The basic principles of practice in fetal medicine are based around the identification of high-risk pregnancies, accurate diagnosis of fetal anomalies using invasive prenatal diagnostic techniques and detailed imaging and a multi-disciplinary approach to counselling of parents. This counselling will be centred on the accuracy of the diagnosis, prognosis for the fetus and neonate and the possibility of in utero therapy. Many conditions such as aneuploidy are not amenable to treatment and many others are best managed in the neonatal period. However, recent advances in in utero therapy have made in utero treatment for some conditions possible. Nevertheless, despite the great strides forward and initial euphoria, many fetal therapeutic interventions have not be shown to improve outcome and cannot now be recommended. Others have yet to be tested in controlled trials and remain anecdotal case series.
Notwithstanding this, continued advances in minimally invasive techniques, in utero imaging and suppression of preterm labour may allow development of therapeutic techniques for a wider range of conditions. This will likely be coupled with advances in stem cell research and in utero gene therapy. However, it must be accepted that any new technique as well as older established techniques need to be exposed first to the rigors of good quality research before they can be accepted as standard practice.
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The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.