GANEEN.COM 

THE INTERGRATED CENTER FOR THE DETECTION

OF FETAL CONGENITAL ANOMALIES

 

Introduction:

This new project aims at the establishment of  an integrated center  for the ultrasonographic screening for the  diagnosis of fetal congenital anomalies as well as  intervention ultrasonography for fetal genetic sampling and possible fetal therapy in indicated cases. This includes amniocentesis, chorion villous sampling, cordocentesis,  in-utero blood transfusion for RH iso-immunised fetuses, drainage of renal or bladder cysts, drainage of obstructive hydrocephalus, amnio drainage for  polyhydramnios and twin-to-twin transfusion  .. etc.

 

This integrated Center will also provide fetal surgery as well as early neonatal surgery.

The project is aiming at providing this integrated service for the outpatient cases  as well as  the follow-up cases known to be at risk of having congenital anomalies e.g. positive family history, diabetics, .. etc. or transmitting diseases e.g. blood, bone, metabolic diseases, … etc. to their off springs.

 

 

1.0 STAGE 1: Establishment of the Center

1-      Team

2-      Location

3-      Web site

4-      Equipment.

5-      Protocol and system of operation

6-      Correspondence with Fetal Medicine Centers abroad

7-      Physician orientation

8-      Referral Policy.

9-      Public Awareness

10-  Development of Registry

 

 

2.0 STAGE 2: Development of the Service

1-      Organizing Seminars to publish our results.

2-      Interacting with other National centers

3-      Inviting International figures to our center

4-      Representation in National and International Conferences

5-      Organise workshops.

6-    Training Center(s).

 

 

1.0 STAGE 1: Establishment of the Center

 

1.1 Team

            The core team includes Obstetricians,  Perinatologists,  Neonatal Surgeons,  Cyto-Genetics Lab specialists.  The support team  includes Neonatal echocardiography specialist, Neonatal ICU specialists, Haematologists, Neonatal Cardiac Surgery specialists, Psychiatrists among other needed specialties. The team includes trained nurses.

 

1.2  Location

            The screening and genetic sampling will be done within the Center. Neonatal surgery will be carried out in Specialised Hospitals. Deliveries will be carried out in equipped Medical Centers and Hospitals. Resuscitation and primary care will be carried out by the Neonatology Team within the Hospital premises. Portable incubators will be called in for transfer of cases whenever needed.

 

1.3  Web site     www.ganeen.com

            This site will include  info on the mothers’ health. In addition it will include info about different congenital anomalies of the baby.

 

 

1.4  Equipment

            Office and Medical Equipment and Furniture: including Telephone and Fax equipment.

            Ultrasound Machines: Digital 2D machine. Multi-frequency, high resolution wide angle probes including a convex linear probe (2.7-5.0 MHz.), micro convex probe for small parts (2.7-7.5 MHz.), transvaginal probe (5-7.5 MHz.). All probes is supplied with needle guide attachments. High resolution monitor at least 12” with a side 12” monitor. Video printers: B&W and VCR. 3D and 4D ultrasound machine are available in an associated Center whenever cases needed this scan testing. Genetic Lab with the most up-todate equipment is associated with the Center.

            Computer System and Software: Desktop with printer

            Disposables and Consumables: including continuous supply of needles for amniocentesis, CVS and PUBS. Office and medical consumables.

 

 

1.5  Protocol and System of Operation

                Each patient attending the Center will have a file with her detailed personal data. Her medical history will be meticulously reviewed and documented in her file. This file will have a reference number which will circulate and will be included in her Center’s  ID CARD. Her computer file will have this number for database management.

Ultrasound screening for high risk cases will be done by the obstetrician during the first or early second trimester. Suspected cases incidentally discovered from the general pregnant population attending the antenatal clinics will be sent to the Center for confirmation and management. Referred cases with known anomalies will be assessed ultrasonographically. Blood test for the mother will be done for genetic screening (triple marker tests) according to the condition. Patients will be counseled. Genetic sampling will be done in indicated cases. Samples will be sent to the cytogenetics lab. Results will be fed back to the Center. The patient will be called back for re-counseling by the Obstetrician and Genetic specialists. The suitable management will be discussed with the couple. and discussing the management. Obstetrician, Perinatologists,  Neonatal Surgeons, Neonatal echocardiography specialist, Neonatal Cardiac Surgery specialists, Psychiatrists or  other needed specialties will be called in according to the case.

            The support team will include secretarial team, nurses, social workers. These will be adequately oriented with our system of work.

 

 

 

 1.6  Correspondence with Fetal Medicine Centers abroad

 

This will help in the setup of the Center and the implementation of the system of operation. Experts from these Centers will be invited for training for the invasive procedures and Lab experience. The methodology and results from our Center  will be shared with the Correspondence Center for quality control and exchange of experience. Telecommunication and Internet facilities and conferencing may be held for this aspect. We will use our web site www.ganeen.com for this purpose as well.

 

1.7 Physician Orientation

            Obstetricians, Perinatiologists, Neonatologists, Pediatricians, Haematologists, Cytogenetic specialists will be oriented with the services offered by the Center. They may be  invited to share in the management of their cases, or reported back to with the steps of the management.

 

 

1.8 Referral Policy

            Patients will be referred to the Center. The Center will provide Forms to be filled by the referring physician. Personal calls will be carried out for extra information.  The file  will include the mothers medical record summary as provided by the  referring physician as well as the management protocol and outcome. This will fed in the computer with a reference number.  .  Results of the tests will be discussed with the RP before calling in the patient for counseling. The RP will be called in whenever needed.             Walk in patients will be handled by the Center’s staff and management will be set for each individual caes as per the Center’s policy.

 

1.9 Public Awareness

Educational programs will be arranged for in the mass media to educate the public about the magnitude of

the problem and the existence of the service in Cairo University- Faculty of Medicine.  Special brochures will be printed and distributed within the Health Service Facilities and Mother and Child Health (MCH) Centers.

 

1.10 Developing a Registry

            All the Center’s cases will be recorded in a permanent record. These records will help develop a National registry for Fetal Anomalies. This data will serve to assess the magnitude of the problem and possible underlying factors. It will also help in carrying out research work related to the field.