| Clinical Service » Maternal Fetal Medicine
» Prenatal
Diagnosis & Conselling Department
INTRODUCTION
Prenatal diagnosis is the process of evaluating the presence of disease or potential disease in the unborn fetus. This enables families to make critical decisions before the birth of the baby.
The Prenatal Diagnostic & Counselling Service including Mrs. Wu Chung Prenatal Diagnostic Laboratory was established at Tsan Yuk Hospital in 1981.
The Prenatal Diagnostic & Counselling team accepts referrals for prenatal diagnosis, counselling & therapy, and provides prenatal screening and diagnosis of thalassaemia, Down syndrome and fetal anomalies.
Over the years, we have improved prenatal
diagnostic service by providing noninvasive prenatal testing. We have been
providing prenatal screening test for Down syndrome as an alternative to
direct invasive test from 1997. We also provide indirect ultrasound monitoring
to exclude homozygous £\0- thalassaemia, avoiding the need for an invasive
testing in an unaffected pregnancy. In addition, we have introduced qF-PCR for rapid aneuploidy diagnosis, three-dimensional/
four-dimensional ultrasound for assessment of fetal volume and anatomy, obstetric
endoscopy for confirmation of ultrasound diagnosis of fetal anomalies and
laser photocoagulation for therapy of severe twin-to-twin transfusion syndrome.
With the support of geneticists, neonatologists,
paediatric surgeon, cardiologists, we are able to provide excellent continuity
of care for normal and complicated
pregnancies.
SERVICES
1. Screening
for fetal abnormalities
- 18-20 week fetal morphology scan
- Nuchal translucency scanning
- Integrated screening/maternal serum screening for fetal Down syndrome
- 1st trimester combined screening for fetal Down's syndrome
- Antenatal screening for £\ and £]-thalassaemia
2. Prenatal diagnosis for fetal
abnormalities
Ć - Targeted 2D ultrasound examination in 1st and 2nd trimester
- Fetal echocardiography (joint consultation with paediatric cardiologists)
- 3D/4D ultrasound examination
- Invasive diagnostic procedures including amniocentesis, chorionic
villus sampling, cordocentesis, embryoscopy, hysterofetoscopy
- Noninvasive ultrasound diagnosis of £\-thalassaemia
3. Prenatal
fetal therapy
Ć
- Various shunting procedures for fetal disorders such as urethral obstruction or pleural effusion
- Thermo-coagulation, for twin abnormalities such as acardiac twin
- Laser photocoagulation for twin abnormalities such as severe twin-twin
transfusion syndrome
- In-utero transfusion for treatment of fetal anaemia
- Amnio-reduction
- Medical treatment for cardiac arrhythmia
4. Fetal
monitoring for high risk pregnancies
- Multiple pregnancies
- Intrauterine growth restriction
- Fetal abnormalities
- Rhesus isoimmunisation
- Pregnancies from couples at risk of having fetuses with homozygous
£\0- thalassaemia
5. Laboratory
services
Ć - Cytogenetic studies
- Rapid aneuploidy detection by qF-PCR / FISH (including pre-implantation
genetic diagnosis)
- DNA studies (genetic studies performed offsite at University Medical
Department)
- Biochemical assay for fetal Down syndrome screening
- Haematological studies
6. Counselling
Ć - Joint counseling for fetal anomalies with pediatricians
- Pre-implantation genetic diagnosis
NEW SERVICES
1. 3D/4D
ultrasound
3D/4D obstetric ultrasound examination was introduced in 2002. The
Three-dimensional ultrasonographic techniques including multiplier
analysis and reordered mode provide additional views for improving
evaluation of fetal anomalies and fetal volume measurement. 4D ultrasound
allows real time observation of fetal surface structure, movement
and behavior. The use of 3D/4D ultrasound has helped in the counselling
of couples with fetal anomalies.
2. qF-PCR
qF-PCR is a technique for amplification of DNA. qF-PCR can be employed in obstetrics for rapid detection of chromosomal aneuploidy and DiGeorge microdeletion in amniotic fluid cells, chorionic villi, or fetal blood cells. The report is available within two days.
3. Selective laser photocoagulation of communicating vessels for twin-twin
transfusion syndrome
Without treatment, severe twin-twin transfusion syndrome is associated with
high fetal loss. Laser photocoagulation is a new and effective technique to
treat severe twin-twin transfusion syndrome.
TRAINING
Our department was recognized by the Royal College of Obstetricians & Gynaecologists
as a training centre for maternal fetal medicine subspecialists in
2000.
We offer training in prenatal diagnosis and ultrasound examination
for:
- Maternal-fetal medicine subspecialists programme
- The University of Hong Kong MMSc programme
- Hospital Authority- level II obstetric and gynaecologic ultrasonography
programme
Team Head
Dr. M.H.Y. Tang
Staff
Dr. C.P. Lee
Dr. C.Y. T. Ong
Dr. A.P.W. Hui
Trainee
Dr. N.W.M. Shek
Dr. C.W.S. Lai
Dr. A.S.Y. Kan
Nurse Specialist
CHAN Ho-yan, Vivian
LEE Yuk-ping
Departmental Manager
Dr. E.T. Lau
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For public referrals, please call the prenatal diagnostic clinic at (852) 2589-2218, or fax referrals to (852) 2517-2373.
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For laboratory services, please call the prenatal diagnostic laboratory at (852) 2589- 2208.
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