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Patient Information

1.What is a fetal invasive procedure?

Fetal procedures are medical interventions performed on a developing fetus during pregnancy. These may include diagnostic procedures or treatments (therapuetic procedures) for certain conditions.

Common fetal procedures include amniocentesis, chorionic villus sampling (CVS), fetal blood sampling and Advanced Fetal interventions such as Intrauterine Fetal Blood Transfusions, Cord occlusion by Radiofrequency ablation (RFA) for complicated Monochorionic twins/ Dichorionic Triplet, ablation of Fetal tumours, Fetal pericardial/Pleural effusion drainage (Fetal Thoracocentesis). These procedures help diagnose genetic disorders and treat certain fetal conditions.

Fetal procedures are typically recommended when there is a risk of Chromosomal abnormality in the Fetus on maternal blood tests (for ex. High risk for Trisomy 21/Down's syndrome on Double markers/quadruple markers testing) OR when there's a suspected or confirmed fetal abnormality on Fetal Ultrasonography that requires intervention.

Timing of Fetal Invasive Procedure;
Chorionic villous sampling ( 11 weeks to 13 weeks 6 days of pregnancy)
Amniocentesis (16 weeks onwards)
Fetal Blood Sampling/Cordocentesis (18 weeks onwards)
Fetal reduction ( 12 weeks onwards)
Advanced Fetal interventions (as and when fetal abnormality diagnosis is performed)

A Fetal medicine specialist (An Preferably Obstetrician who is specifically trained in Fetal ultrasound and Fetal invasive procedure) can perform the fetal procedure

Of course. Detailed fetal structural evaluation is mandatory before undergoing any fetal invasive procedure. Moreover all fetal procedures are ultrasound guided. and Most importantly, A Doctor who is going to perform the fetal procedure must evaluate the Fetus first before proceeding with the procedure in order to ascertain which genetic tests need to be done on amniotic fluid/Chorionic Villi Saample

Fetal invasive procedures are performed under Continuous ultrasound guidance. A needle is passed through a maternal abdomen under ultrasonic vision into the fetal tissue (placenta/amniotic fluid) to take out the fetal sample. Local anaesthesia on skin might be required in a few selected cases.

While most fetal procedures carry some risks, they are generally considered safe when performed by experienced fetal medicine specialist. The decision to undergo a fetal procedure is based on the potential benefits weighed against the risks.

1. What is a fetal ultrasound?

Fetal ultrasound is a non-invasive imaging technique that uses sound waves to create visual images of the developing fetus in the womb. It is commonly used to detect Fetal abnormalities and to monitor fetal growth.

Fetal ultrasounds are typically performed at different stages of pregnancy. The first ultrasound may be done in the first trimester to confirm pregnancy, while subsequent ultrasounds monitor fetal development and check for any issues.

Fetal ultrasounds are performed during every stage of pregnancy.
(1st, 2nd and 3rd Trimester)The first Trimester ultrasound:Dating and viability scan :
 To confirm and date the pregnancy. This scan is performed between 7 to 9 weeks of pregnancy.
Nuchal Translucency scan /NT scan:
To measure the Nuchal Translucency to identify the fetuses which can be potentially at risk for chromosomal/genetic conditions and for early detection of lethal fetal anomalies as well as to identify the pregnancies which are at risk of developing Hypertensive disorder in pregnancy (Preeclampsia).NT scan is performed between 11 to 13 weeks 6 days of pregnancy but preferably should be done between 12 to 13 weeks of pregnancy.
The Second Trimester ultrasound:
Anomaly scan/Targeted imaging for Fetal abnormalities(TIFFA) scan: To identify the structural anomalies in the fetus. Anomly scan should ideally be performed between 19-22 weeks of pregnancy.
Specialised Fetal Scans:
Fetal Echocardiography- Dedicated sonography to identify fetal Heart problems- Done at 22-24 weeks of pregnancyFetal Neurosonography:
 Dedicated sonography to identify fetal brain problems- done at 22-24 weeks of pregnancy
The Third Trimester ultrasound:
Growth scan and Color Doppler studies: Done  to identify fetal growth pattern and blood supply to the fetus. This scan is Performed 28 weeks onwards. typically at 8 weeks, 32 weeks and 36 weeks of pregnancy.

1. What is genetic testing during pregnancy?

Genetic testing during pregnancy involves examining the baby's DNA for any abnormalities or genetic disorders. This can be done through procedures like amniocentesis or non-invasive prenatal testing (NIPT).

Genetic testing is often recommended for women with certain risk factors, such as advanced maternal age or a family history of genetic disorders. It may also be advised if an ultrasound reveals potential abnormalities.

No, genetic testing may not detect all possible genetic disorders. Different tests have varying levels of sensitivity and specificity. It's essential to discuss the limitations and scope of testing with a healthcare provider.

Please note that individual cases may vary, and it's crucial to consult with healthcare professionals for personalized information and guidance based on specific circumstances.

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