Fetal Medicine Center

Ultrasound

I Trimester

  • Confirmation of pregnancy / viability scan
  • Nuchal translucency scan / early anomaly scan.
  • Done at 11 – 14 weeks [CRL – 45 – 84 mm] as a part of aneuploidy screening. Helps to pick up major structural abnormalities at the earliest.

II Trimester

Target scan

  • Done at 20 – 24 weeks.
  • Detailed targeted examination of the fetus to pick up fetal abnormalities.

Fetal echocardiography

  • Done at 20 -24 weeks
  • Indications
    • Previous child with heart disease.
    • Mother with heart disease.
    • Overt diabetes mellitus.

Fetal Neurosonogram

  • Done as extended survey if we detect any central nervous system abnormality during target scan.

III Trimester

  • Growth scan with Doppler

Multiple pregnancy

  • Specialized unit for scanning multiple pregnancies , counselling the couple and guidance for monitoring higher order pregnancies

Screening Test

  • First trimester combined screening tests[NT+ Biochemical screening],
  • Done along with nuchal translucency scan at 11 – 14 weeks [ CRL 45 – 84 mm].
  • Blood is collected on dried blood spot filter paper and analysed for two markers – PAPP – A and β – HCG.
  • Results of the blood part and ultrasound are combined to estimate the risk of down syndrome, trisomy 13 and trisomy 18.
  • This is a screening test with a detection rate of 85 – 90 %.

Screen Negative / Low risk

  • The baby is at low risk for Trisomy 21(downs syndrome), trisomy 13 or 18.
  • Do a target scan at 20 weeks.

Screen Positive / High risk

    • The baby is at increased risk for Trisomy 21[down syndrome], trisomy 13 or 18
    • Since this is a screening test, it should be followed by a confirmatory test like Chorionic villi sampling or Amniocentesis

or

  • You can do a test with high sensitivity like Noninvasive prenatal screening [NIPT]]with 99.9 % sensitivity – still this is a screening test and if positive should be followed by a confirmatory test like Amniocentesis / Chorionic villi sampling.

Quadruple screening test

  • Quadruple screening test
  • This is a maternal blood screening test that looks for AFP,B HCG, Unconjugated estriol and Inhibin-A.
  • Done at 16-21weeks,when BPD is 31-52MM.
  • This test has a sensitivity of about 60-70% for detection of downs syndrome.

Non invasive prenatal screening test[NIPS]:

  • Has a sensitivity of 99% for detection downs syndrome .
  • This is also a screening test. If screen positive – this has to be confirmed with Amniocentesis or Chorionic villi sampling.
  • Preeclampsia screening test

Fetal Interventions

  • Chorionic villi sampling
  • Amniocentesis
  • Fetal reduction
  • Intrauterine transfusion