The Anomaly Scan at 18-22 weeks

An anomaly scan, also known as detailed morphology scan, intends to take a closer look at the baby and the uterus. 

The Fetal Medicine Specialist will check how the baby is developing plus the position of the placenta. 

Anomaly scan is often called a 20-week scan; however, a patient may have it any time between 18 weeks and 22 weeks. 

Although the main target of the scan is as mentioned above, the gender, however, may be revealed by the Fetal Medicine Specialist if desired by the patient.  By 12 weeks gestation, gender accuracy is 95% while at 16 weeks, it is 99%++.

The whole scan takes about 30 minutes for a single gestation.  The Fetal Medicine Specialist will assess the fetal organs.

Major organs are mostly checked by cross section and measured, these are:

·         

    The shape and structure of the head and brain.

·         The Face - Cleft lip and Palate are checked while focusing on the face.

·         The Spine, its length and in cross section, making sure that all the bones            align, and that the skin covers the spine at the back.

·         The Heart. Normal structure, location, normal rhythm pattern.

·         The Abdominal wall making sure it covers all the internal organs at the              front.

·         The Stomach.

·         The Kidneys, confirming that the baby has 2 kidneys and bladder is visible.

·         Fetal Extremities. Arms, Hands, Fingers, Legs, Feet, Toes

The placenta location and structure, umbilical cord and the amniotic fluid are also checked.

To see how well the baby is growing, the HC (head circumference), AC (abdominal circumference) and FL (femur length-thigh bone) measurements should match up depending on when is the expected delivery date.

Authored by Dr. Afshin PourMirza, MD, PhD

Obstetrics and Gynaecology – Maternal Fetal Medicine

Managing Director of Feto Maternal and GenetYX Center

Hereditary Breast Cancer

The body is made up of trillions of living cells. These cells grow, divide, and die in an orderly fashion. This process is tightly regulated and is controlled by the DNA machinery within the cell. When cells of the body at a particular site start to grow out of control, they may become cancerous. Cancer cell growth is different from normal cell growth. This shift from normal cellular growth to abnormal cellular growth is caused by a damage of specific genes or DNA controlling cellular division.

DNA damage known as mutation may be inherited from parents; this will result in hereditary cancer. However, it may result from spontaneous problem that occurs during the lifetime of a person. DNA damage may also be triggered by exposure to certain environmental toxins such as those present in cigarette smoke, this will result in sporadic cancer. Hereditary form often occurs earlier than the sporadic form of the same cancer.

Breast cancer follows the same rules as other cancers. BRCA1 and BRCA2 are the most common genes involved in hereditary breast and ovarian cancers. Breast cancers linked to these mutations occur more often in younger women and more often affect both breasts than cancers not linked to these mutations. Women with these inherited mutations also have an increased risk for developing other cancers, particularly ovarian cancer. Tests that measure likelihood for a disease are called “predictive genetic tests.” Testing these genes does not detect whether a person has cancer or not; it indicates whether a person carries a change in one of these genes which can increase cancer risk.

Other gene mutations can also lead to inherited breast cancers. These gene mutations are much rarer and often do not increase the risk of breast cancer as much as the BRCA genes. If you have a family history of breast cancer, you should see genetic specialist to determine your risk and to explain for you the procedure to follow to determine if you have genetic susceptibility for breast cancer.

 

For early detection of sporadic breast cancer, every female has to do self-breast examination monthly starting at 20 years old. She should have a breast exam by doctor at least every 3 years starting at 20 and every year starting at 40 years. Mammogram is also recommended every 2 years starting at 40 years.

For hereditary breast cancer genetic counselling and genetic tests are not the only things to do. The screening strategy is more frequent with breast self-exam monthly from 18 years, clinical breast exam by doctor every 6-12 months from 25 years and annual Mammography screening from 25 years or younger if family history of breast cancer before 25 as well as annual MRI screening.

Early detection is very important as it will affect treatment modalities with better prognosis and lower risk of recurrence.

Dr. Azza Abd El Moneim Attia Mohamed

French Board

Consultant Clinical Genetics

Feto Maternal and GenetYX Center

What to pack in your hospital bag before a C-section delivery

Opting for an elective c-section allows you to have more time to think and prepare what you will need to pack in your hospital bag.  

Instead of being worried and stressed, the best thing o is to ensure being prepared as you can be – and one of the things you may focus on is what to pack in your  hospital bag.

Being prepared can make all the difference to make certain your pre and post delivery experience is as smooth as possible.

Below are the top items to pack;

For mother:

• ·         A favorite pillow:  Or my "comfort" pillow
• ·         A few sets of Socks/a Cozy Blanket -  hospitals are known to be notoriously cold
• ·         A Compression binder – this can help to support the stomach muscles after surgery. These are also great to wear in the weeks following, though you may want to check this with your Physician!
• ·         Several disposable underwear (Vaginal bleeding is expected even after a c-section and disposable underwear means less fuss and more time to concentrate on your new little person).  
• ·         Slippers/flip flops – something easy to get on and off your feet.
• ·         Mobile phone – you're going to want to take lots of photos and send them to your loved ones back home
• ·         Toiletries (the usual - wash goods, toothbrush, hair brush etc)
• ·         x4 Loose long dresses
• ·         A bathrobe
• ·         Towels
• ·         A going home outfit – we recommend loose drawstring pants, a maternity bra, underwear and a loose shirt
• ·         Of course, don’t forget all your paperwork - photo ID, insurance card, medical papers/ antenatal reports etc. A file folder with  everything neatly in a clear folder to ensure everything was kept together and organized.
• ·         Other things you may wish to pack include; books, photographs of loved ones, magazines; portable devises (not forgetting their chargers/ power banks).

For your baby;

• ·         x4 receiving blankets
• ·         x4 sets baby clothes for the duration of the hospital stay – I brought stretchy onesies with snaps in front for easy diaper changes
• ·         A going home outfit ( a onesie and if his/her feet are exposed, be sure to bring a pair of socks or soft booties. I’d also recommend a soft hat – as babies can really feel the cold in their first few days).
• ·         A baby carrier (I’d recommend one which also serves as a car seat for the journey home)

Myleen R. Camama-Cerilla
Administrative Manager
Marketing Incharged
Feto Maternal and GenetYX Center

I Am Offered Screening Tests, why?

Different screening tests are offered at different times during pregnancy.  

It can be an ultrasound scan, blood test or history (clinical) based assessment. Screening is done to allow the obstetrician to categorize whether the pregnancy is at higher chance, or risk, of a problem or not.

The tests can help decide further tests and care or treatment during pregnancy or after the baby's born.  This means earlier, possibly more effective, treatment or informed decisions.   

Let's say, advanced maternal age or a history of diabetes in the family can put one at risk for high blood pressure (preeclampsia) or pregnancy related diabetes respectively.

Screening literally means recognizing people at risk. It cannot diagnose the problem. However, it can be give the signal for the need for further investigations. The downside of screening tests is it cannot detect all the conditions.  Screening tests do not give us a yes or no answer. In most scenarios, further definitive tests will be required to confirm the diagnosis.

It is very important to understand that the risk assessments are derived from population-based data and modified by the individual’s test results. Once should understand the concept and the obstetrician or Geneticist should explain this in-depth to avoid misconception.

It is all about you and your unborn baby's safety to assure a smooth journey through the pregnancy and giving both parents that peace of mind.

Dr. Afshin PourMirza, MD, PhD
Medical Director

Obstetrics & Gynaecology
Feto Maternal Medicine Specialist

www.fetalmedicine.ae

Feto Maternal and GenetYX Center