Fetal medicine, also known as perinatology, is a new branch in obstetrics and gynaecology which specializes in high risk obstetrics.
Traditionally, while in pregnancy a pregnant woman went to see a gynaecologist, who treated her, but then medical science realized that there are two patients involved, one is the mother and another one is the child or the fetus and a need to take special care for this complicated situation.
So in fetal medicine, doctors look at this unborn baby and trace it through the journey before the delivery and take optimal care to the mother and fetus.
Who is a Fetal Medicine Specialist? How is a Maternal Fetal Medicine Specialist different from a general Obstetrician?
A fetal medicine specialist is an obstetrician gynaecologist who then does extra training to learn the high risk medical and surgical complications of pregnancy.
The general gynaecologist takes care of routine pregnancies, but when a complication arises a Fetal Medicine Specialist is consulted.
They take special care for all types of complications of pregnancy, including women who have serious illnesses.
What does a fetal medicine specialist do?
A fetal medicine doctor or a perinatologist:
- Takes special care for the mother and the baby inside the womb when there are complications developed during the pregnancy or the childbirth
- Diagnoses and helps the mother manage her existing health problems like diabetes, heart conditions, high blood pressure, blood disorders, stress, etc.
- Performs tests like ultrasound to trace the babies’ growth and development
- Do tests such as umbilical cord sampling, or chorionic villus sampling, or amniocentesis to check for any genetic disorder and birth defect
- a perinatologist will develop a plan of care with the patient and her obstetrician, and then a patient would return to their obstetrician for their antenatal care and for their delivery.
- They Perform surgery if required
Some situations where there is a need to consult a Fetal Medicine Specialist
Many of the health issues occur while the fetus is growing in the womb. Thus, it is crucial to ensure the good health of the fetus and the pregnant woman.
When there are more than one babies in the womb, in other words when the lady is pregnant with twins or triplets or quadruplets, very high risk is involved.
In those situations, the way babies are placed inside the womb, the food supply to the babies – all may vary. And there are many specific interventions to ensure the delivery is safe – this is one of the important aspect practiced in fetal medicine.
In many cases, babies don’t grow properly in the womb. This condition is called intrauterine growth restriction. If this condition is not detected then the babies get compromised and when they may take birth with functional disturbances.
A fetal medicine doctor helps you assess the growth of the baby and give you insights as to how to optimize the growth of the baby and also in growth-restricted babies optimize the time of delivery.
The other issue, which occasionally appears, is if the babies have some structural abnormality – in those situations the fetal medicine specialist will help you plan your delivery and take further care.
For example, if the baby needs surgery after birth then your timing has to be optimized so that you deliver at a place where the newborn specialist takes over the care of the babies.
Here are some more conditions, where there is a higher risk associated and consulting a maternal fetal medicine specialist is highly recommended.
- The mother has diabetes
- Bleeding and blood clotting disorders
- Family history of genetic conditions and birth defects
- Pregnancy problems in the past, like a preterm birth
- Abnormal pregnancy
- Heart conditions or high blood pressure, hypertension, seizure disorders
- infections such as parvovirus, cytomegalovirus, or HIV
So there are a number of specific conditions and requirements that are specific to the unborn child and addressing all these issues is the objective of this new science, called fetal medicine.
This is a really new and still developing branch.
One of the very important issues which we have learnt about not until very recently is genetic and chromosome problems.
There are more advances happening in molecular biology and clinical genetics. So that doctors have learnt that these are the problems which happen again and again because of defective genes.
Thankfully now there are methods of checking these genes so a fetal medicine specialist can screen for these conditions. If necessary, even test the unborn baby. So that if a baby has a major problem and there is a chance the baby may not be normal or it may suffer after taking birth, fetal medicine doctors can minimize the suffering in conditions affecting families repeatedly.
So overall this is a very new and promising branch of obstetrics and gynaecology. It involves better management of pregnancy, ensuring that the baby inside is healthy. The ultimate outcome of a good pregnancy is a happy mother and a healthy child.