What is fetal medicine?

* Fetal medicine is a branch that dedicates to manage health concerns of the mother and unborn baby (fetus) prior to, during, and shortly after pregnancy.

* The role of fetal medicine specialist is to monitor and manage all high risk pregnancies either due to to mother related causes or due to fetus related causes.

How important is fetal medicine?

Approximately 3-4% of pregnancies are associated with a fetal defect. It can be a structural defect or a genetic defect. Due to lack of exact diagnosis and monitoring, a baby with severe physical or mental handicap can be born which is very traumatic for the couple and their families. So screening, diagnosis and management of these conditions is very important in all pregnancies.

What does a fetal medicine specialist do?

* Pre-pregnancy / antenatal counselling

* Early diagnosis of fetal abnormalities by doing usg at 11-14 wks and level-II scan at 18-19wks of pregnancy

* Screening for down syndrome and chromosomal defects by doing double marker/quadruple marker test.

* Highly specilaised fetal scans including 3D, 4D and Doppler scans

* Fetal ECHO

* Amniocentesis I.e to take out the fluid around the fetus

* Amnioreduction I.e to remove the fluid around the fetus when it is excess which can be very dangerous to the mother.

* Intra-uterine transfusion I.e to give blood to the fetus in the womb as in case of Rh negative mother.

* Fetal reduction-to reduce the number of babies in womb to save the life of mother and babies

* Fetal autopsy-to give the answer when usg done during pregnancy was normal or the baby was not monitored before birth

* Prediction and prevention of stillbirth/ birth before time/ fetal growth restriction and pre-eclampsia I.e increase of mother”s blood pressure during pregnancy.

* Monitor and manage problems of twin pregnancies

* Monitor and manage pregnancies when mother have some other diseases.

When should you see a fetal medicine specialist?

If you have any of the following conditions:

* Recurrent pregnancy loss/ death of baby in womb/death immediately after birth or delivery before date.

* Mothers who”s blood group is Rh negative

* Known genetic disease in family

* Pregnancy with previous child or family member affected by thalassemia/ haemophilia etc

* Pregnancy with h/o fever with rash/chickenpox

* Pregnancy with Diabetes/high BP/heart disease//Systemic Lupus Erythematosus (SLE), Sjogren’s syndrome, Rheumatoid arthritis

* Pregnancy with hepatitis/cancer/seizure/organ transplant

* Pregnancy with slow growth of fetus.

* Pregnancy with previous history of physical defect in the baby in previous pregnancy or in the family

* Pregnancy with previous history of mental retardation or heart defects in previous pregnancy or in the family

* IVF conceived pregnancy

What is Down`s syndrome and what can be done to prevent it??

* Down’s syndrome is caused by the presence of an extra chromosome in a baby’s cells

* The incidence is gradually rising as the age of mother at the time of baby`s birth is increasing either because of infertility or late marriages. The incidence of down syndrome at the age of 30yrs is 1 in 350 and this increases to 1:100 at the age of 40yrs.

* The down syndromic babies have subnormal intelligence and have various associated physical problems like heart defect, intestinal obstruction, leukemias, thyroid abnormalities, various infections etc.

* It can be prevented by timely screening during pregnancy by various methods available.

* There is no treatment available to treat this condition, so prevention is the only cure available as of now.

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