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Anomaly Certification - Sample Images

Blog

Blog

Key takeaways from the FMFI Research webinar on fetal growth and monitoring

Fetal growth and monitoring has always been a subject of tremendous interest
for the obstetricians ,Fetal medicine specialists, neonatologists and not to forget
-the parents!

Research from various parts of the world has provided  the much needed insight
in this aspect however published work from Indian quarters has always been a
sore point.This is especially when we have some researchers arguing that
growth is ethnicity specific with an equally vociferous disagreement.

We were however fortunate to have Dr Uma Ram and Dr Seneesh KV for the
FMFI Research Webinar on 15.01.21 who have initiated work in this field.

Dr Uma Ram presented her work on how the Diabetic foetuses have increased
subcutaneous fat at the midtrimester scan, predating the clinical diagnosis of
GDM. She also shared that these studies are now being validated as prospective
studies.

An interesting discussion by the chairpersons- Dr S Suresh, Dr Ashok
Khurana and Dr Anita Kaul was whether these findings could be integrated in
an algorithm to initiate early maternal nutrition therapy.

Dr Seneesh showcased his study, prospectively comparing different available
antenatal and postnatal growth charts.

The concluding remarks by the chaipersons emphasised the need of following up every fetus by the
drop/increase in their centiles irrespective of the growth charts that are used. In
addition, multivessel Dopplers added significant value in the decision of
delivery of a fetus that shows declining centiles.

It was a stimulating session and pushed us to think beyond the routine where a
simple additional measurement from a standard fetal plane could potentially
change the course of maternal complications. The hard work put in a
prospective study whilst doing routine clinical work to answer questions that we
come across daily but brush aside due to lack of time was equally invigorating.

We hope to collate many more such research work by Indian authors in the
times to come.

Research, such a necessity – Prof. Kypros Nicolaides

We had the history of Fetal Medicine unfolding in front of our eyes on 23rd October when Prof. Kypros Nicolaides narrated his journey over the past 30 years as part of FMF India’s research webinar series.

He gave a very personalized insight into how he observed patterns and their variations, gathered data , collaborated with like minded people and came up with algorithms for Down Syndrome screening. …and then preeclampsia, preterm births, multiple pregnancy, in utero therapy, non invasive prenatal screening ..and you name it all! His training has raised pioneers across the world and it is no surprise that his team has been at the forefront of investigating and finding solutions for almost every obstetric malady.

We feel proud that we practice evidence based medicine but he is the legend who assembled this evidence. It is his toil, hardwork and exemplary research on which the science of Fetal Medicine is based. When you hear “This one slide in my presentation is hard work of over 25 years” it makes you realise the enormity of it all.

What drives him to spend this time in research? How does he balance work, research and personal life? At the root of it all is the passion to make a difference in women’s obstetric outcome. His innovation in screening strategies using very simple markers and then motivating various research teams on finding solutions have transformed our practice.

Acknowledging the deficiencies in government’s allotment towards research activity, his charity- Fetal Medicine Foundation has donated 45 million pounds towards research in this field. He believes India has the potential and his parting words for us were “For India, the answer is collaborative research”.

Thanks to Anita Kaul for conceptualising FMF India’s Research webinar series and bringing her much beloved Professor, mentor, Kypros Nicolaides to share his passion and zeal for research and inspire others to understand why Research is such a necessity and not a luxury.

Key takeaways from the FMFI webinar on Rh isoimmunization

 – 25th September 2020.

FMFI Webinar on Rh Isoimmunization

  1. 1. Whichever lab is used for titration of Rh antibody titres, once ICT comes positive, check whether the titres are verified by Tube agglutination method rather than column method.
    Most labs have facilities for both but prefer to do the initial screening on the column method. An antibody screening panel test should be done straight away.
    Best would be that as soon as ICT comes positive to refer to a fetal medicine unit
  2. 2. The follow -up for ICT positive women is 2 weekly scans in a fetal medicine unit for MCA PSV.
    The follow-up for Rh negative, but ICT negative is ICT blood checks every 4 weeks from 20 weeks onwards, apart from the booking bloods ICT . This will avoid late referrals for blood transfusion when the fetus is already in heart failure.
  3. 3. Timing of subsequent transfusion after the initial in utero transfusion will be monitored by the cut-off of MCA PSV >1.5 MoM or rate of fall of hematocrit. Increasing the threshold to 1.69 MoMs (as suggested by a few papers) will miss a significant number of anaemic fetuses.
  4. 4. A lot of cases of isoimmunization happen even in women who have received prophylactic Anti-D injections. This could be secondary to inadequate doses, incorrect timing of prophylactic doses or faulty storage.
  5. 5. All Rh negative women who are ICT negative at 28 weeks, should receive full dose prophylaxis between 28-30 weeks and then at delivery in Rh positive babies.
  6. 6. Ideally a Kleihauer -Betke should be checked post delivery and additional doses be given if feto-maternal haemorrhage is deemed to be beyond the neutralization effects of the standard dose.
  7. 7. In peripheral areas, please check that your supplier has maintained the cold chain for Anti-D procurement and storage.

3rd Mastercourse in Neurosonography

Date: 25th & 26th April 2020
Venue: Auditorium, Indraprastha Apollo Hospitals, New Delhi

Faculty
karina
Dr. Karina Krajden Haratz
Specialist in Fetal Medicine and Fetal Neuroimaging,
Senior Consultant at the ObGyn US Unit – Lis Maternity Hospital – Tel Aviv Medical Center, Israel.
Researcher and Lecturer affiliated to the Tel Aviv University.

Target audience
Sonologists and Fetal Medicine practitioners, ObGyn Ultrasound consultants (max 20 delegates for hands-on)

Objectives
A unique 2-day intensive learning experience on Fetal Neurosonography focused on the exam technique and definition of normal imaging patterns: Hands-on training, dedicated time with expert, state-of-the art lectures, 3D practice with real-case volumes.

Programme schedule
Day 1
TIME TOPIC
8:00 Registration and opening
8:30 Physical aspects and presets for better imaging the fetal CNS
09:15 Technical aspects of the Neurosonographic exam
10:00 Neurosonoembryology
10:45 Coffee break
11:15 The lateral ventricles: developmental sonoanatomy and work-up in ventriculomegaly
12:15 Developmental sonoanatomy of the anterior complex and the CC and abnormal imaging patterns
13:45 Lunch
14:45 Live scan 1
15:15 Group hands-on training
Day 2
TIME TOPIC
8:00 Developmental sonoanatomy of midbrain-hindbrain structures and the differential diagnosis of MB-HB anomalies
09:30 3D neurosonography – tips and tricks
10:15 Coffee break
10:45 The fetal brain parenchyma and cortex – normal development and patterns of disease
12:00 The brain vasculature and congenital vascular malformations.
13:00 Lunch
14:00 Live scan 2
15:00 Alternate groups – hands on / 3D practice

 
Registration Fees :

  • 32000 INR for theory with hands-on practical
  • 17000 INR for only theory

*Delegates appearing for practical session need to submit documents of their degree, med council reg and affidavit.

PAYMENT OPTIONS:

1. Bank Transfer to A/c No: 03192560004661; HDFC Bank, South Extension Branch, New Delhi; IFSC Code: HDFC0000319
2. Post Cheque in favour of “Fetal Medicine Foundation,India” to:
Apollo Centre for Fetal Medicine,
Gate No:7, Indraprastha Apollo Hospitals , Sarita Vihar, New Delhi,110044

For Programme Queries, Contact:
Dr Rachna Gupta, General Secretary: 09899294499
Dr Akshatha Sharma, Programme Coordinator : 09891494545
Dr Anita Kaul : 9811100511 anita_kaul@apollohospitalsdelhi.com

For Registration, PCPNDT, Payment details, Contact:
Himanshi: 09560127575, 011-29873018, 011-29873056 or write to fetalmedicine@apollodelhi.com

2nd Mastercourse in Neurosonography

karina

Date: 21st & 22nd September 2019
Venue: Auditorium, Indraprastha Apollo Hospitals, New Delhi

Faculty
Dr. Karina Krajden Haratz
Tel Aviv Medical Center / Wolfson Medical Center

Target audience
Sonologists and Fetal Medicine practitioners, ObGyn Ultrasound consultants (max 20 delegates for hands-on)

Objectives
A unique 2-day intensive learning experience on Fetal Neurosonography focused on the exam technique and definition of normal imaging patterns: Hands-on training, dedicated time with expert, state-of-the art lectures, 3D practice with real-case volumes.

Programme schedule
Day 1
TIME TOPIC
8:00 Registration and opening
8:30 Physical aspects and presets for better imaging the fetal CNS
09:15 Technical aspects of the Neurosonographic exam
10:00 Neurosonoembryology
10:45 Coffee break
11:15 The lateral ventricles: developmental sonoanatomy and work-up in ventriculomegaly
12:15 Developmental sonoanatomy of the anterior complex and the CC and abnormal imaging patterns
13:45 Lunch
14:45 Live scan 1
15:15 Group hands-on training
Day 2
TIME TOPIC
8:00 Developmental sonoanatomy of midbrain-hindbrain structures and the differential diagnosis of MB-HB anomalies
09:30 3D neurosonography – tips and tricks
10:15 Coffee break
10:45 The fetal brain parenchyma and cortex – normal development and patterns of disease
12:00 The brain vasculature and congenital vascular malformations.
13:00 Lunch
14:00 Live scan 2
15:00 Alternate groups – hands on / 3D practice

Registration Fees :
32000 INR for theory with hands-on practical
17000 INR for only theory 

*Delegates appearing for practical session need to submit documents of their degree, med council reg and affidavit.

PAYMENT OPTIONS:

1. Bank Transfer to A/c No: 03192560004661; HDFC Bank, South Extension Branch, New Delhi; IFSC Code: HDFC0000319
2. Post Cheque in favour of “Fetal Medicine Foundation,India” to:
Apollo Centre for Fetal Medicine,
Gate No:7, Indraprastha Apollo Hospitals , Sarita Vihar, New Delhi,110044

For Queries Contact: Dr Rachna Gupta, General Secretary: 09899294499 Dr Akshatha Sharma, Programme Coordinator : 09891494545 or write to fetalmedicine@apollodelhi.com

Email: anita_kaul@apollohospitalsdelhi.com

Registration for Hands on course is now closed. You can still register for Theory course

Download PDF

Download Affidavit

Role of accredited biochemical reagents in aneuploidy and pre-eclampsia screening

Role of appropriate NT (nuchal translucency) measurement in aneuploidy screening is well established. Deviation of standard deviation and median NT from that expected, reduces the detection rates and hence continuous auditing of NT measurements is essential for quality assurance (Kagan et al. Ultrasound Obstet Gynecol 2009; 33: 657 – 664).

Similarly, it is important that laboratories analysing biochemical markers for aneuploidy and pre-eclampsia screening, also follow the same stringent criteria which was used during the research to develop the algorithm for screening test. It is necessary that when FMF algorithm (software) is used to calculate the risks, the laboratories should:

  • Use FMF accredited reagents (Delfia, Roche or Kryptor)
  • Ensure internal audits and controls
  • Submit their results for auditing to an external agency like UKNEQUAS for quality assurance.

Deviation from expected MoMs will reduce the detection rates for condition being screened and the efficacy of the test.

Everyone who is offering first trimester screening tests should understand the nuances of the tests being offered and ensure strict adherence to the quality of the tests being done. As an obstetrician, one should ensure NT is measured by FMF certified operator who uses the FMF risk calculation software and biochemical tests are done by laboratories fulfilling the above criteria.

FMFI North East Symposium



Workshops 1 & 2
Venue: Gauhati Medical College & Hospital
First Trimester 11-14 weeks Workshop
TIME TOPIC
8.30 am Registration followed by Tea
8:45 am Welcome Dr Alakananda Das
9:00 am – 9:45 am Technique for NT + CRL, how to get it in 15 mins.
Live Demo
Audience Interaction
Dr Rachna Gupta
Dr Rachna Gupta/ Prof Ashish K Bhattacharjee
9:45 am – 10:30 am Biochemical markers in First Trimester (Case based discussion)
Audience Interaction
Dr Anitha Shettikeri
10:30 am – 11:00 am Concepts of Risk Calculation
Audience Interaction
Dr Anita Kaul
11:00 am – 11:20 am Tea Break
11:20 am – 12:15 pm First Trimester Anomaly Screening – Always detectable 9
Videos + LIVE DEMO including for Uterine arteries
Dr Prathima Radhakrishnan
Dr Prathima / Dr Shyam Baruah
12:15 pm – 12:45 pm PET Screening – How to make sense of markers Prof Manisha Kumar
12:45 pm – 1:15 pm Multiple Pregnancy – Identifying Risks in First Trimester Dr Akshatha Sharma
1:15 pm – 2:00 pm LUNCH
Intrapartum Monitoring Workshop
TIME TOPIC
2:15 pm – 2:45 pm How to use CTG Dr Jyoti Bhaskar
2:45 pm – 3:15 am How to triage low risk / high risk cases in early labour
-Using Whiteboards
-Concept of Helicopter view
Dr Surabhi Nanda
3:15 pm – 3:45 pm Partogram – how to effectively use it in a busy govt labour room Prof Manju Puri
3:45 pm – 4:15 am Case based discussion – labour room crisis, intrapartum monitoring in multiple pregnancy Dr Surabhi Nanda
4:15 am – 4:30 pm TEA BREAK
4:30 pm – 5:00 pm Role of midwives in reducing intrapartum stillbirths Dr Evita Fernandez
5:00 pm – 5:30 pm Intrapartum Sonogram Dr Surabhi Nanda
5:30 pm – 6:00 pm Shoulder dystocia drill Dr Jyoti Bhaskar, Prof Manju Puri, Prof Manisha Kumar


International Faculty

Dr Surabhi Nanda
Liverpool, UK

National Faculty
Dr Akshatha Sharma
New Delhi
Proof Deepike Deke
Guwahati
Prof Mandakini Pradhan
Lucknow
Dr Prashanta Deke
Arunachal Pradesh
Prof Alakananda Das
Guwahati
Dr Evita Fernandez
Hyderabad
Prof Manju Puri
New Delhi
Dr Prathima Radhakrishnan
Bangalore
Dr Anita Kaul
New Delhi
Dr Indra Kumar Singh
Mainpur
Dr Manjima Baishya Ganguly
Guwahati
Dr Rachna Gupta
Sonepat
Dr Anitha Shettikeri
Bangalore
Prof Gokul Chandra Das
Guwahati
Prof Manisha Kumar
New Delhi
Prof R K Talukdar
Guwahati
Dr Apurba Bhattacharya
Guwahati
Dr Jina Bhattacharya
Guwahati
Dr Meenu Agarwal
Pune
Dr Satyajit Chowhan
Guwahati
Dr Arun Madhab Barua
Dubrugarh
Dr Jyoti Bhaskar
New Delhi
Dr Nabanita Deke
Guwahati
Dr Saket Thakar
Kolhapur
Prof A K Bhattacharjee
Guwahati
Dr Mainka Aggarwal
Shilong
Dr Parul Dutta
Guwahati
Dr Shyam Baruah
Guwahati
Dr Sujata Bhat
New Delhi
Registration
Date Programme TYPE Till 7th March 2019 8th March Onwards
16th March Workshops 1 & 2
-11-14 Weeks, The First Trimester Scan
-Intrapartum Monitoring
Rs 1500/- Rs 1875/-
16th March Workshop 3
Anomaly – Theory Only
Rs 2500/- Rs 3125/-
17th March CME Rs 1800/- Rs 2250/-
Combo offer Workshops 1 & 2 + CME Rs 3000/- Rs 3750/-
Combo offer Workshop 3 + CME Rs 4000/- Rs 5000/-
Sponsors

Payment Details
Cheque, DD, Bank transfer to “Fetal Medicine Foundation India
Bank A/c no: 03192560004661 IFSC Code: HDFC0000319 HDFC Bank, South Extension
Branch, New Delhi. Mail cheques/DD to secretariat address mentioned below ;

Conference Secretariat
Dr Anita Kaul
Apollo Centre for Fetal Medicine
Gate No 7, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi – 110067
Phone: 9811100511, 9560127575, , Email: anita_kaul@apollohospitalsdelhi.com
Dr Rachna Gupta M: 9899294499 Dr Akshatha Sharma M: 9891494545

Download PDF

Organising Team
Organising Chairperson
Dr Anita Kaul
Organising Co-Chairperson
Dr Prathima Radhakrishnan
Organising Secretaries
Dr Rachna Gupta
M: 9899294499
Dr Akshatha Sharma
M: 9891494545
LOC Chairpersons
Prof Alakananda Das
Prof Ratna Talukdar
LOC Secretary
Dr Nabanita Deka
Apollo Centre for Fetal
Medicine Help Team

Bhawna, Himanshi
Cox n Kings Team
Carolina Fernandes
Deep Kumar Yadav