The BBC star and pioneer of fetal medicine talks to Clare Hughes about his success and how he climbed the career ladder

Professor Kypros Nicolaides is the star of BBC1's Life before birth, a two part documentary shown earlier this year. It showed Kypros battling to save the lives of seriously ill fetuses by transfusing platelets and laser treating a lung tumour.

Kypros was born and brought up in Cyprus and wanted to be a doctor for as long as he can remember. His father was also a doctor and used to travel around the villages on a donkey, often taking Kypros with him. He was Kypros's main motivation. As there were no local specialists his father was a surgeon, a general practitioner, and a gynaecologist.

His father, Kypros recalls, had a very high opinion of the United Kingdom: "My father had it drummed into me from the beginning that I would study in England. When I was 17 he sent me off."

He studied medicine at King's College, London. As a fourth year medical student he was taught by one of the pioneers in ultrasonography. It was at this point that Kypros became interested in fetal medicine. "I saw a new ultrasound machine, and after seeing moving images of a fetus I fell in love with that area of medicine. I just wanted to become a fetal medicine doctor."

The development of ultrasound exposed a whole new area of medicine: Kypros realised that life began before birth. He recalls, "Here was the whole of postnatal medicine being applied to a new patient who has now become visible, therefore accessible." He continues, "If a baby is anaemic, you find out why they are anaemic, and treat them. I wondered if I could apply the same principles to an unborn baby to save it from dying?" Fetal blood transfusion is now one of the commonest procedures that Kypros performs.

There was no such thing as fetal medicine when Kypros was a junior doctor. As a senior house officer in obstetrics and gynaecology he became involved in research; he became a professor in 1992. In 1996 he established the Fetal Medicine Foundation, which runs regular courses and attracts speakers and delegates from all over the world. Kypros was recently rewarded for his pioneering work by being awarded the Ian Donald Gold Medal for the highest contribution in ultrasound from the International Society of Ultrasound in Obstetrics and Gynaecology, and the Eric Saling award for the highest scientific contribution in perinatal medicine from the World Association of Perinatal Medicine.

Kypros is also the director of the Harris Birthright Research Centre for Fetal Medicine. The centre was set up in 1984 by Sir Philip Harris and the charity organisation Birthright. It was the first fetal unit in the United Kingdom, and remains the biggest in the world. Kypros began a teaching and research programme which now attracts 1000 health professionals from all over the world every year. The unit examines 15 000 patients a year.

Kypros continues to be fascinated by fetal medicine. Applying the principles and techniques of postnatal medicine to prenatal life, while considering the ethical implications, is a constant challenge. He says, "The combination of these keeps you on your toes. There's a lot of excitement, a lot of sadness, a lot of depression, but a lot of emotion. So it never becomes boring."

The best thing about fetal medicine, he thinks, is developing and applying treatment to a baby with life threatening problems and turning it into a healthy survivor. He confesses, however, "The worst moments are when things don't work out, and the baby dies, despite interventions, or when you can do nothing except give bad news and feel helpless."

The work that he is most proud of includes discovering the "lemon head" in spina bifida, and nuchal translucency and the absence of the nasal bone in Down's syndrome. He says, "You used to need superspecialist training to pick up problems such as spina bifida and Down's, but now because of some basic ultrasound observations and features they can be easily recognised by anybody who has received some basic training."

These basic signs are now looked for on routine fetal ultrasound scans in more than 40 countries in the world. Last year Kypros documented that a high proportion of babies with Down's syndrome lacked a nasal bone and has described this as another sign to detect the syndrome.

Obstetrics and gynaecology is not the only route into fetal medicine. It is still a superspecialist field and allows people with a great diversity of interests to come into it. Fetal medicine also has the added attraction of being a very new specialty. Kypros believes that doctors from all disciplines would have something to offer and would like to see more entering it. He says, "I want people who are essentially physicians in intellect and temperament to be attracted to fetal medicine, in addition to people who are interested and challenged by surgical techniques. I can think of nothing more challenging than operating on the fetus genetically."

He wants to continue research into identifying women carrying babies at a high risk of developing complications and to continue developing strategies to try and prevent them. He shares his vision: "I would like to create an international network of experts to disseminate their knowledge, and collaborate international projects to advance our knowledge of these conditions."

He admits that he feels a lot of responsibility and pressure, because a great many people come to him expecting miracles. So how does he cope? "I never sit down and wonder how I cope. I just get into it and my whole life revolves around it. It's not a job. Unfortunately, or fortunately, it's a way of living--it's my life."