01. tbl. 106. árg. 2020

Fetal medicine is a subspecialty of obstetrics investigating the development, growth and disease of the human fetus. Often, the mother is part of the definition of the subspecialty where maternal diseases specific to pregnancy are included and therefore named Maternal-Fetal
. It is appropriate to have one subspecialty for the maternal-fetal unit and the Icelandic subspecialty is named accordingly; “Prenatal diagnosis and maternal diseases”. The subspecialty was acknowledged in Iceland in 2015 when physician specialty regulations were changed. The advances in fetal imaging, both ultrasonography and MRI, and molecular diagnostic techniques, together with the possibility of interventions in
, make fetal medicine an important, rapidly developing field within women's healthcare. A variety of specialists, such as neonatologists, pediatric cardiologists, medical geneticists, radiologists and pediatric surgeons, are necessary to adjunct in the diagnosis and treatment of the fetus as a patient. In larger communities MFM physicians work as consultants besides working on fetal screening, diagnostics and treatment of mothers and their fetuses. In Iceland the subspecialization is less advanced. This article describes common tasks of the fetal medicine physician and examples are given where advances in technology have changed management for instance in aneuploidy screening, Rhesus allo-immunization and fetal interventions. Finally, the establishment of the Nordic Network of Fetal Medicine is described.

Figure I Effects of pre-exisiting maternal disease on pregnancy.

Figure II Effects of pregnancy on underlying maternal disease.

Figure III Twin-to-twin transfusion syndrome (TTTS). The picture illustrates laser ablation of connecting vessels in a TTTS pregnancy. The fetus on the left is a recipient and is larger with increased amniotic fluid but the donor on the right is small with oligohydramnion.

Figure IV Congenital diphragmatic hernia. The picture illustrates a disruption in the diaphragm on the left side. The stomach and a part of the intestines have moved upwards from the abdomen into the thorax, shifting the heart to the right side of the chest.

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