A new scheme for risk stratification of pregnancy complicated by fetal anomalies

Fetal anomalies are being increasingly detected during pregnancy with the increased adoption of sonological screening and advances in genetic testing. The optimal use and factual interpretation of fetal diagnostic modalities constitute a significant challenge to the concerned specialists. The critical parameters in characterization of a prenatally detected anomaly are the physiological/ pathological nature, severity of the disorder, associated problems/ risk factors, possible progression, likely complications, and its effect on the gestation and the life of the fetus. These factors in turn decide the need for detailed fetal imaging, invasive fetal diagnosis, fetal therapy, changes in obstetric management, perinatal therapy and the option to terminate pregnancy in severe anomalies. All these parameters and factors are integrated in the new system of risk stratification of pregnancy complicated by fetal anomaly (PCFA) proposed here. Though the management of fetal anomalies have to be highly individualized, proper risk stratification could help bring clarity to the decision-making process.