Counselling for Fetal Anomalies

The incidence of major congenital malformations is about 2-3% of live births Most parents come for an ultrasound scan assuming the fetus is normal. So, in case any abnormality is detected, it is a shock and starts a string of unexpected reactions. With better equipment, better resolution of images and increased knowledge of fetal anatomy and physiology we are at a time when describing a fetal abnormality in detail is possible – the difference between fetal imaging and fetal medicine is the correct interpretation of the imaging findings and assimilating a perinatal team for comprehensive, multidisciplinary care to optimize the final perinatal outcome which we offer at our centre with an expertise team of doctors. The diagnostic potential of antenatal ultrasound varies significantly depending on many factors, the most important of which are operator experience and machine resolution. Antenatal counseling is important in making decisions regarding continuation or discontinuation of the pregnancy as also in planning antenatal or post-natal treatment for the diagnosed fetal condition, if possible. The parents would be keen to understand the exact nature of the fetal anomaly and its implications thereof. The Fetal Medicine specialist is usually the person who detects the anomaly and hence carries the onus of arranging a meaningful counseling session and it is a multidisciplinary approach.

Our objectives of antenatal counseling for fetal anomalies are to clarify the following points:

• Whether the malformations in the fetus that are ‘Lethal’ (not compatible with postnatal life).
• If the malformations are compatible with life, whether they may be associated with significant postnatal morbidity and long-term disability.
• Fetal conditions with the potential for intrauterine therapy to prevent morbidity and mortality.
• Fetal conditions that will require postnatal investigation or treatment and lead to a reasonably good outcome.
• Possibility of recurrence in future pregnancies.
• Need for modifying Obstetric management due to the present fetal condition and the implications on Obstetric decisions in future pregnancies.

We at Resolution Fetal Medicine center include all members of the multidisciplinary team and we have an open and interactive communication at all times to ensure continuity of the care pathway.