Dr. Peter Muller is a FACOG, FRANZCOG, and USA Certified Maternal-Fetal Medicine Sub-specialist and is the current Clinical Head of Maternal-Fetal Medicine at the Women’s and Children’s Hospital after previously serving as Director of Women’s Imaging at the WCH from 2005 to 2013. After 8 years in Private Practice in Obstetrics & Gynecology in Charlotte, North Carolina, Peter underwent the three year certified fellowship in Maternal-Fetal Medicine at Duke University Medical Center in Durham, North Carolina. After completion of the fellowship, Peter returned to Adelaide with South Australian born wife Carol, in 2004 as Senior Consultant in Obstetrics at the Women’s and Children’s Hospital. Peter has been a visiting consultant at Adelaide Women’s Imaging in Adelaide since 2004. His clinical and research interests include both red cell and platelet allo-immunization, fetal surveillance for the complicated multiple pregnancy and the fetal growth restricted fetus, cervical insufficiency, and prenatal diagnosis.
ABSTRACT
Title: Obstetric Ultrasound For the Sonically Naïve
Speaker: Dr Peter Muller, Clinical Lead Maternal-Fetal Medicine, Women's & Children's Hospital, North Adelaide Introduction: Ultrasound is the major tool of trade for the obstetrician where counselling and management strategies are directly related to the obstetric ultrasound findings. Indeed, the Specialist Obstetrician will use ultrasound in their daily care of patients more often than any other procedure. Tertiary Obstetric Imaging Centres are centres of excellence in complex obstetric imaging, but also must provide quality assurance for routine ultrasound screening and its interpretation.
Discussion: We will discuss the importance quality assurance, quality interpretation and potential errors for:
• Dating of a pregnancy
• Growth surveillance
• Amniotic Fluid Volume
• Estimated Fetal Weight
Conclusion: Sometimes errors in what appears to be the simple evaluation and interpretation lead to undesired pregnancy management decisions. Continuing a review of quality assurance for the use of routine obstetric screening in our community is paramount for appropriate obstetric care.
Title: Fetal Monitoring in Renal Disease
Speaker: Dr Peter Muller, Clinical Lead Maternal-Fetal Medicine, Women's & Children's Hospital, North Adelaide
Introduction: Perinatal complications such as preterm birth (PTB), preeclampsia (PE), Fetal Growth Restriction (FGR) and stillbirth are increased in all levels chronic kidney disease (CKD)
Discussion: Even with mild renal insufficiency the risk of PTB, preeclampsia and FGR approaches 20%, 10% and 24% respectively. In women with higher grade of CKD, risk of PTB may be higher than 60% (Creatinine > 0.12mmol/l) and >86% (Creatinine > 0.22 mmol/l). Fetal monitoring is essential to the very close maternal monitoring required. Although, fetal monitoring is mainly similar to that with any high risk obstetric scenario, there are some unique variations in women with CKD. We will present a specific case to illustrate both common and uncommon up to date approaches to fetal surveillance in women with CKD.
Conclusion: Pregnant women with CKD offer unique multi-disciplinary challenges and require a collaborative effort to obtain the best outcomes.
|
