Technological development in medicine has enhanced the ability to observe and monitor pregnancies. There is an increase in the capability to diagnose a baby’s health and problems before it is born. The Foetus is seen as an independent individual and foetal medicine is the specialty that deals with the health and care of the unborn baby. It is a new specialty that requires the expertise of a team with specialists including obstetricians, specialized ultrasonologists, perinatologists, neonatologists, paediatric cardiologists, paediatric surgical specialists, geneticists among others.
All pregnancies can benefit from foetal medicine in addition to obstetrics. Across the world, 2–3 out of every 100 children are born with birth defects. If identified early, many birth defects can be prevented. The benefits of foetal medicine include:
- Screening for genetic/ chromosomal defects
- Providing reassurance and reducing anxiety among high-risk groups
- Prediction and prevention of preterm birth/ foetal growth restriction and problems of multiple pregnancies
- To inform and prepare parents for the birth of an affected child
- To allow in utero treatment
- Plan for transfer to a tertiary care centre
- Discontinue pregnancy with an affected foetus
Aside from patient and family counselling regarding the foetal condition, there are various aspects of foetal medicine that include non-invasive, invasive screening and diagnostic studies
Foetal heart evaluation by echocardiography
Foetal Magnetic resonance imaging (MRI)
Blood tests – of the mother are done at different timings during pregnancy to evaluate the growing foetal characteristics and assess several serious foetal afflictions including chromosomal foetal abnormalities like Downs Syndrome/ spinal cord defects in the fetus.
These tests require a form of surgical intervention, ranging from the insertion of a fine needle into the uterus under ultrasound guidance, to more invasive procedures such as foetoscopy. The common invasive tests are:
- Amniocentesis – taking about 20 ml fluid from the sac around the baby and sending the foetal cells/ fluid for analysis.
- Chorionic villus sampling – taking a little placental tissue and sending the placental cell fluid for genetic analysis.
Umbilical cord sampling – also known as cordocentesis, funipuncture, percutaneous umbilical blood sampling, or PUBS.