1. Dr Shuhaila Ahmad Associate Professor FetoMaternal Unit UKMMC

2. What is a detailed scan? A scan done by a trained personnel to look at fetal anatomy Recommended to do at 18-20 weeks gestation Adequate time for referral Better resolution for fetal imaging although fetal echocardiography is recommended at 22-24 weeks If indicated for termination, could be done before 22 weeks gestation

3. Who is considered to be the trained personnel? The person (doctor / sonographer) should : Have undergone basic ultrasound course (Level 1) Be able to do level 1 scan satisfactorily Have attended an accredited level 2 scan course Be certified to perform level 2 scan

4. Advantages Early detection and intervention of fetal anomalies Offer reassurance to the parents regarding their baby Increase bonding between the parents to their unborn baby Promote cooperation between the multidisciplinary teams managing the fetus/ baby Both clinical and non-clinical base team Helps parents to look for support group Research and training

5. Who should have the scan? Best if it can be offered to all patients Due to limited resources, a selected group of should be offered this facility: Elderly mother (>35 years old) Previous history of abnormal baby Known medical illness ( DM) Multiple pregnancy Increased risk during NT scan Others

6. What is actually done during detailed scan? Measurement of fetal parameters BPD, HC, AC, FL Additional measurements Ascertain placental localisation Amniotic fluid assessment ‘eyeballing’ method AFI or MPD Fetal anatomy survey

8. Soft markers for aneuploidy

9. A normal detailed scan does not mean the fetus is 100% normal structurally or functionally

10. Conclusion Detailed scan requires time and skill Appropriate training and equipment are mandatory It is not meant to be ‘commercialized’, therefore all patients undergoing detailed scan must be counseled regarding the indication and possible outcome A referral to a fetomaternal unit if fetal anomaly is suspected for further managment