Fetal medicine includes the assessment of fetal growth and wellbeing during pregnancy, the maintenance of fetal health and the diagnosis of fetal illnesses and abnormalities. With over 25 years of experience, Fakih IVF Fertility Center’s physician are trained to provide the highest standard of care for mother’s and babies during this delicate time.
Fetal medicine can be divided into two branches; prenatal diagnosis, the detection of abnormal conditions of the fetus and fetal treatment, interventional steps that are taken after identifying an unwell fetus.
As technology within the medical field continues to develop, the ability to detect abnormal conditions of the fetus improves. The most common and generally the first test of fetal testing using for prenatal diagnosis is ultrasound. Other available approaches include non-invasive and invasive screening and diagnostic measures.
Conditions that may be detected through screening include Spina Bifida and Down syndrome. There are several techniques that may be utilized during your antenatal care including the Maternal Serum Alpha-Fetoprotein (MSAFP) blood test that may be useful in the detection of Spina Bifida and the Nuchal Translucency (NT) scan which is an important screening tool for Down syndrome. Completing blood tests along with the NT scan allows for an improved detection of Down syndrome. Depending on the number of screening tests, they are referred to as “combined”, “triple” or “quadruple” tests.
Non-Invasive Screening and Diagnostic Testing
Non-invasive screening and diagnostic tests include 2D and 3D ultrasounds, Doppler ultrasounds and cardiotocography and echocardiography of the fetus. The most recent advancement in non-invasive prenatal care is the development of Non-Invasive Prenatal Diagnosis (NIPD). NIPD is a tremendous advancement in prenatal care that allows our Genetics Lab to screen chromosomes 13,18, 21, X and Y at 10 weeks of pregnancy. NIPD detects the most frequent form of Trisomy 13, 18 and 21 (Down syndrome) and identifies the gender of the baby through a non-invasive blood test. The validity of this test and its result has been tested clinically by multiple major health organizations, all coming to the consensus that NIPD is a major leap forward in detecting Down syndrome non-invasively.
Invasive Diagnostic Testing
Invasive diagnostic tests require a form of surgical intervention, ranging from the insertion of a find needle into the uterus under ultrasound guidance, to more invasive procedures such as fetoscopy. The most common invasive tests are Amniocentesis, Chorion Villus Sample (CVS) and umbilical cord sampling.
Fetal treatment is the “operative branch” of fetal medicine. It includes a series of interventions utilized with the aim of achieving fetal wellbeing. These interventions include medical, non-invasive methods and surgical procedures.
Generally, medical intervention includes the administration of medication to the mother. The medication will cross through the placenta and enter the blood circulation of the fetus. An example of medical intervention is a fetus who is diagnosed with arrhythmia, such as atrial flutter.
Surgical intervention on the fetus may involve either a direct operation of the fetus, as with in utero correction of Spina Bifida or an intervention on the placenta, as in the case of twin-twin-transfusion syndrome. In some cases, it may be performed at the time of delivery: the Ex Utero-Intrapartum (EXIT) procedure. These interventions are often complex and are only performed when the prognosis suggests the fetus may either not survive or be severely handicapped without prenatal intervention.
For more information on the fetal medicine services provided by the physicians at Fakih IVF Fertility Center or to ask any questions you may have, book an appointment with Dr. Michel Khalil or Dr. Samer Cheaib at Fakih IVF Fertility Center today.