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Fetal Medicine Services

Fetal Medicine Services

Cloudex Radiology Solutions provides care for pregnant women by doctors who have trained in ultrasound scanning and fetal medicine.

Our antenatal care medical scans are performed by experienced doctors and use the latest ultrasound equipment. We offer advanced ultrasound scans from 6 weeks until the very end of your pregnancy. We are specialists in medical 3D and fetal brains and hearts.

 The centre offers an entire range of services including fetal scans, intrauterine procedures, genetic services, counselling for complicated pregnancies, including emotional counselling, gynaecological scans and procedures. Our fetal medicine consultants can offer a diagnostic second opinion and same day reassurance scan at any stage of your pregnancy.

 

Fetal Diagnosis

The advanced imaging and diagnostic facilities available at cloudex fetal medicine services help us to detect a number of potentially fatal birth defects which would have otherwise gone undetected till the birth of the baby.

High-risk pregnancies involve rare medical conditions which are not seen in routine pregnancies. Detection of these conditions requires special knowledge, expertise, testing methods and equipment. An early and accurate diagnosis is vital to chart the plan of treatment for high-risk pregnancies so as to improve the results of the treatments

Cloudex Fetal Medicine uses a variety of high-tech tools to assess and diagnose fetal conditions. Some of the commonly used diagnostic tools include:

Ultrasound scan to assess structural abnormalities

  • First Trimester and Early anomaly  scan (11- 17 weeks)

Recent Studies and our experience have shown that in the first trimester nearly 56% of anomalies can be detected by early anomaly scans

  1. Advantages of early scanning
  2. Early detection and exclusion of many anomalies
  3. Early reassurance to the expecting mother
  4. Early detection of genetic syndrome
  5. Safer terminations of pregnancies if appropriate
  • Detailed Targeted / Level II anomaly scan with 3D/4D(20-24)

This is a detailed scan done at 20-24 weeks during which each part of the fetal anatomy is examined to see if the baby is developing normally.  Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys and limbs.

Normally the examinations will take between 30 and 40 minutes but in some cases the patient may have to wait longer to allow the baby to move into a more favourable position.

The doctor will point out the baby’s heartbeat and parts of its body before looking at it in detail. It may be difficult for the parents to identify the organs at that stage. The doctor will be able to do so by looking at various angles and sections. However, at the end of the scan the baby will be shown to the parents and their family. The baby’s bones will appear white on the scan and its soft tissues look grey and speckled. The amniotic fluid surrounding the baby will look black. The quality of the scan image depends on many factors, including the position of the baby and the size of the mother.

Sometimes babies with chromosomal abnormalities have signs called ultrasound markers. These include in order of importance thick skin behind the neck (nuchal fold), absent nasal bone, mild fluid within the ventricles of the brain, aberrant subclavian artery in the neck, occasionally short arms or legs, white spots in the baby’s heart or abdomen, or choroid plexus cysts in the brain.

If the doctor suspects that your baby has a heart problem, fetal echo will be done. Fetal Echo is a detailed evaluation of the baby’s heart. Similarly, if any brain abnormality is suspected -Neurosonogram; detailed brain examination is carried out in the same sitting.

If any scan reveals a serious problem, the parents will be given adequate support and counselling to guide them through all the available options. Although such serious problems are rare, in some cases families may be faced with the most difficult decision of all which is whether to end the pregnancy or not.

Other problems may mean a baby needs surgery or treatment after birth, or even surgery while it is still in the uterus. There is a well-equipped and well experienced team available to support you through any difficult times, including obstetricians and neonatologist. Proper guidance will be provided in cases where there is a need of pediatrics surgeon, neurosurgeon or plastic surgeon etc.

• Multiple pregnancy scan

An expectant mother with twin pregnancy would need more frequent hospital visits and more frequent checkups than their singlet counterparts. Most twin pregnancies will have no complications and will have normal deliveries; however, it is important to be aware of the following complications: especially if its monochorionic twins.

In dichorionic pregnancies there is a high chance of preterm delivery, growth restriction and low birth weight (<2.5 kg) in twin pregnancy. In addition to above risks, there is a small increased risk of birth defects in monochorionic twins. They are also at risk of complications arising from unequal sharing of the placenta which include differential growth patterns, twin twin transfusion syndrome (TTTS), a cardiac twinning and even death of a single baby leading to neurological complications in the surviving twin. Further growth scans or fetal well being scans are done at four weekly intervals, i.e., approximately at 24, 28, 32 and 36 weeks respectively after targeted anomaly scan. Similarly, in Monochorionic pregnancies scans are at 2 weekly intervals, i.e., at 16, 18, 20, 22, 24, 26, 28, 32, 34 and 36 weeks.

Ultrasound  scan to assess fetal health 

  • Fetal Viability scan

This is an ultrasound examination that is usually carried out vaginally. It is done to determine the number of fetuses present and to check whether the pregnancy is progressing normally inside the uterus with normal cardiac activity. It also screens for any collections inside the uterus.

  • Fetal well  being scan -Growth scan with  Dopplers  &  BPP

An ultrasound scan to assess fetal well being is offered to all women at about 28-30 weeks of pregnancy with an extra attention for those women who have had previous complications of pregnancy such as pre-eclampsia, growth retardation, diabetics, stillbirth and for those women who develop an abnormality during the course of their current pregnancy

Fetal Echocardiography

This involves Imaging the fetal heart with ultrasound technology to understand the fetal cardiac structure, function and rhythm.

Fetal Neurosonography

If any suspicion of a brain or spinal abnormality is raised during the obstetric ultrasound screening examination, the mother is advised to undergo targeted fetal neurosonography as a diagnostic examination. Targeted fetal neurosonography is a dedicated, multiplanar, diagnostic examination for fetuses at high risk or with suspicion of CNS or spinal malformations. In addition to the planes used in the screening examination, it requires coronal and sagittal views.

Advanced Imaging

• 3D/4D Ultrasound

Most ultrasounds are routinely performed using conventional 2-dimensional (2D) scanning. The image usually appears grey on the ultrasound screen. With 3D ultrasound, a series of thin 2D slices is digitally reconstructed to give more life-like images.

With 4D ultrasound, the added dimension is time, so that the 3D images appear to be moving in real time. The 3D/4D image is usually seen in golden colour on the ultrasound screen, as this colour is easy for patients to look at and highlights features on the baby.

For a good 3D/4D imaging the requirements are a co-operative baby and adequate amniotic fluid in front of the structure being imaged. Some babies press against the wall of the uterus or placenta, or they may have their arms or hands lying in front of the face. This will make obtaining 3D/4D images difficult or impossible.

Services Provided

  • NT Scan(11-14 weeks)
  • Early anomaly scan(13-17 weeks)
  • Detailed Targeted /Level || anomaly scan with 3D/4D(20-24 weeks)
  • Prenatal / pre eclampsia screening
  • Fetal well being scan-Growth with Dopplers &BPP
  • Fetal Echocardiography
  • Fetal Neurosonogram
  • Genetic Counselling

Intrauterine Procedures

  • Amniocentesis
  • Chorionic villus sampling
  • Fetal blood sampling
  • Fetal reduction for multifetal pregnancies
  • Intrauterine transfusion