Jorge Lodeiro, MD, joins CHI Saint Joseph Health as a maternal-fetal medicine specialist
LEXINGTON As the saying goes, two heads are better than one. The phrase refers to the idea, of course, that two people sharing their ideas, knowledge, and expertise are more likely to solve a problem together than they are separately. Case in point, an OB-GYN referring a high-risk patient to a maternal-fetal medicine (MFM) specialist.
“All patients who have maternal complications or fetal complications need to see the maternal-fetal medicine specialist,” says Jorge Lodeiro, MD, OB-GYN, MFM, at CHI Saint Joseph Health in Lexington. “It provides better care through joint treatment for the patient. The MFM takes care of the maternal and fetal problems, and the obstetrician takes care of the delivery.”
Lodeiro emphasizes that dynamic because he knows the importance of OB-GYNs maintaining contact with their patient. The referral to an MFM does not end that relationship; it simply ensures the patients – both mother and fetus – are receiving the specialized care that is needed.
“What we see is that many OB-GYNs like to handle everything and don’t think they need the MFM,” Lodeiro says. “It’s true – some of the OB-GYNs are very good at it, but you have to understand that the MFMs are just dealing with these problems. We are not going to deliver this baby. We are providing care for the problem only. That is why it is good to provide assurance to the obstetrician that the patient will continue being their patient.”
Meet Jorge Lodeiro, MD, MFM
Lodeiro understands the OB-GYN/ patient relationship very well. Not only has he practiced as an OB-GYN himself, but his wife is also a retired OB-GYN. Taking it a step farther, the Lodeiro family is full of doctors. Lodeiro’s brother is a neurosurgeon married to a nephrologist. Lodeiro’s daughter is a psychiatrist; his son is a vascular surgeon, and his daughter-in-law is a bariatric surgeon. If anyone understands the importance of communication and respect between disciplines, it is Lodeiro.
Born in Cuba, Lodeiro attended medical school in Venezuela, where he also did MFM training. He later came to the United States and trained at Mount Sinai in Hartford, Connecticut, and did a fellowship at the University of Connecticut. He went to the SUNY (State University of New York) Syracuse campus where he served as a professor for nearly four years. Next came 15 years practicing in Tampa, Florida, and additional stints in Philadelphia and Tennessee before returning to Florida in 2024. Lodeiro began at Saint Joseph on May 1 of this year.
Lodeiro is excited to be in Kentucky and share his expertise as an MFM. “
When I was about to finish my residency at Mount Sinai, the university told me they wanted to come and do an MFM fellowship with them,” Lodeiro says. “I liked it and got very excited. I have a passion for fetal echocardiography. I like what I do.”
When to Consult an MFM
Most of the patients referred to Lodeiro are expectant mothers who present with high-risk conditions such as hypertension and diabetes.
“Uncontrolled diabetes when the embryo is forming significantly increases the risk of birth defects, especially cardiac and neurologic, which are serious,” says Lodeiro, who emphasizes that both the mother and the fetus are his patients. “Smoking also increases the risk of growth retardation of the fetus, premature rupture of the membrane, and premature delivery.”
Like any other patient-provider interaction, the relationship begins with an initial consultation that is equal parts listening, understanding, and educating worried patients. Lodeiro is happy to be able to alleviate much of their anxiety in the majority of cases.
“When they come to see the high-risk specialist, the majority of my patients are very concerned because they think something is wrong. Seventy-five of the patients, we scan them and tell them the baby looks normal and everything is going well. Then we treat their disease and follow them so they can be under good control,” he says.
Of course, the other twenty-five percent of the time, the news is not so comforting and the importance of clear communication and understanding is paramount.
“There are others where we do find significant fetal abnormalities. Those are the most challenging patients,” Lodeiro says. “Obviously, it is not nice to tell the parents that the fetus has a significant defect that, if not addressed, will create incompatibility with life. They are very scared at that point. You have to guide them through the plan of action, what the steps will be, and how this can be addressed and corrected.”
Lodeiro then connects the patients with the assorted team of specialists that will be part of the treatment plan. For example, a pediatric cardiologist would assist with a fetus presenting with a heart problem.
Technology Advances Care
Advancements in technology have helped increase the likelihood of successful treatment for both mother and fetus via earlier and more accurate diagnosis.
“Two things have revolutionized obstetrical care,” Lodeiro says. “The most important one is the obstetrical ultrasound. Ultrasound machines have become very sophisticated to the point that you can diagnose many abnormalities with them and the diagnosis comes earlier and earlier because these machines are providing very good quality of images. It also allows you to do treatment of the fetusin utero by performing drainage of abnormal collections of fluid or placing of catheters to bypass obstructions.”
Lodeiro notes that the ultrasounds allow physicians to see how the valves are functioning and moving.
“You can see if the cavity is functioning or not because, using color flow, you can see the movement of the blood,” he says. “Some centers are now doing early treatments of cardiac abnormalities to allow proper development of the heart. Many valve obstructions can be diagnosed and corrected in utero with catheters, dilating the obstructed valves. You can correct it early and allow that ventricle to develop normally.”
Lodeiro gives the example of a condition in which a valve blocks a fetus’ urethra, preventing urination and decreasing the amount of amniotic fluid, which is vital for the development of the lungs.
“These fetuses early in pregnancy are diagnosed by an ultrasound that shows there’s no amniotic fluid and that the fetal bladder is very dilated with both kidneys dilated,” Lodeiro says. “Then you have to create a vesical amniotic shunt, plac- i n g a shunt between the fetal bladder and the amniotic cavity s o the fetus can urinate. That shunt is doing the function of the urethra. That is a difficult procedure to do because not having amniotic fluid, you cannot see well. You first have to inject some fluid and create amniotic fluid so you can then see things in the fetus and then you go and put your catheter. The issue about these things is sometimes the fetuses remove those catheters and you have put them back again.”
Performing these delicate procedures on such tiny fetuses requires skill, training, and the support of a strong team such as the one Lodeiro has joined in Lexington. With this collection of highly trained and experienced heads coming together, the likelihood of positive outcomes naturally increases.
“The majority of patients do end up with a good outcome,” Lodeiro says. “If not for the help that we provide, the outcome could be significantly worse. That’s a great incentive for me to keep on doing what I’m doing.”