#HEALTH: Detecting foetal anomalies

A HEALTHY normal baby is every parent's wish, but the reality is that it doesn't happen with every pregnancy.

Problems can and do happen, and it's heartbreaking for couples to discover that their unborn child has an abnormality.

These days, with antenatal screening being more sophisticated than ever, even subtle foetal anomalies can be picked up.

An anomaly scan is usually done when the foetus is around 20 weeks old, says Dr Nada Sudhakaran, consultant paediatric general and urology surgeon at Pantai Hospital Kuala Lumpur.

"Over the last 15 to 20 years, given that ultrasonic diagnosis of antenatal conditions has become more impressive, we are able to identify many more abnormalities. We can even detect subtle abnormalities, anywhere, from the face to the leg," says Dr Nada.

Some of these conditions are treatable even before the baby is born, while others would require intervention after birth.

Dr Nada says some babies may have cysts in the head and others may have it in the neck, causing compression to their airways. Cysts in the chest or within the lungs, may also be possible and can be detected through anomaly scans.

A foetus may also have anomalies with its fingers, such as joined or webbed fingers or abnormalities of the private parts.


Dr Nada says preparing would-be parents to accept such news is crucial, and counselling is important to help them cope with the situation and to better understand the challenges their child may face, and what can be done to overcome the problem.

If the problem is linked to a genetic condition, the information will be invaluable to the couple when planning for a subsequent pregnancy.

Dr Nada says naturally, most parents react with shock and stress when such news is broken and sadly, some conditions can be so severe that there is no chance of the foetus surviving. This includes anencephaly, where the foetus does not have parts of its skull and brain.

In most cases, these abnormalities happen naturally, although in some rare instances, it may be linked to the child's family history.

"If a foetus has three or more abnormalities it's noted as a syndrome and usually associated with or linked to the family," says Dr Nada.

Mothers can pass on certain diseases to their unborn children too. For example, if the mother has Hirschsprung's disease, an abnormality of the intestine, there's a higher chance of her child having it too.

The prevalence of foetal anomalies hasn't increased in recent times, says Dr Nada despite many people assuming that modern lifestyles and imbalanced diets are contributing to the rise in such conditions.

Better awareness and routine screening during pregnancy means more cases are being picked up now compared with before.

The good news is that in many cases, foetal anomalies can be corrected upon birth and the child can go on to have a normal life.


FOETAL anomalies can be either structural or functional.

Dr Nada says structural anomalies can often be seen in antenatal scans and functional ones are generally diagnosed after the child is born.

For example, problems with the bowel, kidney and bladder are usually detected a few days after birth.

Correcting these problems requires surgery and naturally, most parents fret over the idea of their vulnerable infants having to go under the knife.

What's important, says Dr Nada, is for parents to know that many of these abnormalities can be corrected today with a keyhole surgery approach.

This offers faster recovery, reduced hospital stay, less pain and stress for the young child, and less scarring or deformity post surgery.

Most of these surgeries also have a lifelong effect so the child is able to function normally once the problem has been corrected.

"As long as there's an ability for us to fix the problem, we can proceed and this offers hope to parents."

Depending on the condition, some abnormalities would need surgical intervention as soon as the child is born, while others may require surgery when the child is older, about 8 to 9 months old.

Dr Nada says the good news is that babies recover fast and with keyhole surgery, their outcome today is much better than before, enabling these children to experience healthy, normal lives.

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