The field of maternal and foetal medicine is evolving rapidly, much to the benefit of expectant parents, who are now able to learn of potential health risks well before their babies are born.

“We’re constantly pushing the boundaries of foetal scanning,” says Dr Narina du Plessis, a maternal and foetal specialist at Mediclinic Kloof. "This means we are able to achieve clearer pictures through scans of the foetus at ever earlier stages. For example, it’s now possible to see all four chambers of a foetus’s heart at just 10 weeks.”

As exciting as these developments are, Dr Du Plessis observes that technological advancement is not enough if medical specialists are unable to interpret these scans. That’s why she’s an advocate of supplementary training to ensure all practitioners’ skills and equipment are up to date. Dr Du Plessis has undertaken such training herself, helping obstetricians to hone their ability to interpret scans during their patient’s first trimester.

“There is always something new and exciting to learn,” she says. “I enjoy sharing skills and knowledge between colleagues because it gets them excited, too – and the better the quality of the scans and our interpretation of them, the better the quality of the care we’re able to provide.”

Advisory role

Dr du Plessis explains that this is particularly important in her own field, as the patients of maternal and foetal specialists often need extra care. “Essentially, a maternal and foetal specialist is a super-specialised obstetrician who treats mothers with serious underlying conditions, such as uncontrolled diabetes, or high-risk foetuses. If you fall into this category, your gynaecologist would still be your primary caregiver, but we’d be on hand to advise about the treatment you and your baby might need, and to help plan for an optimal birth.

Imagine, for example, that your baby has growth issues. Your gynaecologist and maternal and foetal specialist will work together to determine at how many weeks you should give birth, so your baby has the best chance of a safe, healthy delivery.

Scans play a key role in this regard, as they identify potential health issues that may affect the baby. Dr Du Plessis says this is why scans are offered during the first trimester, where the goal is to identify any potential anatomical or health problems, such as chromosomal abnormalities. “We’re looking for features we always want to see, things we don’t want to miss, and things we don’t want to see,” Dr Du Plessis explains, although she cautions that it’s important for parents to have realistic expectations.

Realistic expectations

“We’d be able to detect brain abnormalities, but we wouldn’t be able to test hearing at this stage, for example. Our goal is to rule out anything that might be life-threatening or non-compatible with life, such as certain heart conditions that may threaten the baby’s quality of life or cause them to pass away shortly after birth. We can even tell parents about more minor issues, such as the existence of a club foot or cleft palate.”

Although there is no way of lessening the shock of learning about such conditions, being aware can help parents prepare or create a management plan for the baby’s birth.

Having access to such information early in the pregnancy can be very helpful, Dr Du Plessis notes, especially if parents must make decisions about the baby’s care. “Expectant mothers often experience a lot of anxiety, especially around the health of their baby. If we’re able to reassure them early on they can enjoy the pregnancy more. Conversely, if there is a problem, it’s better to know sooner rather than later.”

Dr Du Plessis is excited to see how this dynamic area of medicine progresses and is always looking to expand her own knowledge by attending conferences and networking with other professionals. “I truly value the fact that we are able to provide an extra dimension of care during pregnancy,” she says.