The rapid technological advances in medicine have led to an improved ability to observe and monitor pregnancies and thus an increasing capability to diagnose a baby’s health and problems before its birth. The Fetus or Foetus is therefore increasingly seen as an independent individual and foetal medicine is the specialty that deals with the health and care of this unborn baby.
It is a relatively new specialty that often requires the expertise of a team which includes several specialists; including obstetricians, specialized ultrasonologists, perinatologists (also called maternal – foetal medicine specialists), neonatologists, paediatric cardioologists, paediatric surgical specialists, geneticists, and others.
Every pregnancy can benefit from foetal medicine in addition to obstetrics and gynaecology. Globally, 2 – 3 out of every 100 children are born with birth defects. If identified, many of these birth defects can be prevented. The benefits of foetal medicine include,
In addition to patient and family counselling regarding the foetal condition, there are different aspects of foetal medicine which include non-invasive/ invasive screening and diagnostic studies:
Ultrasonography – grayscale/ 2D/ 3D/ 4D with Colour Doppler is the most common and often first test used for prenatal diagnosis. This test creates an image of the foetus in the mother’s womb. During a foetal ultrasound, various parts of the baby such as the heart, head, and spine are identified and measured. The testing may be performed either through the mother’s abdomen (transabdominal) or vaginal canal (transvaginal). Foetal ultrasound provides a safe way to evaluate the health of an unborn baby.
There are several types of foetal ultrasounds, each with specific advantages in certain situations. A Colour Doppler ultrasound, for example, helps to study the movement of blood through the umbilical cord between the foetus and placenta. A 3-D scan provides a life-like image of an unborn baby.
Other tests include,
These tests require a form of surgical intervention, ranging from the insertion of a fine needle into the uterus under ultrasound guidance, to more invasive procedures such as foetoscopy. The most common invasive tests are:
Foetal treatment or foetal therapy includes a series of interventions performed on the ‘sick’ foetus with the aim of achieving foetal well-being. These interventions include medical (i.e. non-invasive) and surgical procedures which can treat or mitigate several disorders. There are, however, some disorders which cannot be treated and in which case doctors can help families prepare for the care of such a child or plan for a termination.
Dr. Mamta Mehrotra
MS (Obstetrics and Gynaecology), DNB (Obstetrics and Gynaecology), PGDS, FMF (London) Accredited
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