Dr. Stoilov, you are one of the few specialists in fetal medicine in the country. How popular is this specialty in Bulgaria and is there continuity between obstetrician-gynecologists and fetal medicine doctors?
Fetal medicine is a modern and rapidly developing specialty. It is incredibly popular all over the world, including Bulgaria. Here, it is growing rapidly – there are already several innovative centers that serve the Bulgarian women. I want to thank the obstetrician-gynecologists who have progressive thinking and accept the novelties in medicine, as well as the new methods in modern obstetrics.
How does the modern medicine evaluate the risk of congenital pathologies of the fetus?
- If we speak about congenital malformations of the fetus, each anomaly is detectible during different periods of the pregnancy and can manifest in a different way. Major structural anomalies can be detected at the beginning of pregnancy, but there are also those that can appear at a more advanced stage. Ultrasound is a very good method because it is easy to use and safe for the pregnant woman and the fetus. However, we must be realistic and know that this method cannot detect all anomalies for various reasons, but mainly due to the nature and the evolution of the various anomalies. For this reason exactly, we have statistics for each disease, what is the detection rate during pregnancy. Our goal is to detect the abnormalities as early as possible, so that we can give the earliest prognosis about the pregnancy.
When are amniocentesis and chorionic biopsy performed?
- These are diagnostic, invasive procedures most commonly used to identify genetic defects. Other invasive procedures that we do during pregnancy include cordocentesis and other tests that can be done in utero. These procedures help us determine if the fetus has anemia, if it is infected with some virus, then we can transfuse blood and do many other interventions. It is important to know that there must be a reason for these procedures, or as we say medically, there must be indications for them. Main indications are:
The most common chromosomal disorder is Down syndrome, but there are many more genetic anomalies that, thanks to the genetic science, can be detected early enough during pregnancy. Genetic tests are important not only for the current pregnancy, but also for future ones. Fear of invasive procedures is widespread, and many pregnant women avoid doing them precisely because of this.
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