In some cases serious problems occur in the mother and/or the fetus or there is a family history of medical conditions.
The diagnosis and the management of these pregnancies often requires the collaboration of a team of doctors, each one contributing to solving their part of the puzzle in order to achieve the best possible outcome.
Examples of such cases are the following:
– A severe abnormality is suspected at the ultrasound examination of the fetus. In this case the abnormality needs to be confirmed by the fetal medicine specialist, whereas, depending on the case, further imaging techniques may be required (such as fetal echocardiography or MRI scan). Following the confirmation of the diagnosis the parents will be counselled by a doctor of the specialty that will deal with the baby’s problem after the birth to discuss the prognosis and management options. The fetal medicine expert in collaboration with the obstetrician coordinates and manages the pregnancy up to the delivery.
– The mother has a medical problem or develops one during the pregnancy, such as hypertension. In such a case the obstetrician, possibly in conjunction with another specialist, will control the blood pressure and the fetal medicine specialist will look after the fetus and decide on the timing of delivery if there are indications of growth problems.
– The couple had a previous pregnancy with a genetic abnormality and they wish to try again. The fetal medicine expert will study the findings of the previous pregnancy and may refer to a clinical geneticist to explore the risk of recurrence. He/she will also counsel on the methods of prenatal diagnosis in the next pregnancy.
The goal of counselling is to explain the problem to the couple and explore the options of dealing with it with respect to their wishes and ethics.