Definition and Overview
A prenatal fetal consultation is an appointment between a prenatal specialist or an obstetrician and a pregnant woman to check the condition of the fetus in the womb. This is very helpful for all expecting mothers who want to ensure the health of their unborn baby. At the end of the consultation, they will find out if the fetus is in good condition or if there is anything to be concerned about, such as a birth defect or a serious illness. In such cases, the mother will be referred to neonatologists to discuss treatment options and recommendations. This consultation allows expecting parents to plan for their child’s treatment, if necessary, even before birth.
Who Should Undergo and Expected Results
A prenatal fetal consultation is highly beneficial for any pregnant woman but is strongly recommended for expectant mothers who meet certain risk factors that increase the possibility of the unborn baby developing certain illnesses or defects.
The risk factors associated with birth defects and illnesses include:
An existing illness in the mother
* Diabetes and other metabolic diseases
* Infectious diseases such as hepatitis and HIV/AIDS
* Blood disorder
* Platelet alloimmunization
* Kidney disease
History of inherited disorders in the family, such as: * Cystic fibrosis * Huntington’s disease * Sickle cell anemia * Cardiac disease * Renal disease * Gastrointestinal disease
* Family history of birth defects * Multiple gestations * Previous pre-term labor, cervical dilatation, or delivery * Previous pregnancy loss or a history of miscarriage/s * Existing children with genetic disorders
A pregnant woman should also undergo a fetal consultation if there is any reason to suspect a fetal anomaly. Signs of an abnormal development include:
- Abnormal fetal growth rate detected during regular prenatal appointments
- Fetal growth restriction, or when the fetus is too small
- Macrosomia, or when the fetus is too large
At the end of a prenatal fetal consultation, the mother will be told about what possible tests can be performed to come up with a fetal diagnosis. This way, she and her partner can discuss the options that are available to them.
How the Procedure Works?
A prenatal fetal consultation is usually scheduled upon the request of a pregnant woman with concerns over her fetus’ health but is also sometimes requested by the patient’s attending obstetrician. The consultation takes place at the clinic of the prenatal specialist and usually lasts for an hour.
The consultation will involve a series of steps, namely:
- Review of medical history
- Review of family history
- Physical examination
Ultrasound (in some cases)
If there is reason to suspect a genetic condition, the consultation will be followed by some special tests, which may include:
AFP blood test (alpha fetoprotein) – This can detect neural tube defects.
- Antenatal serum screening – This can detect chromosomal abnormalities such as Down syndrome.
In utero therapeutic techniques – These are fetal testing procedures that are more invasive and performed on the fetus while inside the womb. Some examples include:
- Blood sampling
- Blood transfusion
- Platelet infusion
- Fetal bladder stent placement
- Chorionic villus sampling
- Fetal MRI
- Fetal echocardiogram
These tests are usually not performed during the same appointment and may be performed by different specialists. During the consultation, however, the pregnant woman can ask any questions she might have about these tests so she can prepare ahead of time.
Nowadays, prenatal specialists can detect a large number of conditions that present before birth. Some of these possible complications include: * Gastroschisis, a type of abdominal wall defect * Brain malformation * Cleft lip and palate * Congenital heart disease * Intestinal atresia * Lung lesions * Skeletal abnormalities * Renal abnormalities * Neural tube defects, such as spina bifida
If it is confirmed, through tests, that there is indeed a disorder or defect, the parents can consider their options and start planning for the medical care and home care of a child with special needs. The possibility of treating the fetus as well as the expected outcomes of treatments may be significantly improved by detecting the problem early. In addition, with the knowledge of any existing fetal condition, the pregnant mother and her doctors can take the said condition into consideration in the management of the pregnancy as well as during labor and delivery.
Possible Risks and Complications
During the consultation, the pregnant mother will not undergo any procedure. Thus, there are no possible risks and complications.
However, the consulting physician may order some tests to be performed at a later date.
Cunningham FG, Leveno KJ, Bloom SL, et al. Fetal growth and development. In: Cunningham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 23rd ed. New York, NY: McGraw-Hill; 2010:chap 4.
Ross MG, Ervin MG, Novak D. Placental and Fetal Physiology. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 2.