Fetal Scanning Procedures
Getting your pregnancy screened at BFMC- IMA Fetal Care enables our fetal specialists to monitor the health of a fetus during development. While most birth defects are best managed with medical therapy or surgery immediately after birth, an increasing number of abnormalities can be treated before birth to reduce some of the life-threatening or devastating consequences of the defects. By having your screening done by us, you will be well informed about potential risks and complications so that you and your family can make the right decision to monitor, prevent or treat any threatening conditions.
In many cases, when a screening test gives abnormal results, subsequent testing will be recommended. Usually a combination of two or more of these screening tests will produce the most reliable results. Some screening and diagnostic tests are routine, while others are prompted by certain early warning criteria, family history of abnormalities or abnormal results of a routine screening.
A comprehensive range of screening, diagnostic and therapeutic services are available to all patients
- Routine and tertiary level ultrasound according to Fetal Medicine Foundation, UK guidelines and protocols by certified and accredited specialists.
- Fetal echocardiography – detailed study of the fetal heart
- First trimester ultrasound screening for chromosomal anomalies and early detection of major abnormalities.
- Counselling for pregnancy and fetal complications – guidance through the pregnancy based on uptodate scientific evidence
- High risk obstetrical consultations
- Pre-pregnancy Counseling
Combined Fetal-Genetics Clinic
Fetal diagnostic and therapeutic invasive procedures
- Invasive testing — Amniocentesis, chorionic villus sampling (CVS), fetal blood sampling
- Intrauterine vascular/peritoneal transfusions
- Intrauterine shunting operations for pleural effusions
- Fetoscopic and other minimally invasive fetal surgery
- Fetoscopic laser ablation for Twin Twin Transfusion Syndrome – 1st team in India to perform
This is an ultrasound examination that is usually carried out vaginally at 6-10 weeks of pregnancy.
The aims of this scan are to determine the number of embryos 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.
This scan is carried out from 11 weeks to 13 weeks and six days. The scan is usually performed transabdominally but in a few cases it may be necessary to do the examination transvaginally.
Aims of the nuchal scan
- To date the pregnancy accurately. This is particularly relevant for women who cannot recall the date of their last period, have an irregular menstrual cycle, or who have conceived whilst breastfeeding or soon after stopping the pill. We measure the size of the fetus and from this we calculate the expected date of delivery.
- To diagnose multiple pregnancy. Approximately 2% of natural conceptions and 10% of assisted conceptions result in multiple pregnancy. Ultrasound scanning can determine if both babies are developing normally and if the babies share the same placenta which can lead to problems in the pregnancy. In such cases it would be advisable to monitor the pregnancy more closely.
- To diagnose major fetal abnormalities. Some major abnormalities may be visible at this gestation. However it will still be necessary to have a 18 – 24 week anomaly scan.
- To diagnose early miscariage. Unfortunately, in 2% of women who attend for a nuchal scan it is found that the fetus has died, often several weeks before and without any warning. Couples will receive full counselling as to the possible causes of this problem and the options for subsequent measures that may be necessary.
- To assess the risks of Down’s syndrome and other chromosomal abnormalities. Each woman will be given an estimate of her individual risk for this pregnancy. This is calculated by taking into account the age of the mother, measurement of two hormones in the mothers blood and the scan findings of nuchal translucency thickness, nasal bone, blood flow through the fetal heart and ductus venosus and fetal abnormalitites. Parents will receive full counselling concerning the significance of these risks and the various options for further investigations including invasive testing or the Harmony test.
This is a detailed scan at 18-24 weeks of pregnancy.
During the scan we examine each part of the fetal body, determine the position of the placenta, assess the amount of amniotic fluid, and measure fetal growth. Special attention is paid to the brain, face, spine, heart, stomach, bowel, kidneys and limbs.
If any abnormalities are detected the significance of the findings will be discussed and the couple will be given the opportunity to have further counselling with one of the Fetal Medicine Specilaists.
Anomaly scan video
Fetal Cardiac scan
During the nuchal scan (11-13 weeks), the anomaly scan (18-24 weeks) and wellbeing scan (30-34 weeks) we routinely examine the fetal heart and connecting blood vessels.
A specialist examination of the fetal heart is recommended for:
- Women with family history of congenital heart abnormalities, those with diabetes mellitus and those taking antiepileptic drugs
- Fetuses with suspected heart defect and those with increased nuchal translucency or certain non-cardiac abnormalities detected during the routine scans
Specialist fetal heart scans at the Fetal Medicine Centre are carried out by Trained Fetal Medicine Specialists. The scans are usually performed at 18-24 weeks gestation, but can be undertaken from as early as 12 – 13 weeks if necessary. If an abnormality is found, a detailed explanation of the problem and the outlook for the baby will be provided to the parents and a plan for the subsequent management of the pregnancy will be discussed.
This is a transvaginal scan to measure the length of the cervix.
It is recommended in women at high risk for preterm birth, including multiple pregnancies, those with a previous preterm birth, abnormalities of the uterus or previous cervical surgery.
This examination is usually carried out at the time of the anomaly scan but in women with previous preterm birth it may be necessary to perform a series of scans starting from 16 weeks.
Fetal Wellbeing/ Growth scan
This ultrasound scan is usually carried at about 28 – 36 weeks of pregnancy.
Some obstetricians advise that this scan to all women. Others reserve such scans for those women who have had previous complications of pregnancy such as pre-eclampsia, growth restriction, diabetes, stillbirth, and for those women who develop a problem during the course of their current pregnancy, twins triplet pregnancy etc.
This scan aims to determine the growth and health of the fetus 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 colour Doppler ultrasound