Fetal Medicine

Welcome to our unit.

Our aim is to improve women’s health, through the different stages of live. We start by premarital genetic counselling and ultrasound scans that are needed for couples before marriage that can help detect inherited genetic disorders and abnormalities in the genital tract.

We help couples trying for pregnancy by doing all the necessary tests and ultrasound examinations needed to monitor fertility and diagnose anomalies that need treatment.

We then go on to a full detailed examination during pregnancy using ultrasound aiming to screen for genetic and inherited conditions particularly Downs syndrome (Mongolian babies) and to examine the different systems of the foetus to confirm that the foetus is developing normally, using state of art top technology real time 3 Dimensional (4 D) ultrasound.

We aim to maintain good health following completing the family by screening for different cancers that can affect the genital tract including cancer of the Womb (uterus), Ovaries and cervix, using the best technology in ultrasound.

 

The following is a list of our services:

Premarital counseling and examination:

We meet couples who are in preparation for marriage to discuss and examine their family history and personal history of anomalies that can affect the baby particularly inherited genetic conditions that run in their family. We offer genetic counseling by a team of geneticists that can help guide the couple to any further tests if needed. We can perform a detailed ultrasound examination of the uterus and ovaries by scan through the abdomen to help reassure the couple.

Pregnancy scans:

Fetal viability scan 6-10 weeks

This is an ultrasound examination that is usually carried out vaginally. It aims to determine the number of fetuses present and whether the pregnancy is progressing normally inside the uterus. This scan is useful for women who are experiencing pain or bleeding in the pregnancy and those who have had previous miscarriages or ectopic pregnancies.

Ultrasound picture at 5-weeks showing a live fetus

Ultrasound picture of a failed pregnancy at 9-weeks showing an empty sac

 

Nuchal scan

The baby is usually fully developed by the end of the third month of pregnancy. With the advancement in ultrasound techniques and research we are now able to examine the fetus carefully for anomalies in the third month of pregnancy. The vast majority of babies are normal. However all women, whatever their age, have a small risk of delivering a baby with a physical and/or mental handicap.

In some cases the handicap is due to chromosomal abnormality such as Downs Syndrome.

The most accurate way of estimating the risk of the fetus having Downs Syndrome is carried out at 11-13+6 weeks and depends on the:

Age of the mother

Amount of fluid behind the neck of the fetus (Nuchal translucency)

Presence or absence of the fetal nasal bone, Leakiness in the heart valves, Presence or absence of any physical abnormalities. Level of two 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 syndrome by the American College for Obstetricians in the United States and The Royal College of Obstetricians in England.

The only way to know for sure whether or not the fetus has a chromosomal abnormality as Downs syndrome is by having an invasive test such as chorion villus sampling (CVS) or amniocentesis (amnio) to take a sample from the placenta or amniotic fluid. However these tests carry a risk of miscarriage of about 1{4965123df64b9e343a68e48a4b7792d8c86f4ce239277d9260d26c7037488831}.

This scan is usually carried out transabdominally. There are a number of benefits:

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

Fetal anomaly ultrasound scan 20-24 weeks

This is a detailed scan during which each part of the fetal body is examined. Special attention is paid 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. This scan is highly recommended to examine that the baby is developing normally and as well to help screen for Downs syndrome and genetic conditions as the those babies usually show features during the ultrasound scan.

Fetal cardiac ultrasound scan 20 weeks

A detailed examination of the fetal heart and connecting vessels is carried out usually at 20 weeks by a consultant. It is especially recommended for ladies with a family history of heart abnormalities, or where increased Nuchal translucency had been found at the 12 week scan. It is also an important scan in assessing the risk for Downs Syndrome because many of these babies have heart abnormalities.

Fetal wellbeing ultrasound scan 24-40 weeks

Some obstetricians advise that an ultrasound scan to assess fetal growth and wellbeing is offered to all women at about 30-32 weeks of pregnancy. This scan aims to determine the growth and health of the baby by:

  • Measurement of the size of the fetal head, abdomen and thigh bone and calculation of an estimate of fetal weight
  • Examination of the movements of the fetus
  • Evaluation of the placental position and appearance
  • Measurement of the amount of amniotic fluid
  • Assessment of blood flow to the placenta and fetus by color Doppler ultrasound.

Real time 3D ultrasound ( 4D ultrasound):

We offer state of art top quality three dimensional ultrasound examination of the baby, which is particularly useful in visualization of the face. This as well helps in assessment of normal development of the baby. After confirming that the baby is normal on scan you can enjoy watching the baby moving inside you and observing their features and activity live by the 4D ultrasound, you can as well obtain records on DVD’s of such memorable moments.

Ultrasound scans for Fertility investigations:

Those scans are done vaginally and we examine the uterus the cervix, 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:

We can examine in detail the lining of the uterus by passing a very fine tube and injecting some fluid during ultrasound scans which gives us clear information on the shape of the uterus internally and help us diagnose accurately any polyps or fibroids that are close to the lining of the uterus without any surgery needed for diagnosis.

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 is a vaginal ultrasound scan that is performed to examine the uterus, cervix and ovaries and can help early detection of tumors in the pelvis which aids early treatment. This is now recommended for all ladies above the age of 45 years, 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 high level of expertise in such fields.

Fetal Medicine Department