Fetal pathology
What is fetal medicine?
Approximately 3-4% of pregnancies are associated with a fetal defect. It can be a malformation (such as heart disease, or spina bifida), a chromosomal defect (eg Down syndrome) or other fetal disease (such as infection or intrauterine growth retardation). In addition, there is a further 4-5% of pregnant women at high risk of having a fetus with a severe problem. This happens in a twin pregnancy, in women with a family history or a previous child with a birth defect. All of these problems is what we call fetal medicine.
How I can know if my baby has a problem?
The main diagnostic technique during pregnancy is ultrasound. Depending on the country, two to three routine scans are performed throughout a normal pregnancy. But there is a high risk for whatever reason, of there is a problem detected in a routine ultrasound, other tests may be necessary. The most frequently used are amniocentesis or chorion villus sampling to rule out chromosomal problems, and echocardiography to rule out fetal heart problems. There are also other techniques, such as neurosonography for diagnosing brain problems, and MRI or fetal blood tests.
These techniques allow many parents to be reassured that their baby is normal. In others they help knowing about a problem long before birth. This information helps the family and doctors to make decisions about the best option.
What I can do if my baby is diagnosed with a problem?
The diagnosis of a problem before the baby is born allows doctors to conduct closer monitoring, perform additional testing and planning carefully the timing and mode of delivery. With the information at hand, doctors discuss with parents all the implications that the defect may have, as well as any treatment options.
The majority of cases have a good outcome if they are correctly diagnosed prenatally and treated after birth. A small group will benefit from fetal therapy, i.e. treatment before birth. Unfortunately, sometimes the fetal condition is incurable. If parents choose to not continuing with pregnancy doctors will offer the best psychological and medical support.
When, how and where will be the delivery, if my baby has a problem?
In general, for most defects babies can be born at term by vaginal delivery. In some cases it may be necessary to deliver earlier or to perform a caesarean section
Depending on the type of anomaly, delivery could take place in the usual hospital. If the baby may need specialized care immediately after birth, we may need to arrange delivery in the Hospital Clinic.
What can we offer in our Fetal Medicine Center Barnaclínic?
All these pregnancies, which together affect at least 10-15% of the total, require specialized medical care and state of the art medical technology. The level of excelence and critical mass of doctors required to achieve high level fetal medicine and therapy is only available in a handful of centers in Europe.
Our center covers all the spectrum of diagnostic techniques and treatments available today, and we provide support for post-natal follow up as well.
The Department has subspecialists in all areas of Maternal-Fetal Medicine. All are Consultants to the Fetal Medicine Department of Hospital Clínic and have national and international reputation. We are among the largest fetal surgery centers in the world, with more than 150 interventions yearly. Our doctors have pioneered the introduction of fetal surgery in Spain and Europe.
