Nowhere is the privilege of experiencing miracles on earth more apparent than in the journey of pregnancy in one’s life. Science has made it possible to witness the baby’s growth with the help of advanced ultrasonography technology. Watching, hearing and feeling the little miracle growing inside you is an unforgettable experience.
Fetal Medicine is a branch of medicine that includes the assessment of fetal growth, well-being, diagnosis of fetal illness and abnormalities. With advances in technology and medicine, our capability to diagnose and treat problems while the baby is still in the womb has been better than ever. Therefore, the fetus is increasingly becoming an independent individual and fetal medicine is the specialty that addresses this “unborn patient”.
Fetal medicine includes prenatal diagnosis and fetal treatment. Prenatal diagnosis is the ever-improving ability to detect abnormal conditions of the fetus and to differentiate them from normal fetal development. The most common test used for prenatal diagnosis is ultrasound.
For the majority of women who undergo prenatal testing, the results confirm the absence of certain abnormalities. Thus, many of those who had entered pregnancy at increased risk because of a specific indication (for example, family history, advanced age or use of certain prescribed medication) or who were more generally anxious can gain welcome reassurance and continue enjoying their pregnancy.
Scientific advances in the last 20 years have improved our clinical ability to detect and address the many potential pregnancy complications from as early as the 12th week of your pregnancy. The schedule and content of antenatal visits is now much more personalized and specific to your pregnancy based on prenatal ultrasound diagnosis and reporting.
Your first scan is usually early in your pregnancy, between 6 to 9 weeks. The indication or need to perform an early ultrasound scan would normally be to identify the location and number of gestational sacs, to assign a gestational age to your pregnancy or to determine whether the pregnancy has a normal appearance. In certain cases, it could also be to evaluate maternal symptoms such as bleeding or pain.
During the first trimester of pregnancy, a unique and dramatic sequence of events occurs, defining the most critical and tenuous period of human development: the remarkable transformation of a single cell into a recognizable human being. As ultrasound technology continues to evolve and improve there is an increasing emphasis on early screening of fetal complications.
Fetal Nuchal ranslucency [NT] scans can rule out Down syndrome and other chromosomal abnormalities by detecting them early. This is also known as the first-trimester screening test. With prenatal testing, a wide range of congenital anomalies that can affect the brain, skull, abdominal wall, urinary tract, skeleton, and limbs can also be ruled out.
For your ultrasound scan in 2nd trimester of pregnancy, the fetus has grown sufficiently in size and remarkable anatomic detail can be visualized. During this period, an anomaly scan or targeted imaging for fetal anomalies [TIFFA] is done. The main aim of this scan is to confirm that all fetal structures are normal.
In your second trimester of pregnancy, if you haven’t had the opportunity to undergo a first trimester screening test, it is recommended that you undergo a triple marker or quadruple marker test at around 16 weeks of your pregnancy. This is also known as the second trimester screening test.
The most common reason for a scan in the third trimester is to check that your baby is growing normally; this is referred to simply as a growth scan. If you have had complications in previous pregnancies or have a medical condition such as diabetes or high blood pressure, you will probably be recommended to undergo regular ultrasound scans in your third trimester. Ultrasound scans in the third trimester may also be prescribed to check the position of the baby and placenta or to monitor amniotic fluid levels and placental function with the help of Doppler scans. These scans in the third trimester help your doctor in planning the delivery of your baby.
While this article talks about the purpose of prenatal testing and various ultrasound scans, please remember that most babies are born healthy and that in a majority of pregnancies, prenatal testing confirms the absence of certain abnormalities. Early and accurate screening gives you and your family peace of mind during your pregnancy and expertise in fetal ultrasound and fetal medicine help your doctor to ensure good pregnancy outcomes for you and your baby.