Understanding prenatal diagnosis: Techniques, benefits, and ethical considerations

Written in association with: Dr Panicos Shangaris
Published:
Edited by: Aoife Maguire

Prenatal diagnosis involves medical procedures and tests conducted during pregnancy to detect genetic disorders, birth defects, or other conditions in the fetus. These assessments help expectant parents make informed decisions about their pregnancy and potential interventions. Leading consultant in obstetrics and maternal and foetal medicine Dr Panicos Shangaris explains everything you need to know about prenatal diagnosis.

 

 

 

What is prenatal diagnosis, and why is it recommended during pregnancy?

 

Prenatal diagnosis involves testing the fetus during pregnancy to identify any abnormalities in its development or to diagnose certain genetic or chromosomal conditions. Potential health issues should be detected early to help ensure the health of both the mother and the fetus. This early detection can allow for better planning around the birth, management of the pregnancy, and preparation for any medical treatment that may be needed after birth.

 

What are the different methods of prenatal diagnosis, and how are they performed?

 

Several methods are used for prenatal diagnosis, each suitable for different stages of pregnancy and specific diagnostic needs:

 

  • Ultrasound scans: These are non-invasive and routinely used to check the fetus's structure and growth.
  • Blood tests: These can identify markers associated with genetic disorders or potential complications such as preeclampsia.
  • Amniocentesis (typically performed after 15 weeks): These involve taking a small amount of amniotic fluid using a needle inserted into the uterus under ultrasound guidance. The DNA from this fluid is extracted and analysed for chromosomal and genetic abnormalities.
  • Chorionic Villus Sampling (CVS) (performed after 11 weeks): A biopsy and a cell sample are taken from the placenta to test for genetic/ chromosomal disorders.
  • Non-invasive prenatal testing (NIPT): This analyses fetal DNA in the maternal bloodstream to detect certain genetic abnormalities as early as ten weeks into the pregnancy.

 

What conditions or abnormalities can prenatal diagnosis detect in the unborn baby?

 

Prenatal diagnosis can detect a range of conditions and abnormalities, including:

 

  • Chromosomal abnormalities such as Down syndrome, Edwards syndrome, and Patau syndrome.
  • Genetic disorders like cystic fibrosis, sickle cell disease, and Tay-Sachs disease.
  • Structural abnormalities such as spina bifida and congenital heart defects.
  • Complications in pregnancy that could affect fetal growth and the health of the mother, such as small for gestation fetus.

 

Are there any risks or limitations associated with prenatal diagnostic procedures?

 

While prenatal diagnostic procedures are invaluable, they carry some risks and limitations:

 

  • Invasive tests like amniocentesis and CVS can carry a small risk (1%) of miscarriage.
  • False positives or negatives can occur, potentially leading to further unnecessary testing or undue stress.
  • Not all conditions can be detected, and some tests may not provide definitive answers, requiring further diagnostic procedures.

 

How does prenatal diagnosis contribute to informed decision-making during pregnancy?

 

Prenatal diagnosis is crucial for informed decision-making during pregnancy. It provides expectant parents and healthcare providers with important information about the foetus’s health and development, enabling:

 

  • Early intervention and treatment planning for conditions that can be managed in utero or immediately after birth.
  • Preparation for the birth of a child with special needs, including connecting with the wider multidisciplinary team, support networks and services.
  • In some cases, decisions about continuing the pregnancy can be informed by a clear understanding of the health challenges the baby might face.

 

This proactive approach allows parents and healthcare teams to tailor prenatal and postnatal care to achieve the best possible outcomes for both mother and child.

 

 

 

If you would like to learn more about prenatal diagnosis and would like to book a consultation with Dr Shangaris, do not hesitate to do so by visiting his Top Doctors profile today.

By Dr Panicos Shangaris
Obstetrics & gynaecology

Dr Panicos Shangaris is a highly skilled consultant in obstetrics and maternal and foetal medicine in London. With over 15 years of experience, Dr Shangaris' dedicated clinical expertise specialises in all aspects of fetal medicine, pregnancy, high-risk pregnancy, prenatal diagnosis, preconception counselling, birthing control, and medicolegal cases.

In addition to his roles within the NHS and academic sectors at King's College, Dr Shangaris provides an extensive range of private maternity care services. These services include in-person consultations as well as video e-consultations. His private offerings span comprehensive antenatal care, featuring additional tests such as non-invasive prenatal testing (NIPT), as well as a range of birthing options that include both private caesarean sections and normal vaginal deliveries. His transparent fee pricing ensure patients understand the costs. 

Dr Shangaris graduated from the Royal College of Surgeons in Ireland in 2005 and completed his foundation training in East Lancashire. He then pursued higher specialist training in London at renowned institutions such as University College London, the Royal Free London, Barnet, and North Middlesex Hospitals.

He obtained a Master's degree in foetal medicine and prenatal genetics at University College London (UCL) with distinction. Notably, he was awarded the prestigious Wellcome Trust SPARKS research training fellowship in 2011, which allowed him to undertake his PhD research at UCL. His research focuses on treating genetic blood disorders through foetal stem cell transplantation or gene therapy.

Dr Shangaris has received additional funding from esteemed organisations like the Academy of Medical Sciences, the National Institute for Health and Care Research, and the Fetal Medicine Foundation to further his clinical research endeavours. During his subspecialty training in maternal and fetal Medicine at St Thomas' and King's College Hospitals, he worked under the guidance of prominent experts in the field. He gained expertise in specialised clinics such as complex fetal medicine, fetal urology, gestational diabetes, hypertension in pregnancy, multiple pregnancy, fetal cardiology, genetics, and perinatal pathology.

Dr Shangaris holds the position of maternal and fetal medicine consultant at King's College Hospital NHS Foundation Trust and a Senior Clinical Lecturer at King's College London. He is also an academic co-lead for the BRC DTP PhD programme and supervises research projects for BSc, MSc, and PhD students.

With a commitment to collaborative research, Dr Shangaris actively contributes to maternal and fetal medicine clinical research, leading to numerous publications in peer-reviewed journals. He is part of the editorial team at the Reproductive Science Journal and holds the position of president of the Royal Society of Medicine, Maternity and Newborn Forum, further showcasing his leadership role in the field.

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