An interview with Dr Robert Cincotta: QUFW co-owner, pioneering obstetrician, passionate clinician
We sat down with QUFW co-owner, Dr Robert Cincotta, to learn more about his journey as a medical practitioner, his remarkable contributions to obstetrics, his vision for QUFW, and more.
Associate Professor Robert Cincotta is an obstetrician and subspecialist in maternal fetal medicine. His major interests are in fetal therapy, prenatal diagnosis and the management of complicated pregnancies. Dr Cincotta is the co-owner of QUFW.
Contents:
- Finding his niche in complicated pregnancies
- Pioneering a groundbreaking, life-changing treatment
- The move to ultrasound, and the origins of QUFW
- Charting breakthroughs in genetic testing and screening
- Gearing up for the future: AI integration and advanced tech
- Mentoring the next generation
- QUFW’s unwavering philosophy
- Recharging outside of work
- Reflecting on his journey
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As we sit down to interview Dr Cincotta, he wastes no time demonstrating his signature passion for obstetrics.
When asked about the beginning of his career, his eyes light up.
“When I saw my very first delivery, I just couldn’t believe how wonderful it was. I fell in love straight away with the whole area. And I absolutely loved how I saw the doctors and the midwives looking after women who are pregnant, and the problems they faced,” he says.
Born, raised, and initially medically-trained in Melbourne, Dr Cincotta was introduced to obstetrics during early rotations as a medical student. Witnessing his first delivery was one of those “life-changing” experiences that he’ll likely never forget, he says.
It’s where he fell in love with obstetrics – a discipline that presented him with both joys and challenges. And while most deliveries were smooth, he was intrigued by the complications that sometimes arose.
“The people who were involved had to be able to know what to do. And as soon as I could, I began my training to become an obstetrician. And then I just absolutely loved it.”
Finding his niche in complicated pregnancies
As his journey progressed, Dr Cincotta discovered that his passion lay in managing complicated pregnancies. One particularly challenging condition that captured his attention was twin-to-twin transfusion, where identical twins share a placenta, leading to a dangerous transfer of blood between them.
With limited knowledge and treatments available at the time, Dr Cincotta was successful in becoming one of Australia’s first trainees in maternal-fetal medicine. Following training stints in Melbourne and London, Dr Cincotta found himself in Brisbane, where he would make significant contributions to the field.
Pioneering a groundbreaking, life changing treatment
In Brisbane, at the Mater Mothers’ hospital, Dr Cincotta began research into existing treatments for twin-to-twin transfusions, being implemented on foreign shores. Determined to bring them to Australia, he collaborated with renowned medical experts like Ruben Quintero, even using early video conferencing technology to learn from overseas surgeries in real-time.
“About 22 years ago, we did the first laser for twin-to-twin in Australia. Then, we started getting people from all around the country. And our results were as good as anywhere around the world at that time.”
“And so we set that service up for the Mater. And then other centres around the country started to be established, and now it’s a standard treatment for this condition.”
Thanks to Dr Cincotta’s efforts, laser treatment for twin-to-twin transfusion was introduced in Australia. This procedure involves using a device in the uterus to ablate the blood vessels connecting the twins. With this innovative technique, the outcomes improved dramatically for such pregnancies.
Dr Cincotta recalls one of his most memorable early treatments.
“We had a case of twin-to-twin that developed when I was down at the Gold Coast. At 26 weeks [the patient] developed this [condition] quite quickly, and the babies looked quite unwell.
“And I could recall seeing cases like this 10 years beforehand when there wasn’t a treatment, and we’d often have to deliver these babies and they’d often do incredibly poorly. But I was able to organise for [the patient] to have a laser that afternoon. The babies made a complete recovery and she delivered at about 33 weeks.”
“And every year or so she comes along and shows us the two little girls.”
“It’s just really humbling when you see things like that, and makes me so grateful for how it happened,” he beams.
The move to ultrasound, and the origins of QUFW
Recognising the critical role of ultrasound in managing pregnancy complications, Dr Cincotta took another pivotal step in his career. Concerned about the quality and interpretation of ultrasound, especially outside major city centres, he established Queensland Ultrasound for Women (QUFW).
“Ultrasound is so critically important in the management of pregnancy complications. And one of the things we always knew or saw was that in the big city centres, the quality of ultrasound is very operator dependent and more importantly, the interpretation of what we’re seeing was very dependent upon the experience of the people reporting it.”
“We always wanted to improve the general quality of ultrasound, and particularly pregnancy ultrasound.”
“I always wanted to set up a service to provide high quality ultrasound to as many people as we could.”
“And so 18 years ago we set up Queensland Ultrasound for Women.”
Starting in Brisbane, QUFW has expanded its reach to several parts of Southeast Queensland, ensuring that women receive high-quality ultrasound services.
Beyond the technical aspects, Dr Cincotta emphasises the importance of counselling and support. He believes that when problems arise, women should not only get a diagnostic report but also have a compassionate expert to explain, guide, and reassure them.
“And more importantly, when there’s problems, to be able to actually counsel those women and talk to them at the time, and to try and provide as good a service as we possibly can.”
Charting breakthroughs in genetic testing and screening
One of the most significant advancements Dr Cincotta has seen recently is in the arena of genetics and DNA. Breakthroughs like NIPT (non-invasive prenatal testing) allow for the identification of chromosomal and genetic problems, revolutionising the way doctors approach prenatal care. The introduction of genetic carrier screening provides even more opportunities to identify potential conditions.
“In the past, you’d see a baby with problems, and often, it might be an extremely rare condition,” Dr. Rob explains.
Today, technological progression means many of these conditions, no matter how rare, can be identified much earlier, and sometimes even treated.
“When I started doing obstetrics, I’d do lots of amniocentesis procedures. For example, I’d do 60 amnios and there’d be only one baby with major chromosome problems. Unfortunately, the downside of doing amnios is the risk of miscarriage, so there’s a lot of unnecessary procedures and risk incurred for only one baby with problems.”
“Then they worked out that looking at the fluid behind the back of an unborn baby’s neck was a good predictor for chromosome problems. If you use that as a screening tool and then base the invasive testing on the thickness of the fluid rather than just on age alone, it went down to an abnormal result of about one every 15 amniocentesis procedures.”
“So this decreased the number of invasive procedures we had to do.”
“And they improved it further by adding blood hormone levels, the biochemistry in it, and that made it about one in 10 or 8 positive results.”
“Then the NIPT test came along about six years ago and that changed everything. The number of amniocentesis procedures we had to do dropped by about three quarters.”
“It really had a dramatic effect.”
“So NIPT changed what we do. And now they’re picking up even less common, rarer conditions, but it can be quite significant. The detail we can get at 13 weeks is incredible.”
Gearing up for the future: AI integration and advanced tech
The future looks even brighter. As Dr Cincotta hints, newer and more advanced ultrasound machines are on the horizon, promising leaps in quality. He is particularly excited about the integration of AI into ultrasound technology.
“We’re hopefully going to get the latest machines coming in, in the next few months. And there’s a huge jump up with the quality, it’s amazing.”
“And also, we’re starting to see AI being implemented into ultrasound machines, into the software, and we’re already seeing that they can anticipate what we’re actually looking at and they can do measurements, labelling, and things like that.”
“It’s not going to get rid of us, but it will allow us to scan more efficiently and with more detail. And I think that’s going to be an incredibly exciting time.”
Mentoring the next generation
One of the hallmarks of Dr Cincotta’s career has been his dedication to training. Whether it’s through his longstanding affiliation with the College of Obstetrics and Gynecology, where he notably served as the chief examiner, or his personal endeavours, Dr Cincotta has always believed in sharing knowledge.
When asked about his advice for medical students, Dr. Cincotta’s enthusiasm is contagious. He believes medicine, particularly his field, is “the best job in the whole world.”
“I’ve been lucky enough to train people in maternal-fetal medicine over the years, and they’ve gone on to be leaders in their own way,” he says.
He fondly recalls setting up a training service for registrars at the Gold Coast, offering them an exclusive three-month stint in ultrasound—a rarity in most places around the country. Beyond doctors, he has also been instrumental in training sonographers, emphasising the importance of holistic care in maternal-fetal medicine.
For Dr Cincotta, it’s more than just imparting knowledge. It’s about ensuring the continued high quality of service for mothers and their babies. “It’s trying to spread that to other people,” he notes, highlighting his belief in making sure every medical professional interacting with patients is the best they can possibly be.
QUFW’s unwavering philosophy
At the heart of QUFW lies a foundational belief that Dr Cincotta absorbed early in his career: pregnancy ultrasounds should be managed, or at the very least reported on, by specialists who have their roots in obstetrics and gynaecology.
This isn’t a personal preference; it originates from a conviction that obstetric and gynaecological professionals offer the highest quality reporting. Their hands-on experience with pregnancies makes them uniquely positioned to understand and address issues more effectively than general radiologists. This ethos isn’t about professional exclusivity–it’s about delivering the best possible care to every woman who steps through their doors.
“We’re really trying to provide the very, very best quality service for the women,” Dr. Rob explains.
QUFW’s story spans nearly two decades, a remarkable achievement in a field that constantly evolves. Reflecting on these 18 years, Dr Cincotta beams with pride, not just for surviving the industry’s challenges but for thriving amid them.
A pivotal moment came about five years ago when the clinic underwent significant changes, setting the foundation for rapid growth. But for Dr Cincotta, expansion isn’t just about numbers. It’s about widening QUFW’s reach and ensuring its services touch as many lives as possible.
“We’ve been going for 18 years and we’re very, very proud of that. About five years ago we started to make a lot of changes because we wanted to strengthen ourselves, and we’ve grown quite rapidly in that period of time.”
“And we’re very, very proud of that, and happy that it’s gone this well.”
However, this expansion comes with its own set of challenges, mostly training and sourcing the right people. Yet, drawing from their success in the last half-decade, Dr Cincotta remains optimistic.
“We’re quite confident,” he asserts, “that with the success we’ve had, particularly over the last five years or so, that we can keep it going.”
Recharging outside of work
Behind the doctor is a man who enjoys the simple pleasures of family life. Outside of his professional sphere, Dr Cincotta has a penchant for films which he shares with his family, often finding solace in the cinematic experience, particularly time travel films.
Were he given a chance, he’d embrace the opportunity to be young again. Yet, if there was one nugget of wisdom he’d offer his younger self, it would be to “enjoy myself more” and “stress less.” A simple yet profound piece of advice that echoes his mantra: “It will be okay.”
He’s also an avid golfer, albeit self-proclaimed ‘bad’. With a chuckle, he admits to “hacking up a golf course” during golf trips with his son.
In this interview, Dr Cincotta not only offers a glimpse into the world of maternal-fetal medicine but also showcases the human side of a medical professional. His dedication, love for the profession, and belief in mentorship serve as an inspiration for both existing and upcoming medical practitioners.
Reflecting on his journey
Reflecting on his career that began in 1988, Dr Cincotta humorously notes the joy (and sign of time passing) in delivering babies for those he once delivered. His legacy is evident not only in the improved clinical outcomes for countless mothers and babies but also in the systems and services he has helped establish.
When prompted to explore any potential regrets or things he might have done differently, Dr Cincotta ’s response is very clear. With a chuckle and a sense of nostalgia, the doctor’s love for his profession shines through.
“Oh God, I’d just love to be able to do it all again,” he declares.
Through Dr. Cincotta’s insights, it’s easier to understand why QUFW has its reputation for industry-leading patient care. It’s more than just machines and medical practices; it’s a blend of expertise, dedication, and a genuine commitment to offering unparalleled care.
In the end, as he so aptly puts it, “that’s what it’s all about.”
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September 2023
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