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Anomaly Certification - Sample Images

Blog

Jaipur outreach programme on First trimester screening

FMFIndia’s 2017 calendar began on the festive Makar Sankranti/ Pongal/ Bihu weekend with its Jaipur outreach programme on 15th January at Orchid Women’s Hospital & Fetal Medicine Centre.

FMF-India trainers, Dr Akshatha Sharma, Dr Rachna Gupta and Dr Karuna Mandal, interacted with group of OBGYNs and sonologists from in and around Jaipur (Sikar, Kota, Alwar, Chomu, Bikaner).

The highly interactive session saw;

– Queries regarding biochemical screening and problems in patient counselling.
– Discussions on how to implement FTS protocols in remote areas, and training in first trimester scan.
– In-depth discussions on prediction & management of Fetal growth restriction, topic which is very dear to obstetricians to prevent perinatal mortality.

The live demo session covered settings of ultrasound machines and technique of scanning in various stages of pregnancy.

The registrants asked for more such programmes to be held in future which we will definitely plan.

FMF India’s Outreach programme in Kashipur

Kashipur outreach programme held on 20th Nov 2016, was conducted in association with Kashipur OBGYN society, faculty being Dr Anita Kaul, Dr Chanchal Singh, Dr Rachna Gupta and Dr Bharti Pant Gahtori.

With excellent brain storming from Dr Bharti, our local organiser, workshop was divided in two sessions. Morning session focussed on obstetricians – covering first trimester screening for aneuploidies as well as perinatal complications, diagnosis and management of fetal growth restriction and case discussions. Afternoon session focussed more on antenatal scanning skills and there was live demonstration of cases for first trimester screening, anomaly scan, fetal growth parameters and Dopplers.

There was positive feedback with this approach and we thank Dr Bharti for her efficient organising skills and hope she joins our team of trainers in the near future.

Faridabad outreach programme

Faridabad outreach programme conducted in association with FOGS by Dr Anita Kaul, Dr Rachna Gupta and Dr Nidhi Arora on 29th September, 2016 was attended by almost 100 delegates, mostly OBGYNs.

The programme was an eye opener in the sense that we need to address the learning objectives of obstetricians and sonologists differently. We realised that obstetricians are more interested in clinical and counseling aspect of scan findings rather than technique of scanning. Case based discussions were well received by the audience with active interaction. Obstetricians also clarified their doubts on management of various cases they had come across.

As a result of the feedback future programmes will be split between topics of interest to the obstetricians during the first half followed by dedicated teaching to the ultrasonologists only in the second half

Congratulations Dr Vimla Dahiya from Sonepat!

We are proud of Dr Vimla Dahiya, obstetrician from Sonepat, who after attending FMFI outreach programme held in Sonepat on 7th Feb 2016, was determined to get her FMF-UK certification, and with persistence and guidance from Dr Rachna Gupta (sec, outreach programme) obtained the certification on 7th Oct 2016. We expect more and more people to achieve this, to bring uniformity and quality to nuchal scans, which is the aim of our outreach programmes.

vimla-dahiya-certi

First trimester screening, outreach programme, Panchkula

FMFIndia conducted another successful outreach program at Paras Bliss Hospital in Panchkula on 29th May 2016.

Dr Anita Kaul ably supported by Dr Rachna Gupta, Secretary, Outreach Programme, aims to propagate the foundation’s mission of delivering high quality training of fetal diagnostic skills to medical professionals all over the country. Panchkula was the 3rd leg of Plan-2016 to cover tier-II and tier-III cities across India.

The outreach programme saw enthusiastic discussion on how to make Combined First Trimester Screening (NT with Dual marker test) feasible and universally applicable in clinics and government hospitals and the important role that obstetricians can play in ensuring Sonographers do the NT scan as per FMF UK standard. Special thanks to Dr Rashmi Bagga and Dr Alka Sehgal, for their valueable inputs and feedback, it really made the outreach worth its idea.

The programme covered all aspects of First trimester scan including combined screening, anomalies, screening for preeclampsia, multiple pregnancy, impact being enhanced with live demonstration and MCQ discussion.

The FMFIndia team is thankful to Dr Nupur Shah, Dr Rishi Mangat and the entire Paras Bliss management team for a stellar programme.

Webinar on 2nd trimester minor markers for aneuploidies – confusion to clarity

Date: 3 april 2016
Time: 10.30 am

This session will be useful for practitioners who deal with counseling patients regarding the findings of the second trimester fetal ultrasound scan.

Minor markers for fetal aneuploidies form a major cause of anxiety in patients and consultants alike. These markers may be variations of normal anatomy if not associated with aneuploidies. However, the call of whether or not to investigate further for fetal aneuploidies and how to follow up these cases through pregnancy is ridden with tremendous confusion. The aim of this session will be to clarify these issues.

Dr.Chinmayee Ratha, an FMF-UK accredited faculty will conduct the one-hour lecture. Dr Ratha works as a Lead Consultant – Fetal Medicine with Navodaya Hospitals, Hyderabad. There will be short MCQ during the lecture on what you have learnt. You will also have the opportunity to interact with the speaker and clear your doubts at the end of the lecture.

Second-trimester-anomaly-scan-level-11-scan

FMFI conducted a Nuchal Scan outreach programme at Sonepat on the 7th Feb 2016

This was part of the mission statement of FMFI to enhance scanning skills in the periphery.

The interaction was particularly good between the attendees and the FMFI faculty as the Chief Guest Dr J S Punia could give feedback on the problems faced at the government hospital level in implementing the NT programme.

It is clear that although the gold standard of screening is the combined test using FMF software and accredited labs, this may be a bit difficult to implement at a government hospital level. Dr Punia was pleasantly surprised to learn that a number of fetal abnormalities can be picked up at the First trimester scan and requested the FMFI team to give hima document of the “always detectable 9” structural abnormalities that should not be missed on the scan.This along with a correctly taken CRL and NT should constitute the absolute minimum requirements of scanning at the peripheral level.

FMFI will be preparing this document and will be interested in overseeing its implementation at a district hospital level

Minimum requirements of the First trimester scan at the Peripheral level

  1. Correctly taken CRL
    crl
  2. Fetal heart rate
  3. Nuchal translucencynuchal
  4. Check of the anatomy

Always detectable anomalies in first trimester:

  1. Body stalk anomaly
  2. Acrania
  3. Iniencephaly
  4. Encephalocele
  5. Exomphalos
  6. Gastroschisis
  7. Alobar holoprosencephaly
  8. Megacystis
  9. Limb reduction defects

Webinar on Setting up of 12 weeks Fetal Wellness clinic

Date: 17 October 2015
Time: 1.30 pm – 2.30pm

This certification is for centres who are regularly providing patients with

  • Aneuploidy Risks using the FMF software
  • Risk stratification for pre-eclampsia by taking maternal blood pressure correctly according to the International Society for the Study of Hypertension in Pregnancy
  • Screening for Thalassemia in every patient
  • Screening for maternal diabetes using 75g Oral Glucose Tolerance Test [according to the International Association of Diabetes & Pregnancy Study groups ( IADPSG )

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The Fetal Anomaly/ Level 2 Scan Masterclass Srinagar, Kashmir

Dear Friends

The Anomaly/ Level 2 scan is one of the most important scans during pregnancy and there have been many requests to revise the theory and practical aspects of this scan to the standard required by the Fetal Medicine Foundation UK and the International Society of Ultrasound in Obstetrics and Gynaecology (ISUOG)

We have the pleasure in inviting you for this focused ultrasound teaching programme comprising of live demo, didactic lectures, plenty of video teaching and case examples conducted by members of the experienced faculty of INSUOG and set amongst the spectacular beauty of Kashmir. This is over the long weekend of Friday 13th, 14 th and 15th November 2015.

The course will be the first step towards obtaining the FMF –UK 18-23 weeks Anomaly certification as attendance of a recognized Theory Course is a prerequisite

We hope the resulting programme will leave you not just better informed but also refreshed in both mind and spirit.
Please do block your long weekend post Diwali.

Anita Kaul

Faculty

  • Dr-Anita-KaulDr Anita Kaul
  • dr-Ashok-KhuranaDr Ashok Khurana
  • Dr-B-S-RamamurthyDr B.S Ramamurthy
  • Dr-Chander-LullaDr Chander Lulla
  • Dr-Geeta-KolarDr Geeta Kolar
  • Dr-S-SureshProf S Suresh

Programme

Day 1

Friday 13th November Arrival Srinagar
Meeting and assistance on arrival and transfer to either hotel or houseboat.

5.00 – 8.00
Introduction to the FMF 18-23 weeks Anomaly Certification Process
Normal and Abnormal CNS system
Normal and Abnormal Face
Normal and Abnormal Spine

Welcome dinner

Day 02
9.00 – 11.00
The cardiac examination and common abnormalities

Tea

11.30 – 1.00
Normal and Abnormal Pulmonary abnormalities
Normal and Abnormal GIT
Normal and Abnormal Anterior Abdominal Wall

1.00 – 2.30
Live demonstration

Lunch by Dal Lake
Outing around Srinagar
Dinner on own

Day 03
8.30 – 11.00
Abnormalities of the Fetal Urinary system
Abnormalities of the Skeleton
Abnormalities of Placenta and Amniotic Fluid
Features of chromosomal defects

11.00-11.30 hrs: High Tea

11.30-13.00 hrs
Session 4
Maternal serum markers for detection of chromosomal abnormalities.
Biochemical screening for adverse pregnancy outcomes in the 2nd trimester.

Transfer to the airport for flight to onward destination.

Conference Fee

Category Early Bird Registration Regular Registration
20 Sep 2015 Post 20 Sep 2015
Registration for doctors INR 3500 INR 4500
Students INR 2500 INR 3500

Register for early bird

Rubella infections

As part of the FMFi- Look for life education outreach, we are starting a monthly newsletter covering subjects which will help towards addressing the problems of perinatal mortality and still birth. The first of these is fetal infections of which the most preventable cause of severe neonatal morbidity is congental rubella infections.

Universal rubella immunization is part of the Govt of India’s childred immunisation programme but nevertheless any woman who is planning pregnancy or is seen at any time during pregnancy has to have her IGG Rubella status checked. ( please note that it is important to not just do an IGM whenever infection screening is done and both IGG and IGM values need to be checked so that correct advice can be given.

Rubella, also called German measles, is a disease of childhood . In the absence of pregnancy, it is usually clinically manifested as a mild self-limited infection.During pregnancy, however, the virus can have potentially devastating effects on the developing fetus. It has been directly responsible for inestimable wastage and for severe congenital malformations.

Recommendations

  • The risk of congenital defects has been reported to be 90% when maternal infection occurs before 11 weeks of gestation, 33% at 11–12weeks, 11% at 13–14 weeks, 24% at 15–16 weeks, and 0% after 16 weeks.7.Since the effects of congenital rubella syndrome vary with the gestational age at the time of infection, accurate gestational dating should be established, as it is critical to counselling. (II-3A)
  • The diagnosis of primary maternal infection should be made by serological testing. (II-2A) The presence of a rubella
    • A fourfold rise in rubella IgG antibody titre between acute and convalescent serum specimens
    • A positive serologic test for rubella-specific IgM
    • A positive rubella culture (isolation of rubella virus in aclinical specimen from the patient)
  • Serologic studies are best performed within 7 to 10 days after the onset of the rash and should be repeated two to three weeks later.
  • Screening to determine the antibody status of all pregnant women to determine susceptibility. Providing programs to ensure postpartum immunization of non-immune women before they are discharged from the hospital.
  • Women who have been inadvertently vaccinated in early pregnancy or who become pregnant immediately following vaccination can be reassured that there have been no cases of congenital rubella syndrome documented in these situations. (III-B)
  • Women wishing to conceive should be counselled and encouraged to have their antibody status determined and undergo rubella vaccination if needed. (I-A)
  • Congenital defects and late manifestations of rubella infection:
    Present at birth Late manifestations : Audiologic anomalies (60–75%) ,Sensorineural deafnessCardiac defects (10–20%) – Pulmonary stenosis , Patent ductus arteriosus, Ventricular septal defectOphthalmic defects (10–25%) –Retinopathy , Cataracts , Microphthalmia , Pigmentary and congenital glaucoma

    Central nervous system (10–25%) – Mental retardation , Microcephaly ,Meningoencephalitis

    Others – Thrombocytopenia , Hepatosplenomegaly ,Radiolucent bone disease ,Characteristic purpura (Blueberry muffin appearance) , Diabetes mellitus , Thyroiditis ,Growth hormone deficit , Behavioural disorder

    (SOGC Guidelines 2008)