Foetal medicine

Hyderabad, September 2023: Apollo Cradle and Children’s Hospital, hosted the second edition of the conference on foetal medicine ‘Optimising Foetal outcomes 2023’ at Hotel Marigold, Hyderabad. The Conference was inaugurated by Dr Sangeeta Reddy, Managing Director, Apollo Health and Lifestyles Ltd., Dr Amitha Indersen, Organising Secretary & Head of the Department of Foetal Medicine, Apollo Cradle Hospitals, Hyderabad was present on the occasion. The program had nationally and internationally recognised expert faculty on foetal medicine and therapy including Dr Krishnan Manikandan, The Fetal Clinic, Pondicherry; Dr Lakshmi Ravi, Shri Lakshmi Fetal Medicine Centre, Krishnagiri, Tamil Nadu and Dr Madhavilatha, Bhishak Fetal Medicine Centre, Vijayawada. Over two hundred obstetricians from Telangana and Andhra Pradesh attended the Conference.

Foetal medicine enables to monitor the development and growth of the baby in the womb. Foetal medicine specialists take care of any abnormalities of development causing structural abnormalities or any genetic abnormalities, by ensuring normal growth and in case of abnormalities try to safeguard the baby.

There are about 3 to 4 abnormal babies out of every 100 babies born. Some of these may have recurrent or genetic causes that can repeat in future pregnancies. Foetal medicine specialists besides identifying abnormalities, try to identify causes and help counsel the couple regarding future risks. In our country, every year approximately 1.5 to 1.8 lakh children are born with congenital heart defects and of these sixty thousand to ninety thousand are critical, requiring early intervention. Majority of these can be detected antenatally if the pregnancy scans are done properly by qualified foetal medicine specialists. Similarly every year there are about ten thousand to fifteen thousand couples who are carriers of genetic problems like thalassemia getting pregnant and a quarter of them are at risk of having babies with thalassemia major where the child may be dependent on blood transfusions to be alive. These kind of conditions can be screened for in the early pregnancy period, required genetic tests are done and affected babies identified.

Speaking on the occasion Chief Guest Dr Sangita Reddy said, it is the combination of skilled neonatal and foetal medicine professional and the outstanding machines we have today that help us identify and give us tremendous insights in this field. It is estimated that 1.5 to 1.8 lakh children are born with congenital deformities, that number is very high, we need to continue to push towards proactive screening protocols. The combination of physical screening, blood pressure, and other tests including genetics should be placed into a perfect protocol, without in any way compromising the wellbeing of the foetus to be born. The area of children, babies, women and mothers’ health is a high priority at Apollo Hospitals. Some significant and great work is being done in this area at Apollo Hospitals across the country. We are placing significant thrust on training of new foetal medicine specialists and are framing a two year comprehensive diploma for it. This is critical to handle the volume of work we have in our country. It is important that we do some pioneering work in this space by adopting advanced techniques like intra uterine foetal procedures.

Dr Amitha Indersen said, the thrust in the field of foetal medicine should be on following the strict criteria, because only if we follow those criteria can we have standardisation. That helps to reaudit what we are doing. Later we can get the images validated and that becomes an accepted practice world-wide.

The Conference deliberated on abnormalities in foetal development and experts shared insights on ways to manage them. These abnormalities are usually due to several causes including chromosomal or genetic defects, infections, environmental factors like pollution, radiation or drugs, multifactorial where genetic and environmental factors may interact or in many cases where causes are unknown. Problems like poor development of blood supply and circulation, due to various causes in the mother or the baby can cause poor growth, low weight and less fluid. Mother’s health issues like diabetes, hypertension and auto immune diseases can affect the foetus. Foetal medicine lays thrust on detection of problems or defects and the subsequent management and monitoring of the condition. This enables to provide the best possible outcome to these babies and allows for preventive intervention early in pregnancy. The parents are informed about the problems faced by the foetus, the possible outcomes to enable them to accordingly make choices regarding the care, besides they being mentally and financially prepared for the outcomes. The Conference highlighted the dearth of practising foetal medicine specialists in India, numbering around 4000. To bridge this wide doctor patient gap, the Conference emphasised on training foetal medicine specialists, which takes 2-3 years post masters or diploma.

The foetal medicine unit in Apollo Cradle aims to provide comprehensive care. Genetic counselling and testing forms an integral part of planning pregnancy especially in those with inherited problems in the family. Testing of pregnancies at risk of genetic problems is being done around the 3rd to 4th month by procedures called amniocentesis and chorionic villus sampling with very less risk. In babies diagnosed with severe anaemia and at risk of cardiac failure due to anaemia, intra uterine blood transfusion is being done directly into the circulation of the baby in the womb. This saves the foetus and helps it to reach a stage where it can be safely delivered and managed outside.

By Sujata