Fetal Medicine

What We Are

FETAL MEDICINE is the super specialized field of obstetrics, which deals with the care of an unborn patient- The fetus, who is still inside the maternal womb. It includes assessment of fetal growth & well being, the maintenance of fetal health and diagnosis of fetal illness & abnormalities Through our sincere efforts, we aim to provide best fetal care in terms of diagnosis and management of fetal related problems including birth defects, aneuploidies, growth monitoring, multiple pregnancies.

FDC is well equipped to perform both invasive and non invasive screening & diagnostic studies.

We have diagnosed multiple rare congenital malformations through scans at out Centre and provided comprehensive management of these fetuses including counseling of parents, invasive testing, genetics tests and autopsy if needed. Prenatal counseling is also provided at our Centre in such cases before panning next pregnancy.

Following services pertaining to fetal medicine are provided at our center-

ULTRASOUND

1.VIABILITY SCAN

Performed in initial 2-3 months to confirm the number, location and viability of the baby.

2. NT/NB SCAN

It is usually done between 11- 13+6 weeks to look for certain markers of aneuploidy like Nuchal translucency (NT), Nasal bone (NB), Blood flow across ductus venosus and tricuspid valve. This scan also looks at the gross morphology of the fetus as few birth defects like, Open neural tube defects (Anencephaly), Abdominal wall defects (Omphalocele) can be detected at this gestation.

3. EARLY ANOMALY SCAN (15-17 WEEKS)

This is generally done in some high risk cases like previous history of any birth defects, IVF pregnancy, uncontrolled diabetes or suspicion of any abnormality in first trimester scan.

4. DETAILED ANOMALY SCAN (18 – 20 WEEKS)

This scan is performed to look at the detailed morphology/anotomy of the fetus and for detection of any malformation. This scan generally takes around 30 minutes or longer depending on the position of the baby.

5. FETAL ECHO

This scan looks at the fetal heart and is usually done after 18-19 weeks to look for any structural heart defects.

6. GROWTH MONITORING SCAN

This scan is performed 7th month onwards to look for the fetal growth and any other evolving structural anomaly.

7. 3D/4D SCAN

This scan is done to look for minor details which can be missed on level 2 scan and for better delineation of fetal structure.

8. COLOUR DOPPLER

It studies the flow of blood in blood vessels in the fetus.

In case of any abnormalities detected in any of the above scans, a detailed counseling is done for the couple regarding the condition and need of further investigation and plan of management is discussed.

All the PRENATAL SCREENING options are also available at our center.

1. DOUBLE MARKER

It is done between 11-13_+6 weeks, it includes serum markers- Beta HCG &PAPP-A- and USG markers – Nuchal translucency and nasal bone. Combined test has 90 % detection rate for down syndrome with 5% false positive rate.

2. QUADRUPLE TEST

It is done after 15weeks and includes B-HCG, AFP, Estradiol and Inhibin A. It has a detection rate of around 80% for fetal aneuploidies.

3. NON INVASIVE PRENATAL SCREENING

This screening test is done on cell free fetal DNA in maternal blood and provides 99% sensitivity to predict for down syndrome.

FETAL PROCEDURE

1. CHORIONIC VILLOUS SAMPLING

It is done between 11-13 weeks. In this test, a needle is inserted through mother’s abdomen and few cells are taken from the placental tissue.

2. AMNIOCENTESIS

This test is performed after 16 weeks. In this test, a needle is inserted through mother’s abdomen, and amniotic fluid around the baby is collected.

3. AMNIOINFUSION/AMNIOREDUCTION

In this, if amniotic fluid is less, some fluid is instilled in to the amniotic cavity and in case of excess fluid around the baby, extra fluid is removed.

(Note- All the invasive procedures are associated with minor risks including abortion, infection etc. But we perform the tests under all aseptic precautions and so meticulously, that the rate of these complications is very less)