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Division of Maternal-Fetal Medicine

Andrea Greiner

Andrea Greiner, MD, MHA

Division Director


Maternal-fetal medicine specialists at the University of Iowa care for the most complex obstetric patients in Iowa as the only tertiary academic referral center. The MFM practice is full scope which includes both consultative and longitudinal prenatal care provided in the outpatient and inpatient settings. There are clinical collaborators in multiple adult and pediatric subspecialties. There are currently three faculty with two new faculty and one locums physician onboarding in August 2023. Recruitment is ongoing for additional faculty members.

High-Risk Obstetrics Clinic

This clinic is staffed by the MFM faculty, fellows, residents and ARNPs.  The physicians provide consultative care as well as longitudinal prenatal care for pregnant people who need to deliver at UIHC. The ARNPs see patients in collaboration with the physicians to include confirmation of pregnancy visits, return prenatal visits and postpartum visits. There is a nurse clinician who triages referrals, coordinates follow-up and organizes the weekly clinical care conference for these patients.

Fetal Diagnosis and Treatment Clinic

Fetal Diagnosis and Therapy (FDT) Clinic is where pregnant people at risk for or who have known fetal anomalies are seen for consultation, diagnostic ultrasound and coordination of care. The MFM physicians are supported by a multi-disciplinary team of nurses, sonographers and genetic counselors. There are 4 FTE genetic counselors. Prenatal diagnosis procedures offered include CVS, amniocentesis, amnioreduction, PUBS/IUT, pleurocentesis, shunt placement, fetal cardioplegia and multifetal or selective reduction. The MFM physicians read all the obstetric scans for UIHC and outlying clinics.

The Obstetrics and Gynecology Ultrasound Program is certified by the American Institute of Ultrasound in Medicine (AIUM).  Telemedicine visits with ultrasound are available with or without a face-to-face consultations via video visit.

Diabetes During Pregnancy Program

The diabetes in pregnancy program functions within the high-risk OB clinic.  On average, 80-100 patients are managed at any one time. This mission of this clinic is to provide coordinated care for pregnant women with type 1 or type 2 diabetes, and women who develop gestational diabetes.  The care team includes the MFM faculty physicians and fellows, ARNPs, nurse clinicians and diabetic nutritionist.  Each patient receives an innovative and easy-to-use cellular-enabled glucometer.  The practice also includes patients who use insulin pumps and continuous glucose monitors. By connecting in real time, our care team can see, track, and evaluate each patient’s glucose levels and ultimately identify issues before a problem arises.

Perinatal Care Clinic

The Perinatal Care Clinic (PCC) is a multi-disciplinary clinic for pregnant patients with complex fetal anomalies or genetic syndromes which alter the neonatal outcome, from NICU admission to neonatal demise. The PCC visit is a group visit with MFM providers, NICU physician, other pediatric subspecialists as indicated, nursing, genetic counseling, perinatal palliative care and social work. The patient and their support person are included in the visit. Each member of the team discusses their role in the care of the patient or the fetus/newborn and a multi-disciplinary plan is made for delivery and peripartum period.

Telemedicine

Virtual visits with ultrasound have been provided since 2016. Virtual visits without ultrasound have been provided since 2019. This is a tremendously important service in rural Iowa where patients cannot access subspecialty care locally.