In Zen philosophy, a mother and a child have been compared to two blossoms on a single branch. And never is this truer than during pregnancy. The comparison also highlights that the health and well-being of the unborn child or fetus is as important as that of the mother. In a normal pregnancy, the obstetrician’s role in monitoring the pregnant mother and fetus’ health through periodical check-ups suffices. But when there is a high-risk pregnancy with danger to the health of the fetus, there is need for a specialist in fetal health and well-being. This is where the branch of medicine known as Fetal Medicine comes in.
Dr. JyothiMancheri is the Senior Consultant and Head of Department at the new Department of Fetal Medicine at Aster MIMS Calicut. She said, “Fetal Medicine essentially recognizes that the unborn child or fetus is an independent individual and treats this ‘unborn patient’. It’s a comparatively new speciality that focuses on holistic care of the fetus for maintenance of fetal health and diagnosis of fetal illnesses and abnormalities, if any.”
Fetal medicine is the branch of medicine that assesses fetal growth and wellbeing and works towards maintainingfetal health. It also covers the diagnosis of fetal illnesses and abnormalities. A specialist in fetal medicine is a gynaecologist and obstetrician who has further specialised in fetal medicine to become a high-risk pregnancy expert.
Dr. JyothiMancheri said, “A fetal medicine specialist comes into the picture when the mother-to-be is a high risk pregnancy due to any medical condition like diabetes and hypertension, or complications during a previous pregnancy, or in case the gynaecologist finds some abnormality during routine scanning. The role of a fetal medicine specialist covers prenatal diagnosis and fetal treatment.”
With advances in medical technology, prenatal diagnosis now enables specialists to detect abnormal conditions of the fetus, differentiating these from normal fetal development with increasing accuracy. The most common test for this is the ultrasound. Screening is also done to detect abnormalities in high risk pregnancies or when there is a family history of such abnormalities. These include Nuchal scan for Down’s syndrome and screening for fetal congenital abnormalities like spina bifida which causes a defect in the spine, cardiac abnormalities etc. Management of complicated multiple pregnancy is one of the main focus of fetal medicine where treatment of complications can be offered by keyhole surgery of the fetus with laser and other fetoscopic surgeries.
In some cases, invasive diagnostics tests like amniocentesis, chorion villus sampling or cord blood sampling may also need to be carried out by the specialist to confirm any chromosomal abnormalities.
Dr. JyothiMancheri said, “Apart from the diagnostic aspects, treatment of the fetus is also done through medical or surgical procedures. Medical treatment is generally performed by administering medicines to the mother, which then crosses through the placenta to reach the blood circulation of the fetus. For example, dioxin for fetal cardiac arrhythmia.Treatment can be given directly to the fetus by ultrasound guided injection to the fetus or through the umbilical cord for example blood transfusion can be given to the fetus if the fetus is anaemic due to parvo virus infection in the mother. Advances in surgery are making it possible to conduct surgical procedures on the fetus and correct conditions such as congenital diaphragmatic hernia, spina bifida etc.”
Augmented by the Department of Fetal Medicine, Aster MIMS now makes a multi-disciplinary approach possible in the management of high risk pregnancies and treatment of fetal abnormalities and protecting the unborn fetus for the first time in North Kerala.
