abnormalities during pregnancy
The fetus may experience formative problems during its growth period in its mother''s womb, and this is what obligated a pregnant woman to follow up regularly in the gynecology and obstetrics clinic from the moment of the discovery of pregnancy, for the early detection of any birth defects in the fetus, to take the decision to complete the pregnancy or end it. This becomes imperative if there is a previous medical history for the mother or fetus.
Heart of the fetus
I spoke to "Your Health" Professor Rima Al-Badr, Professor of Consultant Pediatrics, Pediatric and Fetal Heart, Chairman of the Second Scientific Conference of Television Filming of Fetish, which was recently held at the Saudi-German Hospital in Jeddah, and I explained that the importance of this conference is in the early diagnosis of fetal abnormalities in general, with training for pregnant mothers Awareness of the importance of the period of the first three months of pregnancy in which the fetus is formed, and is photographed from week 18-22 to discover any abnormalities, especially in the heart, that are the cause of many intrauterine deaths and miscarriages.
She added that with the technological development and manufacture of ultrasound devices, early diagnosis of malformations, especially in the cardiac apparatus, is possible starting from the 11th week, when the mother and fetus are prepared to move to the specialized center for postpartum heart surgery, and thus excluding the problems expected usually after Childbirth, and careful attention is also paid to this pregnancy to keep the fetus inside the womb for as long as possible in order for the fetus to gain more weight, and the full growth and maturity of the lung and brain.
The diagnosis of deformities in the heart early, that is, in the 18-22 week, its results differ from the late diagnosis, such as in the 31st week, for example, where it is difficult to make a decision regarding the fate of pregnancy between continuing or ending, taking into account the legal fatwa in that. Unfortunately, we in the Kingdom do not have a health system that requires the mother to work the rays at the 18th week to detect malformations early, and then the early intervention takes place.
Professor Rima Al-Bader explained that, as a pediatric and children''s heart and fetus consultant, she receives a pregnant woman referred to her from embryo clinics, radiology or gynecology when there is a suspicion of irregular heartbeat, or problems in the atria or ventricles, such as the presence of atria One or one ventricle, which is one of the serious cases that necessitates hypnotizing the child immediately after his birth in intensive care of the heart and heart surgery to make the appropriate intervention at the appropriate time, as some abnormalities prevent the continuation of pregnancy, which means the death of the fetus inside the womb, especially when there is water around the heart or lung Which makes pregnancy difficult for the mother.
The question here is: When is this child born? The obstetrician-gynecologist is the decision-maker in determining the appropriate time for delivery, and the cardiologist is the one who decides whether the fetus’s heart bears a normal delivery, otherwise it is a c-section.
"Ultrasound" examination
Dr. Rima Badros, consultant gynecologist, obstetrician, and fetus doctor at the National Guard Hospital in Jeddah spoke to one of your speakers at the conference about the stages of fetal ultrasound examination since its formation inside the womb of the mother, as the first examination begins at the beginning of pregnancy at weeks (11-14) , Where it is determined: the age of the fetus, the number of fetuses, the type of placenta, and the thickness of the fetus''s neck. It is also decided whether the patient needs to be followed up with the cardiologist and fetus. As for the second examination, it will be in the weeks (18-22 or 24), where the child''s size is monitored, the changes that occurred, and the discovery of any abnormalities in the fetus, whether in the heart or urinary tract, or the presence of hydrocephalus in the brain, or the presence of an imbalance in Chromosomes, or any other genetic abnormalities, the most common of which is Down syndrome, which requires specialized follow-up from the third month. It is also ensured that there is no need to take counseling from any other specialty, or a specific surgical intervention work report, or even termination of pregnancy, taking into account the legal opinion.
TV scans (ultrasound) of the fetus give a diagnosis of 80 per cent. If the results of weight and degree of growth in recent months are positive, then this indicates that pregnancy is normal, and follow-up is completed at the gynecologist and childbirth.
Lifetime of pregnancy
Speak to "Your Health" Dr. Ayman Abdullah Bukhari, a consultant gynecologist with a specialization in maternal and fetal medicine and television photography to follow the pregnancy. The associate professor at the Faculty of Medicine at King Abdulaziz University is one of the speakers at the conference, and he explained that the calculation of the age of pregnancy is done through the work of photography The TV show that is preferred at the beginning of pregnancy. For doctors, they prefer calculating it in weeks, because it is more accurate in determining the time for analyzes and determining diagnoses and preventing diseases, according to each period of pregnancy. If there are any problems that require surgical intervention, for example, to save the child, it is done early. As for the number of repetitions of television photography, usually two television pictures are made at least, and the treating doctor determines whether there is a need for another photography or not, according to the results and the development of the fetus’s development. Doctors must adhere to the global guidelines for monitoring pregnancy and scheduling television photography to follow the child’s development in terms of functions and fluid surrounding the child and his work when needed, because frequent photography is not desirable if the condition is normal.
And on the types of imaging, Dr. Ayman Bukhari explained that there are two types of imaging: the first is through the abdomen, and the second is through the vaginal canal, and each type has its implications. In the case of suspicion of a heart problem, for example, or other abnormalities, there are other methods and specialized devices with functions that enable you to know the situation and diagnose it in detail.
The size of the fetus
Dr. Ilham Mohamed Jalal, Consultant Gynecology, Obstetrics, and Maternal and Fetal Medicine Head of the Maternal and Fetal Medicine Unit at King Fahd Hospital of the Armed Forces in Jeddah, spoke to one of your speakers, and said that it is possible to know all the details of the fetus, in terms of size, growth and development, through examination Ultrasound during regular visits and follow-up with the doctor.
If any problem is discovered, whether in the size of the fetus or otherwise, the specialist consultant is used to clarify the reasons, and to know the steps that are taken for the fetus or the mother. Through ultrasound, all measurements are made of the fetus, such as the head circumference, the waist circumference and the length of the femur, and on the basis of which calculations are made inside the radiology apparatus, knowing the weight of the fetus in grams or kilograms, and is this appropriate for his age or not, so that all the necessary procedures for surgical intervention are done? To save the fetus.
Dr. Ilham Jalal adds that although there are genetic origins that differ from one people to another, these differences in equations and measurements are not taken into consideration as far as taking into account the global rates of all fetuses, according to each age group, and interest in the natural fetal growth within the mother''s abdomen.
As for the large size of the fetus, it is necessary to accurately calculate the gestational age through radiation during the first months of pregnancy. If it is larger than usual, we study the mother’s condition: Does she have gestational diabetes and does not know, or does she have regular diabetes and does not commit to proper treatment and food, so her blood sugar level rises and moves to the fetus, which leads to its large size? There are other possibilities for the size of the fetus, as it may have a syndrome, and therefore each case is studied separately to find out the reasons in detail.
With regard to the small size of the fetus, it must also be confirmed the age of pregnancy first, there may be a lack of accurate diagnosis because the mother did not follow up with the specialist doctor at the beginning of pregnancy, the accurate diagnosis was not made, and there are many cases where the diagnosis is made incorrectly as a result of the mother not following the doctor in Beginning of pregnancy. The second step is to do analyzes and x-rays to find out the true causes of the small size of the fetus, and whether the fetus has a problem as one of the distortions or syndromes that affect the size of the fetus or not. Third, we analyze the fluid around the fetus to find out the cause, as well as follow the umbilical cord of the fetus every two weeks during the follow-up period.
If all of this is done and there are nothing in the results that affects the fetus, we start looking at whether the mother was exposed to any external viruses that affected the size of the fetus. And if we make sure that everything is healthy, we start to follow the size of the fetus periodically every two weeks, we measure the size and follow the growth, and more importantly, we follow the integrity of the umbilical cord every week, and we follow the work of the fetus''s electrocardiogram. And if we find that the small size is fixed, we start by doing a number of tests to find out the real reasons for finding that, and does the mother have a satisfactory history, and has she ever had a previous pregnancy with the same problem? And it is decided whether she needs to interfere with an early delivery, such as a change in the umbilical cord, and the age of the fetus is taken into account, and if it does not exceed 32 weeks, this poses a risk to its health.
The minimum fetal age at which childbirth can take place is 26 weeks, and parents must be frank about all the risks to the child, and intensive care is prepared for newborns and premature infants, and the decision is taken collectively, because the child''s life during this period is in a very high risk.
