Fetal Medicine Department

The main aim of the fatal medicine department is to improve women’s health throughout the various stages of her life including premarital stages, when she is trying to conceive, during pregnancy and afterwards.

The process starts with premarital genetic counselling and ultrasound scans that are required for premarital couples to test for any inherited genetic disorders and abnormalities in the genetic profile.  

We assist couples who are trying to conceive by completing all necessary tests and ultrasound examinations in order to monitor their fertility and diagnose any anomalies that require treatment.

A thorough examination during pregnancy is completed using ultrasound scans to screen for any genetic and inherited conditions particularly for conditions such as Downs Syndrome and to assess the various physiological systems of the foetus to confirm that the foetus is developing normally. These procedures are carried out using state of art technology such as real time 3 Dimensional (4D) ultrasound.

Our goal is to keep women healthy throughout all of her life stages by also screening for various cancers that can affect the genital tract including cancer of the uterus, ovaries and cervix, using the best technology in ultrasound.

 

The fatal medicine department’s services

Premarital counselling and examination:

Our foetal medicine department hosts premarital counsellors who meet with couples who are about to marry and discuss their family and personal histories such as the presences of any genetic disorders in order to identify any anomalies that can affect their future baby.

We offer genetic counselling that is conducted by our team of geneticists that can help instruct the couple to any further tests they may be required to do. At Bedaya we can perform a detailed ultrasound examination of the women’s uterus and ovaries to help identify any problems or if there are none to help reassure the couple that there are no problems to be concerned about.

 

Pregnancy scans:

Fatal viability scan at 6-10 weeks

Our fatal medicine department are responsible for carrying out all necessary scans throughout the women’s pregnancy. The first necessary scan is called a foetal viability scan and this occurs at 6-10 weeks into the women’s pregnancy. This involves an ultrasound examination that is usually carried out via the women’s vagina. This procedure aims to determine the number of foetuses that are present in the women’s uterus and whether the pregnancy is progressing normally or not. This scan is useful for women who are experiencing pain or bleeding during pregnancy and for those who have had previous miscarriages or ectopic pregnancies.

 

Nuchal scan

The baby is usually fully developed by the end of the third month of pregnancy and with the advancement in ultrasound techniques and research we are now able to examine the foetus carefully for anomalies in the third month of pregnancy. The vast majority of babies are normal and health, however all women, no-matter their age, have a small risk of delivering a baby with a physical and/or mental condition. In some of these cases the condition is due to a chromosomal abnormality such as Downs Syndrome.

The most accurate way of determining the risk of having a foetus with Downs Syndrome is to carry out various tests at around 11-13 weeks of the pregnancy. The likelihood that the mother will experience problems with developing a healthy baby depends on:

 

  • The age of the mother
  • The amount of fluid behind the neck of the foetus, this is known as nuchal translucency
  • The presence or absence of any physical abnormalities such as the presence or absence of the foetal nasal bone or leakiness in the heart valves.
  • The levels of two specific hormones (ß·hCG & PAPP·A) in the mother’s blood

The nuchal scan performed at 12 weeks (3 months) of pregnancy is now the recommended screening test for Downs’s syndrome by the American College for Obstetricians (ACOG) and The Royal College of Obstetricians and Gynaecologists (RCOG).

 

The only way to know for sure whether or not the foetus has a chromosomal abnormality as Downs’s syndrome is by having an invasive test such as chorion villus sampling (CVS) or amniocentesis. These tests involve taking a sample from the placenta or amniotic fluid. The tests involve inserting a needle through the abdomen to reach the required tissue. The test is the only accurate way to determine and exact diagnosis, but they do carry a risk of miscarriage of about 1%.

 

The nuchal scan is usually carried out on the women’s abdomen using an ultrasound machine and has a number of benefits:

  1. To accurately predict the date of the pregnancy
  2. To assess the risks of Downs Syndrome and other chromosomal abnormalities
  3. To diagnose multiple pregnancies
  4. To diagnose certain major foetal abnormalities
  5. To diagnose early pregnancy failure

 

Fatal anomaly ultrasound scan 20-24 weeks

At around 20-24 weeks of the pregnancy the mother is required to have a foetal anomaly ultrasound scan. This is a detailed scan used to examine each part of the foetal body. Special attention is given to the brain, face, spine, heart, stomach, bowel, kidneys, limbs and the sex of the baby. If any abnormalities are detected the significance of the findings will be discussed with the parents. This scan is highly recommended to determine if the baby is developing normally and as well to help screen for Down’s syndrome and any genetic conditions. This specific timing of the scan is ideal as usually at this stage babies show obvious features and any abnormalities are easy to detect.

A detailed examination of the foetal heart and connecting vessels is carried out usually at around 20 weeks by a consultant. It is especially recommended for women with a family history of heart anomalies, or in the cases where an abnormality at the 12 week nuchal scan was identified. Many babies with Down’s syndrome have heart abnormalities therefore this detailed examination of the heart can aid in further detection of this condition. 

 

Fatal wellbeing ultrasound scan 24-40 weeks

Many obstetricians recommend that an ultrasound scan to assess foetal growth and wellbeing is offered to all women at about 30-32 weeks of pregnancy. The aim of this scan is to determine the growth and health of the baby by:

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

 

Real time 3D ultrasound (4D ultrasound):

At Bedaya we offer a state of the art three dimensional ultrasound examination of the baby. This scan is particularly useful in visualization of the face and helps in the overall assessment of the normal development of the baby. After confirming that the baby is normal by the scan parents can enjoy watching the baby moving inside the womb and observing their features and activity live. Bedaya offers parents the option to obtain records of these memorable moments on DVD’s.

 

Ultrasound Scans for Fertility Investigations:

Ultrasound scans are also useful in fertility investigations. Fertility scans are conducted vaginally and we examine the uterus and the cervix. We check the lining of the uterus, examine the ovaries, monitor ovulation and help diagnose anomalies of the uterus like polyps or fibroids that can affect fertility.

 

Sonohysterography:

A sonohysterography helps us to examine, in detail, the shape of the uterus internally and identify any polyps or fibroids that may be present. This examination involves passing a very fine tube through the wall of the uterus and injecting a dye which gives us a clear image of the uterus during the ultrasound. It is important to diagnose any polys of fibroids at this stage to and determine through close examination if they require treatment or not.

 

Pelvic ultrasound scans:

This is a vaginal ultrasound scan that is performed to examine the uterus, cervix and ovaries and can help diagnose any abnormalities in patients with pelvic pain or abnormal bleeding.

 

Screening for cancers:

This involves a vaginal ultrasound scan that is performed to examine the uterus, cervix and ovaries and can help in the early detection of tumours in the pelvis. Early identification of such tumours can significantly aid in early treatment. This screening is now recommended for all women above the age of 45 years old, and it is the best available method at present to screen for cancers of the uterus or ovaries.

 

 All the above scans are performed using the best available technology in ultrasound imaging. In addition our team is a distinguished group of consultants with a high level of expertise in these fields.

Fetal Medicine Department