1,32 CME

Fetal Medicine Cases, Spot the Diagnosis & Management

Conférencier: Dr Samina Dornan

Anciens élèves du Collège royal des obstétriciens et gynécologues

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Description

Fetal medicine specialists assess ultrasound findings to identify NTDs, such as spina bifida, and collaborate with multidisciplinary teams for surgical interventions and postnatal management. Down Syndrome (Trisomy 21): Using advanced imaging techniques and genetic testing, fetal medicine experts can detect markers for Down syndrome, allowing for early diagnosis and comprehensive counseling regarding management options. Intrauterine Growth Restriction (IUGR): Monitoring fetal growth through ultrasound helps identify IUGR cases, and management strategies may include close fetal surveillance, Doppler studies, and timely delivery when necessary. Congenital Heart Defects: Fetal echocardiography plays a crucial role in spotting congenital heart defects, enabling early intervention planning and coordination with pediatric cardiologists for postnatal care and many more

Résumé

  • The speaker emphasizes the importance of accurate dating in pregnancy to reduce complications and deliver babies on time, highlighting the need for scans to measure crown-rump length for accurate dating, especially in early pregnancy. Good quality images, where the entire crown-rump length is visible and appropriately sized, are crucial for accurate measurements.
  • The session moved on to nuchal translucency scans, highlighting the importance of a neutral head position and a clear view of the membrane for an accurate reading. She pointed out the importance of a neutral position and the visibility of key features like the bum.
  • The speaker showed images of a baby with an NTD, a defect in the posterior part of the fetal brain, along with increased nuchal translucency and a dirty amniotic fluid. She also cautioned against performing NIPT tests too early in pregnancy, emphasizing the importance of a 12-week scan to assess the baby before opting for NIPT. She advises against relying on NIPT results obtained too early due to the lower fetal fraction at 9-10 weeks.
  • The speaker highlights that not all Down syndrome babies show ultrasound features. In addition, they present some images of a twin pregnancy, including monochorionic twins with cord entanglement and discuss the stages and management of twin-twin transfusion syndrome (TTTS), emphasizing the best time for referral and intervention.

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