What we do at our clinics
Our FMU clinics:
- Assess women at added risk of fetal abnormality.
- Confirm diagnosis of fetal abnormality.
- Give detailed information about likely outcomes, including
- Inform women and families about the choices available. On-going
psychological support and counselling is provided by the Fetal
- Provide women with a named midwife in Fetal Medicine.
- Institute ongoing monitoring of pregnancies where
- Undertake interventional and therapeutic procedures, such as
fetal blood transfusion.
- Assess possible complications in multiple births.
The service includes screening for, diagnosis of and treatment
(where relevant) of:
- Chromosome abnormalities.
- Fetal anomalies.
- Single gene genetic diseases.
- Haemolytic disease of the newborn.
- Complex multiple pregnancies.
- Fetal growth restriction.
Communication with referring clinicians and other specialties is
a crucial part of the work of the FMU service, with this being
formally assessed in both CNST (NHSLA) and Specialist Commissioning
evaluations of service effectiveness.
Types of Clinics
We have general clinics daily throughout the week. Here you will
be seen by one of our highly qualified consultants and specialist
midwives. During the appointment you will be scanned followed by
counselling about the diagnosis, outlook and further
Depending on the outcome of your scan, you may be offered one of
the following procedures within our clinic:
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 of 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
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
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
- Chorionic Villus Sampling
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
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's. A needle is
inserted through the abdomen (tummy) or occasionally through the
cervix (neck of the womb). The placenta has tiny fingerlike
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
CVS is offered when it has been suggested that there is a high
risk of the baby having such conditions. This could be
- 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
- Your baby has an anomaly that can be caused by chromosomal or
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 and is only available in a few hospitals such
as Saint Mary's Hospital.
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
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.