Fetal Medicine

Ultrasonography to access fetal structural abnormalities and fetal health

Nuchal Translucency (NT) Scan (11wks to 13wks 6days)

The nuchal translucency scan (also called the NT scan) uses ultrasound to assess your developing baby’s risk of having Down syndrome (DS) and some other chromosomal abnormalities, as well as major congenital heart problems.

Second trimester anomaly / Target scan

This is a detailed scan at 18-20 weeks of pregnancy. During the scan we examine each part of the fetal body, determine the position of the placenta, assess the amount of amniotic fluid, and measure fetal growth. Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys and limbs.If any abnormalities are detected the significance of the findings will be discussed.

Multiple Pregnancy Scan

In the first trimester, ultrasound allows to diagnose the number of multiples, chorionicity and amnionicity, the presence or absence of nuchal translucency, early growth discordance, severe malformations and the origin of activities and contacts between multiples. In the second and third trimester, the opportunity to examine the cervix by transvaginal ultrasound should not be missed to detect the risk of premature delivery. Ultrasound is essential for the early grading and treatment of twin-to-twin transfusion syndrome (TTTS), the diagnosis of malformations and growth disturbances. Finally, ultrasound is used for the detection of the position of multiples and the decision of the optimal route of delivery. This is of main importance in delayed interval delivery and expectant management of multifetal pregnancies and early cervical dilatation.

Fetal well being Scan (Growth Scan)

Fetal Growth or Well-Being scans are performed at any stage after 24 weeks of pregnancy. This scan aims to determine the growth and health of the fetus by:

• Measurement of the size of the fetal head, abdomen and thigh bone and calculation of an estimate of fetal weight.
• Examination of the movements of the fetus.
• Evaluation of the placental position and appearance.
• Measurement of the amount of amniotic fluid.
• Assessment of blood flow to the placenta and fetus by colour Doppler ultrasound.

Fetal Doppler

Fetal Doppler are often used to check the placental blood flow, the foetal umbilical blood flow, and blood flow in the heart and brain to ensure everything is normal.

Fetal Echocardiography (Detailed examination of fetal heart)

Heart diseases in babies are commoner than thought; about 5 % of all pregnancies have a baby with heart defects and 1 % of all live births have heart defects. Foetal echocardiography (Foetal echo) is the detailed evaluation of the heart of the foetus to check for any abnormalities so that decisions can be taken during the pregnancy in the best interest of the foetus.

3D & 4D Ultrasound

3D scans show still pictures of your baby in three dimensions. 4D scans show moving 3D images of your baby, with time being the fourth dimension. In Lifeline if our doctors prefer 3D and 4D ultrasounds because they can show certain birth defects, such as cleft palate, that might not show up on a standard ultrasound.

Invasive Procedures

Chorionic Villus Sampling

Chorionic villus sampling (CVS) is a prenatal test that involves taking a sample of tissue from the placenta to test for chromosomal abnormalities and certain other genetic problems. CVS is offered in pregnancies where there is a high risk of the baby having a serious inherited condition.

• Family history or previous child with a genetic disease, or chromosomal or metabolic disorder
• Maternal age over 35 years by the pregnancy due date
• Risk of a sex-linked genetic disease
• Previous ultrasound with questionable or abnormal findings.

Fetal Blood Sampling (Cordocentesis)

Fetal blood sampling is a procedure to take a small amount of blood from an unborn baby (fetus) during pregnancy.

Amniocentesis

Amniocentesis is a procedure used to obtain a small sample of the amniotic fluid that surrounds the fetus during pregnancy. Amniocentesis is not offered to all pregnant women. It’s only offered if there’s a higher chance your baby could have a genetic condition. This could be because:

• An antenatal screening test has suggested your baby may be born with a condition, such as Down’s syndrome, Edwards’ syndrome or Patau’s syndrome
• You have had a previous pregnancy that was affected by a genetic condition
• You have a family history of a genetic condition, such as sickle cell disease, thalassaemia, cystic fibrosis or muscular dystrophy.

Multi-fetal pregnancy Reduction

Multifetal pregnancy reduction (MFPR) is a procedure used to reduce the number of fetuses in a multiple pregnancy. When a pregnancy involves three or more fetuses (high-order pregnancy), the risks of miscarriage, stillbirth, and lifelong disability increase with each additional fetus. It is also known as “selective termination” when it involves a fetus with severe defects or one that is expected to die later in the pregnancy, which would threaten the life of the surviving fetus or fetuses.

Intrauterine Transfusions

Intrauterine transfusion is a procedure in which red blood cells from a donor are injected into the fetus. Intrauterine transfusion may be recommended when a fetus has anemia (low red blood cell count). The goals of fetal blood transfusions are to:

• Prevent or treat fetal hydrops before delivery—Hydrops is caused by severe anaemia. It leads to fluid collecting in the skin, lungs, belly, or around the heart. It can develop into heart failure.
• Continue the pregnancy so the fetus can be born close to due date.