Great strides in screening for foetal anomalies

Foetal medicine, a highly specialised care that focuses on the diseases of the unborn (foetus), needs a lot more impetus, given the prevalence of consanguineous marriages (between close cousins/relatives), and broad range of co-morbidities like hypertension, obesity and diabetes.
Great strides in screening for foetal anomalies


Even in healthy pregnancies, there is a 0.5 to 8 per cent risk of complications. The main aim of foetal medicine is to prevent ill health (morbidity) and death (mortality) in the unborn baby and give it the best start to life, says Dr Lakshmi Shanmugasundaram, senior consultant, The Institute of Reproductive Medicine and Women’s Health, a unit of The Madras Medical Mission. 
She says it is now possible to screening placental insufficiency, preterm labour, common genetic conditions and congenital anomalies to name a few. “With advances in technology including 3D and 4D ultrasound, scans provide much clearer images than in the past and can detect several anomalies and genetic markers at an earlier period of 11 -13 weeks. It helps to detect and treat foetal growth restriction, anaemia, arrhythmia, certain anomalies and infection,” she says. 
The possibility of complications increases especially when there are three or more foetuses (higher order multiple pregnancy) as can happen with In Vitro Fertilization (IVF). “Among identical twins, from 16 weeks’ fortnightly scans are needed to check complications from blood circulation mixing between the two foetuses,” adds Dr Lakshmi. 
MediScan that is jointly hosting the IV National Conference of the Indian Society of Inborn Errors of Metabolism (IEM), has been a pioneering institute in the field of foetal care. IEM can be diagnosed in prenatal scan at three months of pregnancy, points out Dr Sujatha Jagadeesh, HOD, Dept. of Clinical Genetics, Mediscan. She explains that the inherited genetic mutation in each IEM prevents the body from breaking down substances contained in the diet. Infants with these conditions are generally healthy at birth but symptoms begin to appear when they are exposed to breast milk or infant formula containing dietary components that their bodies cannot process properly. As a result, compounds build up in the blood and brain, leading to undesired health outcomes. These conditions are managed by restricting the offending dietary components and providing nutrients that become deficient due to the limited diet.  
Dr Sujatha says that some of these disorders are as common as one in 4,000 and some as rare as one in a lakh. “If a couple has a child with one of the conditions, during the second pregnancy, they should go for a prenatal scan in the third month for an early diagnosis,” she points out. The conference will cover a broad range of topics including a laboratory workshop for earliest detection. 
Talking about the strides in the field of foetal care, she says, though there was concentration of the speciality in the cities, the gap is slowly being bridged. “It is not like what it was five years ago,” she adds.
Timely Care
Foetal medicine unit (FMU) is a highly specialised service that deals with diseases of the unborn baby (foetus) during pregnancy.
Its prime aim is to avoid ill health (morbidity) and death (mortality) in the unborn baby and give it the best start to life.
The foetus carries at least 0.5-8 per cent risk of complications, even in apparently healthy pregnancies.
Counselling is a vital part of managing foetal conditions and it has to be done with  sensitivity due to the emotional and socio-cultural aspects associated with a pregnancy.

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