Foetus as a patient

October 10, 2018 0 By CH Unnikrishnan

Principles and Practice of Fetal Medicine By Raju R Sahetya, Jaideep Malhotra & Hema Purandarey pp381 Jaypee Brothers

The prevalence of genetic diseases and birth defects in India is far higher than what is apparent on casual observation. Advances in genomics and growing awareness would certainly help to fathom the situation better. Still, since genetic disorders are multisystem and lifelong, genetic services alone won’t entirely suffice. The efforts should be integrated with related medical services like prenatal health, preconception planning, child development monitoring etc..

This is where the emerging discipline of Foetal Medicine achieves greater importance. The scope of prenatal diagnosis, through the last four decades, has increased from routine to predictive diagnosis of disorders that are likely manifest later in life.

Principles and Practice of Fetal Medicine,  authored by Raju R Sahetya, Jaideep Malhotra and Hema Purandarey, presents an extensive discussion of the rapidly expanding field of prenatal and perinatal diagnosis and treatment.

Spread across forty-three chapters covering every aspect of foetal medicine, the book forms a major source of reference and guidance to a wide range of professionals.

Starting with an overview of prenatal diagnosis, the ten sections of the book give in-depth insights into prenatal counselling, invasive and non-invasive prenatal screening and diagnostic techniques, lab techniques on genetic testing and pre-implantation diagnosis, antenatal use of foetal therapy, prenatal foetal surgery, ethical and medicolegal aspects and the future of prenatal diagnosis.

The concluding section of the book offers good practice guidelines recommended by the International Federation of Gynaecology and Obstetrics (FIGO) and best practice advice on maternal-foetal medicine.

These sections, coupled with more than 350 clinical photographs, tables, illustrations, figures and charts, make Principles and Practice of Fetal Medicine a ready-reckoner and a handbook of choice for obstetricians, geneticists, genetic counsellors, ultrasonologists, paediatricians and lab technicians.

The authors, after providing brief historical and contemporary perspectives, attempt to trace the influence of genomic medicine in pregnancy management and pregnancy outcome in coming days.

Emphasising the need for an ”energetic shift” in the research focus on prenatal screening and diagnosis, they call for an expansion of all future studies to include therapeutic strategies.

Although the ultimate objective of the book is to promote improved clinical management of pregnancies affected by an anomalous foetus, the immediate goals include better detection, diagnosis and understanding of ”the Foetal Medicine and foetus as a patient”, as the authors state in the preface.