Crystalizing the concept of fetal medicine in north east

Dr Gargi Sinha

MBBS (Lady Hardinge Medical College, New Delhi), PGDACP(India), 
Grad Dip Public Health (Edith Cowan University, Western Australia) 
Member of Australian Health Promotion Association 
Member of Australian Integrative Medicine 
Visiting Consultant, Sinha Medical Acupuncture Research centre, New Delhi India 
Researcher, Drug and addictive behaviour 
School of Medical and Health Sciences 
Edith Cowan University, Western Australia 
Phone: +61 8 94458181 
Author of health sociology blog 
Author of educational resources on public health 
Co-founder ,strategies of addiction for north east

Despite the advancement in medical technology, many pregnant women undergo the trauma of miscarriages, abortion, and even death due to lack of availability and accessibility to fetal medicine in the Northeast. A lot of research has suggested the necessity to focus on antenatal check-ups to identify high-risk pregnancies to reduce the burden of high maternal mortality rate in Northeast India.

Typically, an antenatal check-up involves a few visits at the start of the pregnancy and gradually increases the visit number with the advancing trimesters. However, with a considerable improvement in the early detection of disease and complications in pregnancy, a new model of antenatal care has been proposed, popularly known as the inverted pyramid of care. The new model emphasises that all woman should be screened in first trimester. The woman who is at low risk does not need frequent visits. However, an identified high-risk pregnancy needs specialised medical care throughout the pregnancy. In the pockets of the northeast where the maternal mortality rates are higher than the average national statistic, it is vital for the practitioner to focus on a different approach to antenatal care. One of the critical strategies to recognise and intervene in high-risk pregnancies is to provide training and support to the Northeast health practitioners.

Fetal medicine includes detecting maternal, placental, and fetal issues in pregnancy such as fetal growth difficulty and structural or chromosomal issues. Despite the technological advancements in fetal medicine, many precious lives are lost at the time of delivery due to lack of knowledge and training in fetal medicine. For instance, the prenatal detection of a chromosomal abnormality such as Down syndrome or neural tube defects requires a combination of skills. However, these procedures require health providers to have more training, which is less readily available in the rural and remote areas of the Northeast. With the knowledge of fetal medicine, many life-threatening but treatable conditions can be identified before birth, such as posterior urethral valves or congenital heart disease. As a result, referral to a tertiary centre can be arranged for a mother and a baby well in advance.

Hence, to overcome the challenge of lack of availability, Fetal Medicine Foundation India organised a symposium in association with Guwahati Obstetrics & Gynaecology Society and FOGSI Imaging Science Committee on 16 – 17 March 2019, in Guwahati, Assam. The Fetal Medicine symposium in the northeast is introducing a team of experts from the field of fetal medicine from India and abroad to provide a better understanding of tools to manage a high risk pregnancy. Such advance knowledge about diagnosis and management of maternal and fetal condition would provide the clinician with a useful tool to deal with the maternal and fetal issue at the local level. For further information visit fetal medicine foundation of India at

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