Antenatal surveillance of fetal growth is an essential part of good maternity care, as lack of detection of fetal growth restriction is directly associated with stillbirth and perinatal morbidity. New algorithms and guidelines provide care pathways which rely on regular third trimester ultrasound biometry and plotting of estimated fetal weight in pregnancies considered to be at increased risk, and their implementation has increased pressures on ultrasound resources. Customised growth charts have improved the distinction between constitutional and pathological smallness and reduced unnecessary referrals.
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.
Most serious abnormalities can be detected on a scan. However, it is not possible to see all problems. 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 size of the mother.
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.
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Although pulmonary medicine only began to evolve as a medical specialty in the 1950s, William Welch and William Osler founded the ‘parent’ organization of the American Thoracic Society, the National Association.