Advanced Maternal Fetal Medicine Clinic by King’s
Fetal medicine focuses on the care of pregnant women (obstetrics) where there is a need to monitor the health and wellbeing of the unborn child (fetus). This includes monitoring the rate of the baby’s growth, as well as diagnosing and managing fetal disorders and abnormalities using both invasive and non-invasive methods.
Women are normally referred to the unit for routine scans during pregnancy and when a routine scan has shown an abnormality in their unborn baby, or if there is any concern for the unborn baby’s health. We offer specialist care, including counselling, for women who are having problems with their pregnancy, or who have had a previous pregnancy where there have been fetal abnormalities. Our doctors work closely with obstetrics and gynaecology teams at the hospital to offer a complete package of care for expectant mothers.
Our fetal medicine service has direct links with The Fetal Medicine Research Institute in London which is part of King’s College Hospital, led by world-renowned fetal medicine expert, Professor Kypros Nicolaides. We also have links with King’s College Hospital’s Harris Birthright Centre, a leading clinical unit and research centre for the assessment and treatment of unborn babies, caring for more than 10,000 patients each year.
The service is led by a team of doctors who are highly skilled and proficient in the diagnosis and treatment of problems associated with unborn babies. Women who are referred to our team are seen urgently and, depending on the results of their scan, will be referred to other doctors within our group who specialise in genetics, fetal cardiology, neonatology, surgery and/or neurology who will advise on the best treatment options.
Services we offer: Tests and ultrasound scans in singleton and multiple pregnancies
Your doctor will be able to advise you about the tests and scans that are recommended during your pregnancy. These do not always offer definite answers but they can help to identify high risk pregnancies. We offer the following tests and services:
- Viability scan / Early pregnancy scans: carried out at 6-10 weeks of pregnancy to check the number of embryos and whether the pregnancy is progressing normally.
- First trimester combined screening/nuchal scan: the combined first trimester screening test aims to calculate your risk for having a baby with chromosomal abnormalities. During the scan, we will measure the amount of fluid at the back of baby’s neck/nuchal translucency. Each woman will be given an estimate of her individual risk for this pregnancy. This is calculated by taking into account the age of the mother, measurement of two proteins in the mother’s blood and the scan findings of nuchal translucency thickness, nasal bone, blood flow through the fetal heart and fetal liver and the presence or absence of any fetal abnormalities. Parents will receive full counselling regarding the significance of the calculated risk and the various options for further investigations if necessary.
- Early anomaly scan: usually carried out before 18 weeks of pregnancy, this ultrasound scan checks for significant abnormalities in the baby.
- Detailed anomaly scan: this routine ultrasound scan is usually performed between 18 to 24 weeks of pregnancy. During the scan, a series of measurements of the fetus (fetuses) are taken to assess fetal growth, each part of the fetal body is examined in detail, and the position of placenta and the amount of amniotic fluid are determined.
- Cervical assessment: carried out vaginally, this ultrasound scan can detect any changes in the cervix that may lead to a preterm (premature) birth; it’s offered to high-risk patients who have previously had a premature baby and women with multiple pregnancies.
- Doppler scan: an ultrasound scan that assesses your baby’s health, measuring blood flow in various parts of the body including the umbilical cord, placenta, brain and heart, and checking the baby has all the oxygen needed via the placenta.
- Fetal wellbeing scan: carried out at around 32-34 weeks of pregnancy. You may be offered this ultrasound scan if you’ve had previous complications of pregnancy such as pre-eclampsia, growth restriction, diabetes, or stillbirth; or if you have a problem with your current pregnancy. The scan measures the size of the baby’s head, abdomen and thigh bone; estimates the baby’s weight; checks for movements; evaluates the placental position and appearances; measures the amount of amniotic fluid; and assesses blood flow to the placenta and fetus using the Doppler ultrasound.
- Fetal Echo Scan / Fetal Echocardiography: This is a detailed assessment of the fetal heart using a special ultrasound. This test helps to rule out any cardiac anomalies
- Non-Invasive Pre-natal Test (free cell DNA test): this test analyses fetal DNA in the mother’s blood and indicates whether the fetus is at high or low risk of having the most common chromosomal conditions including Down’s syndrome, Edward’s syndrome or Patau syndrome.
- Down’s syndrome (or trisomy 21) is a disorder caused by an additional chromosome 21, which results in delay in growth, the development of characteristic physical features and, in many cases, learning disabilities.
- Edward’s syndrome is caused by an additional chromosome 18 and babies are often born smaller than average and with heart defects.
- Babies with Patau’s syndrome have an additional chromosome 13, affecting the unborn baby’s growth and development as well as causing a number of other serious medical problems.
- Antenatal diagnosis and management of fetal abnormalities:
- Chorionic villus sampling (CVS) is a needle test to examine a sample of cells taken from the placenta to check the chromosomes and the genes of the baby. (This test is offered between 11 and 16 weeks of pregnancy)
- Amniocentesis is a needle test where a very small amount of amniotic fluid is taken to test for chromosomal or genetic syndromes. The test is offered between 11 and 16 weeks of pregnancy.
- Cordocentisis is an invasive test to check for any genetic abnormalities by taking a blood sample from vessels in the fetal umbilical cord.
- Regular monitoring of high risk pregnancies using ultrasound: these provide important information about the development and the growth of the baby. It is the choice of both parents whether they should have all the recommended scans or not.
Our consultants have a wealth of knowledge and experience in providing professional, quality care to expectant mothers. For more information on our fetal medicine services call or book an appointment below.