Authors (including presenting author) :
Leung WC(1), Ng WF(2)
Affiliation :
(1) Department of Obstetrics & Gynaecology, Kwong Wah Hospital
(2) Division of Anatomical Pathology, Department of Pathology, Hong Kong Children’s Hospital
Introduction :
A multidisciplinary approach to the management of abnormal fetuses is well known to provide the best outcome in both diagnosis, management and counselling to the family.
Objectives :
To establish a multidisciplinary team of FMPRG as a pilot study from 2019 to explore such a model. The preliminary results are presented and the way forward explored.
Methodology :
With the support from the HCE of HKCH and the COS of the Department of Pathology, the second author (Ng WF) started a pilot fetal pathology service from 2019. FMPRG is the abbreviation for the multidisciplinary team: Fetal Medicine, Pathology, Radiology and Genetics.
The team has 31 members (up to Dec 2020) including Fetal Medicine subspecialists/ obstetricians of four obstetric departments (KWH, QEH, QMH/TYH and UCH); clinical geneticists from the Clinical Genetic Service of the Department of Health; paediatricians of NICU of HKCH, radiologists with special interest in perinatal imaging (MRI, etc.) from HKCH; scientific officers from Prenatal Diagnostic Laboratories; scientific officers and pathologists of Genetic and Genomic Pathology and Anatomical Pathology of HKCH. Complex fetal cases requiring detailed pathological examination and multidisciplinary consultation are referred from KWH, QEH and UCH to HKCH Anatomical Pathology. After pathological workup, the cases with the clinical information, annotated radiology and pathology images are put up in the FMPRG platform for discussion, correlation with genetic findings, decision on follow up actions and for education. The platform for communication was initially based on e-mailing (HA intranet) among the group members. From Oct 2020, a pilot web-based platform:
Division of Anatomical Pathology - Fetal Pathology - Home Page (ha.org.hk)
has been established under the Department of Pathology of HKCH. The website facilitates the uploading of active cases for discussion and management decision together with an archival site for old cases for education.
Result & Outcome :
A total of 21 cases of complicated fetal anomalies were handled from 2019 – 2020. These cases are categorized for presentation.
This is a pilot project and the work has been done out of dedication by the concerned members. The concerned parties are exploring to submit a multidisciplinary bid to Hospital Authority Annual Planning exercise to secure funding to extend the FMPRG to become a HA territory-wide multidisciplinary platform in order to benefit more families.
