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Fetal Medicine

Fatal Growth

Foetal medicine is a branch of medicine that includes the assessment of foetal growth and well-being, maintenance of foetal and diagnosis of foetal illnesses and abnormalities.

Our goal is to protect and nurture the unborn foetus. Our scans are performed with the state of the art equipment's maintaining highest standards followed by sensitive counselling.

Foetal Medicine Services

Prenatal Screening

We offer prenatal screening at 11 to 14 weeks of pregnancy which includes blood test and an ultrasound scan which will tell the chances of the baby having any chromosomal abnormality like Down’s Syndrome and also early diagnosis of structural abnormality.

This is only a screening test, which will only tell whether the baby is at risk for the common chromosomal abnormality like Down's Syndrome, Trisomy 18/13. If the screen test is positive it should always be followed by a diagnostic test.

Who should be offered a screening test?

Every women have a risk of having a baby with Down's Syndrome. Hence, all women during early pregnancy should be offered screening test.

1.Combined Test- Nuchal translucency scan (NT Scan) + Serum Biochemistry (β -Hcg and PAPP-A). This screening involves an ultrasound assessment of the foetus including the nuchal translucency, and the new markers such as nasal bone, tricuspid regurgitation and ductus venosus PI. The maternal blood is also checked for PAPPA, free beta- HCG and an integrated risk assessment is given.

2 .Non-invasive Prenatal Test – During pregnancy, some of the DNA from the baby crosses into mother’s blood. Thus by foetal DNA can be analysed using maternal blood. NIPT test is highly effective in determining if there is only one chromosome where there should be a pair, or if there is an extra chromosome, especially for the chromosomes that are responsible for Down syndrome, Edwards syndrome, Patau syndrome and certain sex chromosome trisomies or if there are three sets of each chromosome, which is known as triploidy.

3.Quadruple test Quadruple test the Quad screen /Quadruple marker measures

  • Alpha-fetoprotein (AFP)
  • Human chorionic gonadotropin (HCG)
  • Estriol
  • Inhibin A

It is done between weeks 15 and 20 of pregnancy in the second trimester. It detects common chromosomal abnormalities and neural tube defects.

Genetic Sonogram

It is performed to look for specific markers suggestive of chromosomal abnormality like Down's syndrome

Foetal Diagnosis

  • Pre-pregnancy counselling
  • Early pregnancy scans for viability, location and number
  • First trimester /NT scan – Nuchal translucency, nasal bone, ductus venosus, early anomalies
  • Mid-trimester anomaly scan
  • Foetal echo
  • Workup of anomalies /counselling
  • Multiple pregnancy scan
  • Interval growth
  • Foetal doppler
  • 3D /4D scans throughout pregnancy

Invasive procedures

  • Amniocentesis
  • Chorionic villus sampling
  • Foetal blood sampling

Genetic Counselling

High Risk Pregnancy

  • Recurrent pregnancy loss
  • Previous unexplained intrauterine foetal demise (IUFD) or stillbirth
  • Known genetic disorder in family
  • Pregnancy with previous child affected by thalassemia
  • Pregnancy with suspected foetal infection (TORCH, chickenpox)
  • Pregnancy with diabetes
  • Pregnancy with chronic hypertension
  • Pregnancy with heart disease
  • Pregnancy with autoimmune and connective tissue disorders
  • Pregnancy after transplant
  • Pregnancy with suspected morbidly adherent placenta (MAP)
  • Management of foetal growth restricted babies (FGR)
  • Doppler's
  • Non stress test (CTG)


Dr. Adinarayana Makam

Dr. Adinarayana Makam
Obstetrics, Gynaecology and Advanced Training in Fetal Medicine