverse outcomes and medical errors
  • Demonstrate sensitivity and responsiveness when communicating with a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation
  • Provide comprehensive information when referring patients to other professionals

Systems-Based Practice

  • Incorporate considerations of cost awareness and risk-benefit analysis in patient care
  • Provide care with multidisciplinary teams to promote patient safety and optimize patient outcomes

Practice-Based Learning and Improvement

  • Design or participate in practice or hospital quality improvement activities

Evidence-Based Medicine

  • Incorporate evidence-based practices and national guidelines to improve practice patterns and outcomes
  • Implement evidence-based protocols to enhance recovery after surgery (ERAS)
View a Printable Version of the 2021 Qualifying Exam Topics