Emergency : 04933 220 222

What do we do in Fetal Medicine Unit?

  • Assess women at added risk of fetal abnormality.
  • Confirm diagnosis of fetal abnormality.
  • Give detailed information about likely outcomes, which includes providing multi-disciplinary input.
  • Inform women and families about the choices available. On-going psychological support and counselling is provided
  • Initiate ongoing monitoring of pregnancies, where appropriate.
  • Undertake interventional and therapeutic procedures, such as fetal blood transfusion.
  • Assess possible complications in multiple births.

Ultrasound Scans and Tests

The Ultrasound and Fetal Medicine unit offers a consultant-led service. Using state of the art ultrasound equipment, you and your Obstetrician can be informed about the anomalies, fetal well-being and growth which will aid in clinical decision regarding the further antenatal care and mode of delivery.

Scan Type When to do
Early Pregnancy & Dating 6-10 weeks
Combined Screening Test 12-13 weeks +/- 6 days
Fetal anomaly scan (2nd Trimester) 19-21 weeks
Growth Scan 28 weeks onwards

Early Pregnancy and Dating Scan

The first early ultrasound scan provides you and your consultant with important information about the number of babies and the expected date of delivery. The presence of a pregnancy and detection of the fetal heart can be seen from 6 weeks gestation by vaginal scan and from 8-9 weeks by abdominal scan. measurements and images are taken of the gestational sac, the crown to rump length of the embryo, to accurately date the pregnancy, and assess the pelvic region to exclude pathology.


Screening

The service includes screening for, diagnosis of and treatment (where relevant) of:

  • Chromosome abnormalities.
  • Fetal anomalies.
  • Haemoglobinopathies.
  • Single gene genetic diseases.
  • Haemolytic disease of the new born.
  • Complex multiple pregnancies.
  • Fetal growth restriction.

Communication with referring clinicians and other specialties is a crucial part of the work of the Fetal Medicine Unit at our hospital.


Fetal Anomaly Scan

Between 19-21 weeks the anatomy of your baby is scanned in detail so that any about the many body systems, such as the urinary tract, digestive tract, heart and major blood vessels, brain and others, can be imaged and interpreted. The careful and accurate measurements made during the scan help to monitor the wellbeing of your baby.


Fetal Echocardiography Scan

Consultation and scanning is available in our Fetal Medicine unit for scans of the heart and major blood vessels. This is carried out by cardiologists and involves comprehensive real-time scanning and counselling to diagnose or exclude malformation of the heart. 3D/4D scan will be helpful to identify external body structure anomalies.


Interventional Procedures

Depending on the outcome of your scan, you may be offered one of the following procedures within our clinic:

Amniocentesis

Amniocentesis is a prenatal test that allows your fetal medicine doctor to gain more information about your baby’s health from a sample of your amniotic fluid. Amniotic fluid is the fluid that surrounds your baby in the womb.

The most common reason to have an amniocentesis is to determine whether a baby has certain genetic disorders or a chromosomal abnormality, such as Down syndrome, sickle cell anaemia or muscular dystrophy. This might be due to high risk from a screening test, fetal anomaly that might be caused by a genetic or chromosomal abnormality, past history of having a baby with a chromosomal abnormality or you and/or your partner have or are carriers a genetic condition with increased risk of your baby inheriting this condition from you.

If you have been offered this test it does not mean that your baby definitely has any of these conditions. It just means you are at a higher risk of having one of these conditions. By doing the test it will give us more information about the health of your baby. This test is usually carried out after 15 weeks of pregnancy. During the procedure, a needle will be used to extract a sample of amniotic fluid. Amniotic fluid contains cells shed from the fetus that can be examined and tested for a number of conditions. Before the procedure we will talk you through the possible complications and risks associated with amniocentesis. There is a 1% risk of miscarriage. The final decision whether or not to have this test is up to you. And we will support you through any concerns you may have.

Chronic Villus Sampling (CVS)

Chorionic villus sampling (CVS) is a test carried out during pregnancy that diagnoses chromosomal abnormalities such as Downs syndrome, and where appropriate, rarer specific genetic disorders.The test involves removing and testing a small sample of tissue from the placenta. The placenta is the organ that links the mother’s blood supply with her unborn baby. A needle is inserted through the abdomen (tummy) or occasionally through the cervix (neck of the womb). The placenta has tiny finger like projections called chorionic villi and this is where the sample is taken from. The villus sample is sent to the cytogenetic laboratory where different techniques such as karyotype, QF-PCR and chromosomal microarray are used to show any possible abnormalities.
CVS is offered when it has been suggested that there is a high risk of the baby having such conditions. This could be because:

  • An earlier antenatal screening test (such as the combined screening test for Down’s syndrome) has shown that you are at an increased risk.
  • You have had a previous pregnancy with these problems, such as a baby born with a chromosome abnormality.
  • You and/or your partner have or are carriers of a genetic condition such as cystic fibrosis, sickle cell anaemia or muscular dystrophy and there is an increased risk of the condition in this pregnancy.
  • Your baby has an anomaly that can be caused by chromosomal or genetic abnormalities.

CVS is usually carried out between 11-14 weeks of pregnancy. The main advantage of CVS over amniocentesis is that you can have it done earlier. The main risk is that of miscarriage, which is about 1-2%.
Once this test has been recommended to you, you have the final decision on whether you would like to go ahead with CVS or not. We will support you in making a decision and addressing any concerns you may have.

Intrauterine transfusion (IUT)

Intrauterine transfusion (IUT) is usually required when a baby has severe anaemia while still in the womb and it is too early to deliver the baby. Severe anaemia can be caused by antibodies such as Rhesus antibodies produced by the pregnant mother destroying her baby’s red blood cells or by infections such as. In IUT the baby is given a blood transfusion while still in the womb. An intrauterine fetal blood transfusion requires specialist training .

IUT involves inserting a needle through the mother’s abdomen (tummy) and into the umbilical cord so that donated blood can be injected into the baby. An ultrasound scanner is used to help guide the needle to the right place. Local anaesthetic is used to numb the area, but you will be awake during the procedure.

You may need more than one intrauterine fetal blood transfusion. Transfusions can be repeated every two to four weeks until your baby is mature enough to be delivered. IUT may even reduce the need for other treatments (phototherapy) after birth, but further blood transfusions could still be necessary.There is a small risk of miscarriage and fetal death during an IUT, so it is usually only done in particularly severe cases. Understandably this can be a very overwhelming time and we will be here to support you and your baby every step of the way.

Back to Top