Detecting abnormalities of the fetus

The growth of various parts of the baby takes place at different rates (Fig. 4.8); hence harmful substances may affect a variety of organs, depending on the stage of pregnancy.

There are now a whole range of tests available for pregnant women, to assess the risks of the baby having an abnormality. While certain abnormalities can be diagnosed, there is always a margin of error. No test is 100% accurate. Nor does diagnosis in any way mean that a condition can be rectified. Often there is nothing a woman can do apart from use the option to terminate. For this reason, antenatal tests should perhaps be carried out only if the mother is sure she knows what she would do. If having a termination is not an option, there is little point in having the tests done.

For example, more women are opting to have the nuchal translucency test done to detect for Down's syndrome (see below; also Cuckle & Wold 1990). This is done early in pregnancy but is by no means 100% accurate. By the time a woman has had the AFP (alpha-fetoprotein) test done, she will be 15 weeks' pregnant. It takes a further 2 weeks for the results to come back and if these are abnormal, she is then faced with having an amniocentesis. Again she will have a 2-3-week wait, by which time she will be able to feel the baby moving inside her. By now she will undoubtedly be worried sick and very stressed. If she does decide to terminate the pregnancy, she will be between 18 and 22 weeks' pregnant. Termination at this stage means going through a mini labour.

Antenatal tests are not obligatory. If a woman does decide to have them, it is a good idea for her to explore all the possibilities and alternatives first.

Figure 4.7 Antenatal handheld records.

SIGNATURE

H.

H.

H.

JS

REMARKS

u/s arranged 1/// to check maturity

taking iron

NEXT VISIT

20/7

2G/S

1//9

1//1G

HB

12.G

11.2

OEDEMA

I

I

I

I

FETAL HEART

I

FMP

FHH

H

REL PP TO BRIM

HEIGHT FUNDUS

m

1S-2G

2G-22

24-26

LIE & PRES

I

I

I

I

12

5/ 12

O OC m Q-

'E

'E

'E

'iE

RINE KET

'E

'E

'E

'iE

C5 D 0)

'E

'E

'E

'iE

WEIGHT

58 kg

59.2 kg

61 kg

64 kg

WEEKS

m

S

2 2

6 2

DATE

15/6/0/

2G///G/

2G/S/G/

1//9/G/

Figure 4.8 Embryonic and fetal development.

Central nervous system Face Ears Eyes Palate Arms and legs Hands Heart Gut Kidneys Genitourinary system

Baby Vagina

Number of weeks from conception

Figure 4.9 Measurement of the nuchal fold thickness and the appearance of the cerebellum dumbbell-shaped ventricles. (Reproduced with permission from Symonds & Symonds 1997.)

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