Maternal and Foetal Medicine is a relatively new subspeciality of obstetrics. Maternal medicine deals with management of medical disorders in pregnancy. Foetal medicine treats the unborn baby as an individual patient and strives to ensure complete well being of the same. The tools involved are serum screening (double marker/ quadruple test), specialized ultrasound scans and assessment of maternal conditions which could impact foetal well being.
An effort is made to optimize foetal well being by optimizing the medical condition of expectant mothers. The services offered include:
Fetal Wellness Clinic at 12 weeks
NT/NB Scan, Double Marker, Non Invasive or Invasive Testing as desired.
12 weeks period of gestation of pregnancy is an important time to assess both maternal and foetal well being. It also gives an opportunity to identify the mother’s risk of developing pregnancy complications like preeclampsia (high blood pressure) or Intrauterine growth restriction (Decreased growth of baby). We can also pick up major structural malformations in the baby like non development of skull or herniation of intestines outside of abdomen.
A combination of ultrasound findings like nuchal transluscency, nasal bone, ductus venosus Doppler and tricuspid regurgitation along with biomarkers can help predict the risk of chromosomal abnormalities in the foetus.
Prenatal screening for aneuploidies and detectable syndromes and structural malformations
It will involve two ultrasounds, one at 12 weeks and second between18-20 weeks and tailor-made tests including Double Marker, Quadruple Test, N.I.P.T. and Invasive Testing
Preclampsia and Preterm Labour Screening
This is done by routine measurements of uterine artery Doppler and cervical length
Foetal imaging to assess fetal health
- Fetal Viability Scan
- Fetal Wellbeing Scan
- Doppler Ultrasound
- Level II scans/ Targetted imaging for foetal anomalies (TIFFA)/ Anomaly scan
- Fetal Echocardiography: Imaging the fetal heart with ultrasound technology to understand the fetal cardiac structure, function and rhythm.
- Advanced imaging: 3-D and 4-D Ultrasound
- Fetal M.R.I. : This sophisticated tool can help doctors identify structural abnormalities that older tests would miss.
Invasive Procedures
- Chorionic Villus Sampling
- Fetal Blood Sampling/ Cordocentesis
- Genetic Amniocentesis
- Embryo Reduction/ multifoetal pregnancy reduction/ Selective foetal reduction
- Amnioinfusion/ amniodrainage
- Foetal paracentesis/ cyst aspiration
Genetic counselling
Counselling is given to mothers who have previous babies with any chromosomal abnormality, genetic syndrome or birth defect.
Pre pregnancy evaluation and preconceptional counselling
Our centre also provides preconceptional counselling to women suffering from certain medical diseases or those that have a bad obstetric history so that best outcome can be achieved in subsequent pregnancy. We also offer preconceptional counselling in cases of -
- Recurrent pregnancy loss
- Previous unexplained Intrauterine Fetal Demise (IUFD) or Stillbirth
- Known genetic disorder in family
- Pregnancy with previous child affected by Thalassemia, structural malformation or syndrome
- Preconceptional evaluation in women with diabetes, hypertension, heart disease, renal disease and rheumatological conditions
Supervision of high risk pregnancy
- Pregnancies complicated by structural or chromosomal abnormalities in the foetus.
- Pregnancies with abnormal serum screening results or soft markers in ultrasound.
- Pregnancies with medical disorders like diabetes, hypertension, thyroid abnormalities, SLE, Rheumatoid arthritis, heart disease, anaemia, epilepsy, kidney disease,cancers etc.
- Management of pregnancies with infections like TORCH group.
- Ultrasound monitoring of pregnancies with intrauterine growth restriction
- Management of twins and higher order pregnancies including Multifetal Pregnancy Reduction
- Management of Oligohydramnios and Polyhydramnios
Foetal therapy
- Management of fetal heart blocks and fetal goitre.
- Fetal surgeries like Ultrasound Guided Paracentesis, Vesicocentesis and Cyst Aspirations.