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Department of Radiology

Fetal Medicine Centre

Fetal Medicine

Fetal medicine is concerned with the health of the unborn baby at every stage – monitoring growth & development; predicting, detecting & managing any complications; and treating  in the womb itself.
At the KMCH fetal medicine centre , experts in maternal-fetal medicine,obstetrics , neonatology and paediatric surgery share a passion for providing exceptional, comprehensive care for mothers and babies experiencing complex fetal conditions or high-risk pregnancy.
Our team provides care in an atmosphere of compassion to help patients and families when they are in a situation dealing with difficult decisions and fears about the future.
We offer prenatal evaluation, fetal diagnosis and treatment services.
We work as a team to take you and your baby through a safe pregnancy and delivery .



Chorionic Villus Sampling

Commonly known as CVS, the procedure involves procuring a tiny bit of the developing placental tissue. This is done by inserting a needle through the mother’s tummy, uterus and into the developing placenta – all the time under the guidance of ultrasound. The procedure is generally safe: in healthy pregnancies, the procedure related pregnancy loss is less than 0.5% in experienced hands. The tissue obtained is then processed for various genetic tests according to the requirement. The most common reason for performing CVS is to rule out Down syndrome. In other instances, CVS is done to know the chromosomes of the fetus that has structural defects or to know if the fetus has the same gene level defect that is present in another family member. The test is usually performed until the 14th week after which the ‘yield’ is low.


Also referred to as ‘amnio’, is a simple procedure to obtain a small quantity  of amniotic fluid (about 20mL) by inserting a special needle through the mother’s tummy and into the uterus. The needle will always be under ultrasound guidance so that it does not harm the fetus. The reasons for performing an amniocentesis test are essentially the same as that for doing a chorionic villus sampling. The amnio test is done after 16 weeks. The safety and complications of amnio test are also similar to CVS in experienced hands. Choosing between the two tests is a matter of preference by the physician: CVS has the advantage of early testing while amnio has the advantage of being widely available due to its technical simplicity.

Fetal Blood Sampling

Testing the fetal blood directly is required in certain conditions. Commonly, when there is  accumulation of fluid inside the fetus (hydrops), fetal blood sampling  is required to find out the cause. In other situations, the reasons for testing is essentially the same as that of chorionic villus sampling or amniocentesis. Generally, when the testing has to be done beyond 20 weeks, FBS is preferred over amniocentesis.


Multi-fetal Reduction

Triplet pregnancy and higher-order pregnancies carry a high-risk of premature births, miscarriages, stillbirths and neonatal deaths. Medical or surgical interventions have not shown to be of much help in reducing the above mentioned problems. The current standard treatment to improve the outcome of such pregnancies is to ‘reduce’ the pregnancy to a twin pregnancy. However, reduction may not be acceptable to some parents. We give counseling to the  parents. Parent’s worries and concerns are addressed and then an optimal plan is fixed. When the fetuses have their own placenta each, then this reduction is done at 12 weeks using a simple technique; when the fetuses share a single placenta, then reduction is performed at 16 weeks using radiofrequency ablation technique (RFA). The procedure related loss rate after fetal reduction is about 2% when done in the first trimester and is about 10% when done in the second trimester ( RFA).

Intrauterine transfusion

It is a life saving intervention when the fetus is affected with severe anaemia. The most common situation  is when the mother is Rh negative and the fetus is Rh positive. In about 1-2% of such pregnancies, the mother will produce antibodies (attacking proteins) that will go into the blood of the fetus and cause destruction of the red blood cells of the fetus. This makes the fetus anaemic and when it becomes severe, the anaemia can be lethal for the fetus. Correction of anaemia through direct fetal transfusion is the treatment of choice. Depending on the stage of pregnancy at which the fetus becomes anaemic the number of transfusions required might change. Typically the decision to do the procedure is taken after analysing various factors including what happened in a previous pregnancy, the blood flow velocity in the fetal brain vessel, and the stage of pregnancy.

Complicated Monochorionic Twins

In about 15% of single-placenta twins (monochorionic twins), there would be serious complications affecting one or both fetuses, that if left untreated would end up damaging both fetuses. During serial monitoring of the monochorionic twins, timely identification of such complications allow us to intervene at the correct time to avoid losing both babies. The aim of the interventions is to separate the two circulations as the babies sharing the blood might cause harm to one of both of them.This can be achieved by the use of fetoscopic LASER coagulation of the connecting vessels on the surface of the placenta or by  occluding the umbilical cord of one of the fetus using  radio frequency energy. Occlusion of the umbilical cord vessels results in the demise of that fetus while protecting the other fetus and is offered when the chances of saving two fetuses are low.


When fluid collects inside the fetal thorax, it is referred to as pleural effusion or hydrothorax. This fluid collection may increase in quantity within the fetal chest causing pressure effect on the heart and the main blood vessels leading to heart failure and ultimately fetal death. In such situations, insertion of a shunt tube that drains the fluid from within the chest to the outside of the fetus (i.e. into the amniotic sac) relieves the pressure and protects the baby from dying due to heart failure.

Antenatal scans

First Trimester Screening

Prenatal screening comprises of blood tests with an ultrasound, which are done starting at 11 weeks of pregnancy and they tell you, your chance of having a baby with Down syndrome, trisomy 18 ,13 or structural abnormality. Every woman has a risk of having a baby with Down syndrome. Double marker test and non invasive prenatal screening (NIPT) are the first trimester screening tests.A screening test is offered to all women during early pregnancy to look at the risk in this pregnancy of the baby being born with Down syndrome. It is important to understand that the screening test does not give a definite ‘yes’ or ‘no’ answer as to whether or not the baby does have Down syndrome. If your screening test shows a high risk that the baby has Down syndrome, you will usually be offered a diagnostic test. These screening tests can also be utilised to get individualised chance of mother developing Pre-Eclampsia (increased blood pressure and related complications of pregnancy).

Anomaly Scan

All women, whatever their age, have a small chance of delivering a baby with structural abnormalities that cause physical or mental limitation. Many such abnormalities can be diagnosed and ruled out with the fetal anomaly scan. 
What might be seen?

Most of the serious abnormalities can be detected on a scan. However, it is not possible to detect all abnormalities.Some conditions such as cerebral palsy and autism will never be seen on a scan. The quality of  imaging depends on many factors, including the position of the baby and the physical built of the mother. For example, it will be more difficult to see the baby clearly if the mother is overweight. Some conditions, including certain heart defects and bowel obstructions, may not be seen until later in your pregnancy. And certain abnormalities can be picked up only after birth. 

Can Down syndrome or chromosomal abnormalities be seen on the scan?

 30% to 50% of cases of Down syndrome appear normal on ultrasound, only an amniocentesis (testing the fluid surrounding the baby for its chromosomes) can give you this information for certain. If any scan reveals a serious problem, we will  guide you through all the options .We will support you to give a comprehensive care with the help of obstetricians,neonatologists, paediatricians, paediatric surgeons, paediatric cardiologists/neurologists.

Growth Scan

The growth scan is typically done in the third trimester of pregnancy, i.e after the 28th week. The main objective of this scan is to assess the fetal size and growth velocity.
The scan is usually scheduled at 34 weeks in low risk pregnancy.If there are any risk factors, then the monitoring usually starts at 28 weeks.

In growth scan we look for fetal nutritional status and oxygen status.
The blood flow pattern is also assessed as part of this scan.We then check for evolving or late manifesting abnormalities,especially in brain,heart,kidneys and intestines.

Fetal Neurosonogram

It is commonly accepted that dedicated fetal neurosonography has a much greater diagnostic potential than that of the standard transabdominal examination, and is particularly helpful in the evaluation of complex malformations. However, this examination requires a higher grade of expertise.Dedicated fetal neurosonography is useful in patients with an increased risk of CNS anomalies, including cases in which the basic examination identifies suspicious findings.
The basis of the neurosonographic examination of the fetal brain is the multiplanar approach.Trans vaginal as well as trans abdominal approach can be used depending on the position of the fetus.
Fetal neurosonogram includes qualitative and quantitative evaluation of fetal head ,brain and also detailed examination of fetal spine.

Fetal echo

Fetal echocardiography is a specialized ultrasound study that focuses on the fetal heart. We look at the structure of and blood flow through the fetal heart and fetal cardiac rhythm.
Most fetal echocardiography studies are performed greater than or equal to 20 weeks of gestation for specific indications. Early fetal echocardiography may be performed between 11 to 16 weeks, and in such cases, a complete fetal echocardiogram follow-up will be recommended again at greater than or equal to 20 weeks of gestation.

Fetal MRI

With recent technological advances, fetal magnetic resonance imaging (MRI) has become a safe and efficient way to evaluate the fetal brain. Fetal MRI allows us to evaluate the fetal brain with greater detail compared to ultrasound. Because of this, fetal MRI is being increasingly performed as part of clinical care when a brain abnormality is suspected on prenatal ultrasound and/or when the fetus is at increased risk of developing a brain abnormality.
The purpose of fetal MRI is to complement an expert ultrasound examination,either by confirmation of the ultrasound findings or through the acquisition of additional information.


The Fetal medicine unit in KMCH is the brain child of Dr.Mathew Cherian with a vision to establish a self sustaining, state of the art fetal care center by inculcating ethical practice and cutting edge technology.

It was started in the year of 2018 with Dr.N .Sumathi as the lead consultant. She is a radiologist with more than 10 years of experience in the field of imaging.Her special interest is Fetal MRI.

The other 2 consultants Dr.Saira Rajan and Dr.S.Amuthavalli have finished Masters in obstetrics and gynaecology and have undergone 2 years of intensive fetal medicine training under the mentorship of Dr.S.Boopathy Vijayaraghavan who is one of the pioneers in this field.

The unit is associated with Dr.K.Manikandan who is a specialist in therapeutic fetal interventions.He brings in rich experience from his training at Mediscan systems ,Chennai and further experience from Texas Children Hospital,Houston,USA.He is also a keen researcher having specially trained in clinical epidemiology and biostatistics from HarvardX.

Prenatal genetics

Prenatal Genetics provides information about the inheritance of genetic conditions, the cause of various birth defects, and the tests that are available to determine whether an individual or couple has a chance to have a child with that condition or birth defect.We provide risk assessment and genetic evaluation in a future or current pregnancy.Prenatal genetic counseling often includes grief counseling for individuals and couples who have lost pregnancies and children with birth defects and/or genetic conditions.A detailed family history and pedigree analysis is done.Specific genetic tests are offered on case to case basis after discussing with the couple the various available testing options .

Perinatal pathology

Perinatal pathology deals with the examination of the placenta and the fetus.The fetal medicine experts work hand in hand with the pathologists for the expert interpretation of placental pathology and fetal autopsy (post-mortem)findings to provide the most accurate information possible in regards to underlying causes of poor pregnancy outcomes, causes of fetal death, recurrence risk and potential treatment options.

Health of the unborn baby at every stage

Fetal Medicine KMCH

Why choose us?

We make parenthood possible by providing a host of solutions to specific and unique concerns. At KMCH we combine our years of expertise with best in class technology to give a comprehensive fetal care to make the impossible possible.

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    • 99, Avanashi Road, Coimbatore – 641014, TamilNadu, India.
    • 0422-4324929

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    For Emergency Services, We open 24/7
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    Mon - Sat08:00 AM - 05:00 PM


    • I run a textile business where my presence is crucial. When I was diagnosed for uterine fibroids, I thought the treatment would put me to bed for a few weeks. Thanks to Dr. Mathew and the Interventional Radiology techniques, I was back on my feet on the third day, to my business as usual.

      Yamini Dhanraj
    • I had an unbearable headache and was taken to the hospital. Further investigations revealed a blood clot in the brain secondary to a ruptured AVM. My family was dependent on me, getting back to work was crucial. At KMCH Dr. Cherian and his team blocked the abnormal blood vessel without opening my brain. I was soon back to normal. The meter in my auto is running again, quicker than I thought.

    • One day strangely I felt a kind of heaviness in my bowels. I had blood pouring when I went to the toilet. Over the next few hours, I started losing huge amounts of blood every time I emptied my bowels. I was nearing death. A timely procedure done by Dr. Mathew saved my life. I imagine an open surgery would have kept me for weeks in bed not to mention the other discomforts. I was back attending my patients on the third day.

      Dr. Sriram