Jain Suhani, Acharya Neema
Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Science (Deemed to be University), Wardha, IND.
Cureus. 2022 Sep 11;14(9):e29039. doi: 10.7759/cureus.29039. eCollection 2022 Sep.
While assessing maternal health is relatively easy, assessing fetal well-being has always been tricky. This has led to tremendous technological development in fetal well-being assessment, thus bridging the gap between biotechnology and antenatal medicine. It is broadly divided into early pregnancy, late pregnancy, and during labour assessment. While the early assessment involves genetic check-ups and malformations, the late pregnancy check-ups aim at delivering a healthy fetus at term by normal vaginal delivery. The early tests can be invasive or non-invasive. Non-invasive include cell-free fetal DNA assessment and fetal cell-based assessment. Invasive tests include amniocentesis and chorionic villous sampling. These are followed by chromosomal microarray and next-generation sequencing. Under this procedure, exome sequencing is done, which is either clinical or whole. Sequencing of the whole genome can also be done. A recent advancement is pre-implantation genetic testing. These are mainly useful in identifying monogenic disorders for which the locus causing disease is identified beyond any doubt. In late pregnancy, the most commonly used test is biophysical. It works on the principle that an increase in the fetal heart rate occurs in conjugation with fetal movements. The next widely employed technology is Doppler, which is used to know fetal heart rates, valve timing intervals, and umbilical artery waveforms. Cardiotocography is also widely used both during pregnancy and during labour. It measures the fetal heart rate while correlating it with uterine contractions. Wireless fetal and maternal heart monitoring and telemonitoring are recent upcoming fields.
评估孕产妇健康相对容易，而评估胎儿健康状况一直颇具难度。这促使胎儿健康评估技术取得了巨大发展，从而弥合了生物技术与产前医学之间的差距。它大致分为孕早期、孕晚期和分娩期评估。早期评估涉及基因检查和畸形排查，孕晚期检查旨在通过正常阴道分娩足月产下健康胎儿。早期检测可以是侵入性的或非侵入性的。非侵入性检测包括游离胎儿DNA评估和基于胎儿细胞的评估。侵入性检测包括羊膜穿刺术和绒毛取样。随后是染色体微阵列和新一代测序。在此过程中，会进行外显子组测序，分为临床外显子组测序和全外显子组测序。也可以进行全基因组测序。最近的一项进展是植入前基因检测。这些主要有助于识别单基因疾病，对于这些疾病，致病基因座已被明确无误地确定。在孕晚期，最常用的检测方法是生物物理检测。其原理是胎儿心率会随着胎儿活动而增加。接下来广泛应用的技术是多普勒技术，用于了解胎儿心率、瓣膜定时间隔和脐动脉波形。胎心监护在孕期和分娩期间也广泛使用。它测量胎儿心率，并将其与子宫收缩情况相关联。无线胎儿和孕产妇心脏监测以及远程监测是最近兴起的领域。
