Perinatology

Perinatology is a sub-discipline of Gynecology and Obstetrics, dealing with high risk pregnancies. Recently, major improvements are achieved, both in our country and worldwide, that translated into healthy pregnancy both for mother and fetus and ability to screen mother and fetus for potential medical problems during pregnancy and to employ diagnostic and therapeutic methods for suspicious cases. Developments in genetics, advancements in technology of ultrasound – an imaging modality that is very crucial for evaluating fetus-, widespread use of MRI, boosted sensitivity of screening tests (dual test, quadruplet test, NIPT), and accumulated experience in invasive interventions have played an important role in these achievements. As it is globally acknowledged, these services that require high technology, experience and knowledge should be rendered by a separate discipline and thus, Ministry of Health recognized “Perinatalogy” as a sub-discipline in 2011. “Perinatology Division” is operated as an independent unit at our hospital to maximize quality of above mentioned services.

Perinatology division principally deals with: evaluation of fetal health by investigating and analyzing bodily deformities and chromosomal anomalies; necessary tests are done and invasive procedures (amniocentesis, CVS, cordocentesis) are performed; evaluation and supervision of pregnancies that are complicated by diseases which exist before pregnancy or develop during pregnancy (hypertension, diabetes mellitus, preeclampsia, hypothyroidism, hyperthyroidsm, etc.); medical treatments (fetal cardiac arrhythmias, fetal goiter etc.) or invasive procedures (intrauterine blood transfusions, placement of fetal shunt, etc) for treatable structural or functional fetal anomalies; diagnosis and treatment of complications specific for multiple pregnancies; and preconceptional counseling and examination and treatment plan for existing genetic or systemic disease in parents or for women with history of maternal or fetal problem(s) in previous pregnancies.

Perinatology Division intends to help our patients regarding diagnosis and treatment of maternal and fetal health problems and assist gynecologists and obstetricians who supervise them.

Services available in Perinatology Division:

• Clinical and ultrasonographic examination and medical counseling for presence of abnormal findings in early pregnancy.
• Down syndrome screening at weeks 11-14, trisomy 18/13 screening (nucal translucency-PAPP-A/Free Beta hCG, with nasal bone; with ductus venosus and tricuspid regurgitation, if necessary) and detailed sonography at week 11-14.
• Detailed 4D ultrasound at Week 20-24 (level 2 ultrasound).
• Diagnosis and management of fetal anomalies.

Prenatal diagnostic invasive procedures:

• Amniocentesis
• CVS (Chorionic villus sampling)
• Cordocentesis
• Evaluation and management of high-risk pregnancies on screening at Week 11-14 (double marker test), quadruplet test or NIPT (cffDNA)
• Diagnosis and supervision of perinatal infections (Rubella, CMV, Toxoplasmosis, Parvovirus B19, etc.)
• Supervision of pregnancy in cases of erythrocyte alloimmunization (Rh incompatibility or alloimmunizations due to other erythrocyte antigens)
• Examination of fetal anemia with MCA Doppler
• Cordocentesis for diagnosis of fetal anemia and intrauterine transfusion, if needed.
• Assessment of multiple pregnancies regarding potential risks (abnormality, TTTS, TAPS, selective UIGR)
• Examination with ultrasound and Doppler ultrasound to detect fetal growth and development defects (IUGR or macrosomia) and plan most appropriate time for birth.
• Evaluation and supervision of high-risk pregnancies secondary to systemic maternal diseases, such as hypertension, pre-eclampsia and diabetes mellitus, and planning most appropriate time for birth.
• Evaluation and management of amniotic fluid abnormalities (oligohydramniosis, polyhydramniosis) .​​