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MEDICAL JARGON DEMYSTIFIED BY DR EMMA PARRY: Obstetrician: A doctor who has been through post graduate training and exams and is expert in pregnancy and pregnancy complications. Gynaecologist: The same doctor as an Obstetrician as it is a combined specialty. This part of the specialty deals with women's health issues, in particular diseases of the female genital tract and in some cases urinary tract. Echocardiography: A scan of the fetal heart by an expert in heart scanning Amniocentesis: An invasive test where a needle is inserted into the uterine cavity and a sample of amniotic fluid is withdrawn Hypertension: High blood pressure Thrombophilia: An underlying condition which leads to a tendency for blood to clot more easily. Preeclampsia: New onset hypertension in pregnancy in association with protein in the urine (this is due to 'leaky kidneys'). It only occurs in pregnancy and can be mild or severe. a Caesarean section was disappointing but there you go. That's why I have a job, but not being able to have my mum in theatre is the one thing I would have changed if I could. Since that time people have tried to get an extra person in theatre, 'but doctor it's really important...' and although I feel for them, I hold to the party line as that is what happened to me! ARE THERE ANY CHILDREN THAT YOU HAVE WORKED WITH THAT COME TO MIND AS 'MIRACLE BABIES'? Gosh, loads of them! Most of my area of high risk pregnancy makes one feel impotent as we make diagnoses but often can't do much to fix the problems. One of the procedures I perform is to transfuse a fetus with blood when it is anaemic from Rhesus disease and this means survival for a baby that would have died. This is a procedure we do a few times a year and is technically challenging and always makes me feel proud of our Unit. However, there are other cases where there is less of a standard approach and as Doctors we have gone out on a limb and done a procedure that is novel. One case is a baby who had a big tumour at the base of its spine. These are usually treated with a good outcome after birth but while the baby is in-utero it can develop heart failure and die. We had a couple of babies where this happened and when the next case came along we offered the parents a lifeline of laser treatment. We used Ultrasound to guide a needle into a position next to the biggest blood vessel and then passed a laser fibre down the needle and fired the laser to cauterise the big vessel. After this, the blood flow to the tumour shrunk and the tumour shrunk with the baby doing well. I still get phoned by colleagues in Australia asking how we did this and we have had more successful cases since. WHATQUALITIES/ CHARACTERISTICS DOES A PERSON REQUIRE TO WORK IN SUCH AN EMOTIONALLY CHALLENGING AREA? Maternal-Fetal Medicine is very emotionally challenging and recent research has shown that amongst Obstetricians and Gynaecologists this area has the highest burnout rate of any sub-specialty area. I think you need to be strong yourself and able to appreciate that you are no use to the families you care for if you are feeling their pain as well. You have to keep a bit of distance, which can sometimes be hard. I have a couple of patients who ultimately became my www.h e rmagaz in e .co.n z | 11