World Birth Defect Day

Fetal medicine is a sub-specialty of obstetrics to diagnose and treat problems of the fetus (baby in womb).
All pregnant mothers have regular consultations with an obstetrician. They are referred to Fetal Medicine specialist for fetal scanning on 2 important occasions (bare minimum) – NT scan @ 12 weeks of pregnancy & Anomaly scan @ 20 weeks of pregnancy.
For those with twin babies or those with medical problems, more scans will be done by the Fetal medicine doctor to monitor their growth & development.

Fetal medicine specialists perform advanced ultrasound imaging of the fetus during 2 important times: 12-14 weeks & 20 weeks of gestation.
The goals for such meticulous fetal scanning are:
1. To pick up anomalies
2. To look for ultrasound signs, that may suggest a genetic/chromosomal problem.

If the baby is found to be structurally normal, we may advise the pregnant mother to undergo screening tests for fetal Down syndrome, for example double marker/ quadruple marker/ NIPT.
Further fetal scans will be planned and scheduled.

After diagnosing an anomaly, the couple goes through a comprehensive counselling.
Discussions are done about amniocentesis or chorionic villus sampling (CVS) which are invasive needle-based procedures for genetic diagnosis.
They are also referred to other specialists (ex: Pediatric cardiologist for a heart anomaly), to give a clear understanding of the problem and a plan for postnatal treatment.
The option of termination will also be discussed, so that they make an informed decision.

Can fetal problems be treated in utero?

Are there any fetal surgeries?

Fetal therapy- both medical & surgical are available for a few fetal problems.

1. Intrauterine fetal blood transfusion is a procedure to treat anemia in the fetus.
2. Intrauterine surgery for complications in monochorionic pregnancies (identical twins), such as laser separation of placenta in TTTS and selective fetal reduction.

These advanced fetal procedures / surgeries are also done at our fetal medicine unit.