Pregnancy is also referred to as gestation. It is a period in which a fetus or baby grows inside the uterus of a woman. A missed menstruation cycle or period is the most common indication of a pregnancy. A few women show other indications such as weakness, back pain, and nausea. A maternal fetal medicine specialist or a fetal medicine expert is a doctor who has the expertise in helping and taking care of the women with high-risk pregnancies.
These doctors are also known as obstetricians who have also completed three additional years of training in high-risk pregnancy. Specialists for fetal medicine are also referred to as a perinatologist.
No matter if it is your very 1st pregnancy or 3rd one, hearing your obstetrician, midwife or nurse practitioner say that your pregnancy is high risk can feel concerning. High-risk pregnancy is a team that can be a symbol of a wide range of common conditions. A lot of them are associated with pre-existing conditions you may have had prior to turning out to be pregnant or conditions that you may have developed at the time of being pregnant or during delivery.
A high-risk pregnancy does not essentially signify that your pregnancy will be more challenging or difficult as compared to the pregnancy with low risks. However, at times, it does signify that you will need to have a word with a reputed and experienced maternal fetal medicine doctor in Alain and go through more monitoring as compared to a person with low-risk pregnancy.
Roles and responsibilities of a fetal medicine doctor
Ø One will carry out routine pregnancy, non-invasive tests such as routine screening tests and ultrasound, and invasive tests such as amniocentesis and CVS (chorionic villus sampling)
Ø One will help keep an eye on a pregnant woman who may fall at high risk of developing pre-eclampsia
Ø One will help manage the prevailing conditions of a pregnant mom such as hypertension or diabetes
Ø One will provide routine antenatal care for the ones with high-risk pregnancies
Tests that a pregnant woman has to go through in routine during pregnancy
The very 1st test is to confirm a pregnancy. It is simple urine pregnancy test that can be carried out with the help of a general kit at home, or it can even be performed at a lab. You will also need to go through checking the Beta HCG levels in a laboratory. After this, a woman goes through a transvaginal scan, which is also referred to as a dating scan, to check for the position of the embryo.
The doctor can find out whether the implantation has taken place and check for the fetal heartbeat by means of a transvaginal scan. In general, this scan takes place between four to six weeks of gestation.
The following are the two pregnancy tests:
a. Screening Tests
b. Confirmatory Tests
Screening tests help to find out the risk of recognizing a genetic abnormality or chromosomal abnormality with the help of ultrasound tests or blood tests. Screening tests are non-invasive tests, at the same time as confirmatory tests are invasive tests.
Let us begin with screening tests that are carried out as per the gestation period.
Ø Combined 1st Trimester Screening (NT Scan and Double Marker)
In order to measure the biochemical approximation of two parameters – Beta HCG and pregnancy-associated plasma protein-A (PAPP-A), combined 1st trimester screening is carried out. This screening is performed along with an ultrasound examination of Nuchal Translucency (NT). Depending on the age and level of PAPP-A, Beta HCG, and NT, the risk is projected with the help of making use of Astria or Lifecycle platforms. It is carried out from 11 - 13.6 weeks of gestation. The sensitivity and specificity for this testing are 85% - 90%.
Ø Quadruple Marker Test
In general, a quadruple marker test is carried out between fifteen to eighteen weeks of gestation. The specialist for maternal fetal medicine normally checks four biomarkers:
a. Inhibin A,
b. Estriol (uE3),
c. Human Chorionic Gonadotropin (HCG), and
d. Alpha-fetoprotein (AFP)
Depending on the levels of these biomarkers, the test can help evaluate the risk for Trisomy 13, 18, 21, and NTD (Neural Tube Defects).
Ø Non-Invasive Prenatal Testing
Also known as NIPS (non-invasive prenatal screening) non-invasive prenatal testing helps to screen chromosomal aneuploidies. It is a plain blood test that a pregnant woman can go through from the tenth weeks of gestation. The specificity and sensitivity of NIPS for Trisomy21 are more than 99% at the same time as the specificity and sensitivity for Trisomy 13 and 18 are 93% - 95%. For sex chromosomes, the specificity and sensitivity are 85%.
Ø TIFFA(Targeted Imaging for Fetal Anomalies)
Every pregnant woman goes through a thorough head-to-toe checkup of the fetus around the eighteenth week of gestation. An expert for fetal medicine checks for structural abnormality in a fetus by making use of an ultrasound. TIFFA scan is normally carried out from 18 - 23 weeks of gestation. Every major organ is imagined and inspected in this scan. This scan is also used to find out congenital anomalies such as movement of the fetus, septum defects, clubfoot, and a lot more.
If any of the test mentioned above are high risk, invasive testing such as amniocentesis or CVS (chorionic villus sampling) is recommended to a pregnant woman.
a. Amniocentesis - It is an ultrasound-guided invasive procedure. A fetal medicine expert initially checks for the position of the fetus by making use of an ultrasound, and about 20 ml of amniotic fluid is gathered with the help of a sterile syringe. Amniocentesis is carried out from sixteen to eighteen weeks of gestation. There is a risk for miscarriage from one to two percent.
b. CVS (Chorionic Villus Sampling) - It is an ultrasound-guided invasive procedure. An expert for fetal medicine collects a sample either from the abdomen or from the cervix, known as transcervical, known as transabdominal. It is carried out from ten to twelve weeks gestation. Chorionic villus sampling can be performed in order to find out any type of chromosomal aneuploidies or for any single-gene disorders such as Thalassemia. There is a risk for miscarriage from one to two percent. This is for the reason that this is an invasive procedure.
Will all my future pregnancies be high risk?
Having a high-risk pregnancy does not signify that all your future pregnancies will be deemed high risk as well. You may have a fetal complication to take place in one pregnancy that would not be in another, and certain health conditions may change in the fullness of time.
However, if you have had a pregnancy that ended in preterm delivery, you are at greater risk or having preterm labor at the time of your next pregnancy. If this takes place, your obstetric provider will manage the pregnancy with the help of medication, and a specialist for maternal fetal medicine will keep an eye on the cervical length with ultrasound surveillance.
Ultimately, the most important thing to keep in mind regarding having a high-risk pregnancy is that your specialists for maternal fetal medicine and OB/GYN have the experience and knowledge necessitated to keep you and your baby as healthy as possible. If you are also in search of a specialist for maternal fetal medicine near me, look no further than visiting Mothers and Fetuses!
Fetal Echocardiogram Treatment in India.
Fetal echocardiography is almost as same as ultrasound.
This procedure is used to see the functioning and structure of the unborn baby’s heart.
This procedure is generally used in the second month of pregnancy (18 to 24 weeks).
Fetal echocardiography is the name of the test used to diagnose cardiac conditions in the fetal stage.
Cardiac defects are amongst the most common birth defects.
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When a thorough postmortem is conducted on the placental, neonatal, and fetal tissue to determine the reason for fetal death and other reasons for diseases, injuries, and genetic abnormalities, it is known as a fetal autopsy.
