The ultrasound scan uses high-frequency sound waves (no radiation) to produce an image of the baby. As there is no radiation is involved, this is a safe test to undergo during pregnancy. How the pregnancy scans are performed? All the scans will be performed by a specialist Fetal and Maternal Medicine consultant in the presence of a chaperone. The room light will be optimised to visualise clear images on the screen. We will use a water based gel to achieve good contact between the scan probe and the skin. A gentle pressure would be needed at times to perform the detailed scan. During the scan the images will be displayed on the wall mount screen along with the screen on the scan machine. This will allow the parents to see the image and bond with the baby.

As scans are safe in pregnancy there is no limit to the number of scans one canhave during their pregnancy.

All scans will be performed by a specialist Fetal Medicine consultant, Dr Ashwini Bilagi at P4 Pregnancy.

We, at P4 pregnancy believe in providing personalised care. We realise continuity of care is very important in conditions like pregnancy. Hence, you will be seen by the same specialist at every visit. It will be the same doctor performing the scan and consultation so you get comprehensive and holistic care.

Anomaly scans are one of the important scans during your pregnancy. This scan is usually performed between 18 to 23 weeks of pregnancy. A detailed assessment of the anatomy of your baby is carried out along with the check on the location of the placenta. During the scan we will be interacting with you and show you the detailed anatomy of the baby. The findings will be discussed with you in detail. If any abnormalities are detected, it would be discussed comprehensively and your hospital (where the pregnancy is booked) will be contacted and notified to arrange further management. We will provide you with a detailed scan report, scan images (printed) and USB stick with videos/images of the baby.

Structural heart differences are one of the common anomalies seen in the babies. Fetal echocardiography is a scan that examines baby’s heart in detail. This scan aims to rule out some of the structural heart differences. The optimum time to perform this test is around 19-24 weeks. This will be done by the Specialist Fetal Medicine Consultant.

A 3D scan is a still image of baby, a 4D scan is a moving image. The HDlive scan uses the latest in ultrasound technology to offer you an even clearer view of the baby. Ideal time to perform this scan is between 26-32 weeks. You will get a soft copy of pictures/videos and hard copies of the scan

This scan is performed to ensure wellbeing and the growth of the little one .We also check for umbilical blood flow studies along with liquor volume assessment. This will also help in bonding with the little one.

Uterine arteries are the major feeding vessels to the womb. Studying the blood flow in these will help us assess the risk of two very common problems in pregnancy - blood pressure issues of pregnancy growth concerns of the little one.This scan is performed by Dr Bilagi,subspecialist Fetalmedicine consultant.

We understand pregnancy can be a challenging time for the women with all the physical,psychological and social changes. We aim to complement the care you are getting from national health services. Each appointment is about 30 minutes long with a consultant where the pregnancy care is comprehensively discussed Discussion of care and mode of delivery BP and urine Check Discussion of possible tests and their implications such as GBS, NIPT tests, baby scans

In this package you will be seen by Dr Bilagi throughout the pregnancy at regular intervals(approximately every month). You will get regular scans (~6-7 scans) and we will discuss your pregnancy care and guide you in making some decisions. We will also see you post delivery and plan the postnatal recovery.

A detailed consultation of postpartum symptoms and challenges. Wound check and discuss routine blood tests and physiotherapy options.

Non-invasive prenatal testing (NIPT) is a screening test – it is a test for women who are unlikely to have a baby with a chromosome condition. It is much more accurate than first trimester blood screening and ultrasound tests. This has reduced the need for invasive tests such as chorionic villus sampling (CVS) or amniocentesis, although these will still be required to confirm a high probability result. NIPT screening for trisomy 21, 18 and 13 – the most common chromosome conditions – provides the highest accuracy. Screening for other syndromes or for fetal sex is reasonably reliable; however, it is not as accurate as the screening for trisomy 21, 18 and 13.

Chromosomal conditions like Down syndrome (trisomy 21) do not typically run in families and can happen in any pregnancy. Although the chance of having a baby with Down syndrome increases with age, most babies with Down syndrome are born to women under 35.2 You must be at least 10 weeks pregnant for this test. Patients who have received bone marrow or organ transplants, or those who have metastatic cancer are not eligible for the test.

There are small fragments of DNA in the mother’s blood that have come from both the mother and the placenta. This is a normal process. TDL Genetics uses an NIPT assay called Veriseq v2, manufactured by Illumina and processed in our London laboratory. The assay analyses the proportions of the DNA fragments that come from specific chromosomes. If a particular proportion is too high or too low, this indicates that there may be a chromosome condition involving the placenta and, potentially, the developing baby.

Your sample is checked to see if there is sufficient DNA from the developing pregnancy to provide a reliable result. Then, for each condition included on the request form, the report will indicate whether there is a low or high probability of the condition being present. Results will be sent to your healthcare provider in 3–5 business days. Your healthcare provider will discuss the report with you and let you know if any other investigations are recommended. In your initial consultation, prior to the test being ordered, we strongly advise that you discuss what you would do with the possible results. If your report indicates a high probability of a chromosome condition being present, a CVS or amniocentesis procedure can be arranged by your doctor to obtain a definitive result.

No, any screening test carries a chance of a ‘false negative’ however the chance of this happening with NIPT is much lower than with conventional screening for Down syndrome and other chromosome conditions.

No, not necessarily. It means that there is a higher chance that your baby may have a chromosome condition, and you will be offered the option of amniocentesis to assess the chromosomes directly. You will be offered support and counselling to help you reach that decision.

This test can also be applied to twin pregnancies but is not suitable in the case of a vanishing or demised twin. The sex of twins will be reported as one result. If male, one or both of the twins will be male. If female, both twins will be female.

Two out of 100 women will require a repeat test. Patients will not be charged if we are unable to obtain a result. On rare occasions, it is not possible to issue an NIPT result. This is usually due to the complex biology of pregnancy rather than a failure of the test method. If NIPT cannot provide an assessment for the three most common chromosome conditions (trisomy 21, 18 and 13) after one collection of a blood sample (or two, if recommended by the laboratory), you will not be charged.

The NIPT assay used by TDL Genetics – VeriSeq NIPT Solution v2 – is not validated for use in pregnancies with more than two fetuses, nor in cases of fetal demise, mosaicism, partial chromosome aneuploidy, triploidy, translocations, maternal aneuploidy, transplant or malignancy. VeriSeq NIPT Solution v2 does not detect neural tube defects. Certain rare biological conditions may also affect the accuracy of the test. For twin pregnancies, HIGH PROBABILITY test results apply to at least one fetus; male test results apply to one or both fetuses; female test results apply to both fetuses. Due to the limitations of the test, inaccurate results are possible. A LOW PROBABILITY result does not guarantee that a fetus is unaffected by a chromosomal or genetic condition. Some fetuses without a trisomy or chromosomes anomaly may have HIGH PROBABILITY results. In cases of HIGH PROBABILITY results and/or other clinical indications of a chromosomal condition, confirmatory testing is necessary for diagnosis.

https://www.rcog.org.uk/en/news/rcog-response-to-uknscrecommendation-on-nipt-testingfor-high-risk-women/ [Accessed 31.05.2018] Morris JK, et al BMJ. 2009 Oct 26;339:b3794 Position statement from the International Society for Prenatal Diagnosis on the use of non-invasive prenatal testing for the detection of fetal chromosomal conditions in singleton pregnancies . Hui L, Prenatal Diagnosis – Wiley Online Library. https://obgyn.onlinelibrary.wiley.com/doi/10.1002/pd.6357