When our grandmothers were pregnant, they had little idea of the baby growing inside them. Due dates were not much more than an informed guess and, if anything was wrong with their baby, they would normally have no idea until the birth.
How times have changed. Now pregnancy has become high-tech, allowing prospective parents to see and learn a lot about their babies evenbefore they are born. This doesn’t just serve an expectant mother’s curiosity. Modern scans and antenatal tests mean that medical conditions can now be detected with greater accuracy than ever before.
“One of the most significant breakthroughs has been with testing for the genetic condition Down’s Syndrome,” says Dean Meredith, Lead Sonographer at The Portland Hospital.
“Until now the only options were a blood test and scans called nuchal translucency.” “If, after they are carried out, the pregnancy is deemed to be high risk – a risk of one in 250 or over – then expectant mothers are offered either an amniocentesis test during which fluid is extracted from the womb with a needle or chorionic villus sampling (CVS). This involves taking a sample of the placenta either with a needle through the womb or with a tube inserted into the vagina. Both come with a risk of infection or miscarriage and that’s not the only down side.”
“Using either method picks up 93 per cent of Down’s babies but there are seven per cent who do not get detected, whose pregnancy progresses with the mother thinking that she is at low risk,” says Mr Donald Gibb, a Consultant Obstetrician at The Portland and at The Birth Company based in Harley Street.
Now it is possible to use a blood test which gives a greater degree of accuracy without the risk of harm to the unborn baby. “It is revolutionary - in the thirty years I have been in maternity care this is the biggest advance that we have seen,” says Mr Gibb. The blood test, known under various names such as Non Invasive Prenatal Testing (N.I.P.T.) or The Harmony Test, is carried out after 10 weeks of pregnancy along with a scan.
“A blood test is taken and tested for DNA from the baby – which will come from the placenta,” says Mr Gibb. Its accuracy rate is over 99 per cent, yet it is also totally non-invasive. As well as testing for Down’s, it can pick up other conditions such as Edward Syndrome and Patau Syndrome.
The only drawback, apart from the cost of £600, is that it takes two weeks for the results to come back from the laboratory and in one in 30 cases not enough of the baby’s DNA will be found in the blood sample and there will have to be a repeat test (performed without additional cost).
But it’s not just tests that have moved on. Scans too have become increasingly sophisticated. It is now possible to get a 3D-image of your baby in the womb or even a 4D-moving image. “The 4D moving images are useful for looking at heart defects while the baby is still in the womb – as it helps to see the heart actually moving – and tells us more than a static image would,” says Mr Gibb.
“If a baby has a problem such as a cleft lip then seeing a clear 3D image can help parents prepare themselves for what to expect. “There is also some evidence that mothers bond with their babies better if they have seen a clear image of the baby before it is born.” With new technology called iBabyScan, parents can log into a secure website and browse a library of images and select scans of their baby and share them with friends and family via email, Facebook, Twitter or other social media. It can also help medically and is being trialed as a way to share images of difficult pregnancies with other obstetricians. New technology has also revolutionized the outcome for babies once they are born – and especially for premature babies. A Neonatal Intensive Care Unit (NICU) has equipment designed for newborn babies and staff specially trained to care for them. “The NICU has improved the likelihood of survival for a baby born at 28 weeks gestation from 20 per cent to over 90 per cent,” says Dr Simon
Bignall, Consultant Paediatrician and Neonatologist at The Portland. There are other advances too. Dr Bignall helped develop a ventilator so that rather than forcibly push air into a baby who is struggling to breathe, it gently puffs air into a newborn’s nose. “We are learning that with young babies, non-invasive techniques are best – and the more we can leave the baby alone (in the medical sense) the better it is for their outcome,” he says.
Even babies born at full-term and who suffer low oxygen at birth can be helped with new techniques to cool their body temperature. “Without this these babies would suffer brain injuries,” says Dr Bignall.
So what are the new developments in the pipeline? “I think the next big thing may be mapping the genome of the baby before it is born – so we will be able to tell things such as what his or her IQ might be, its risk of developing Alzheimer’s , whether or not it will get diabetes at 50,” says Mr Gibb.
“It will happen – but I think it will be a bit further down the line yet.”
By Lucy Elkins