Fetal medicine clinics
We give individualised care if we’re concerned about the health of your unborn baby. We’re part of a regional multidisciplinary team with access to other specialist doctors when needed including neonatologists, fetal cardiologists and neurosurgeons.
What we do in our fetal medicine clinics
You’ll have a named midwife in fetal medicine who’ll look after you.
- assess people at added risk of fetal abnormality
- confirm diagnosis of fetal abnormality
- assess possible complications in multiple births
- tell you about the choices you have and likely outcomes in detail
- monitor you and your baby where needed
- give ongoing psychological support and counselling.
Understandably this can be a very overwhelming time. We’re to support you and your baby every step of the way.
What to expect from your fetal medicine appointment
When you arrive, report to our reception desk. We’ll take your pregnancy notes and check you in.
We’ll try to see you on time. Sometimes delays can happen but we’ll keep you updated and tell you when we’re likely to see you.
When we’re ready, we’ll call you into one of our scan rooms and take your medical and obstetric history. Before the scan, we’ll explain what will happen and confirm that you’re happy to go ahead.
What happens after the scan?
We’ll explain the results and give you time to ask any questions.
You may feel anxious about your appointment. If you have any questions or concerns, speak to one of our midwives. You can also get advice and support from Antenatal Results and Choices (ARC) about what to expect during and after antenatal screening.
Other clinics and services
We also run other specialist antental clinics.
A consultant obstetrician, midwife and maternity support worker runs this clinic.
We’ll see you if you have:
- given birth before 34 weeks gestation
- had your waters break before 34 weeks (preterm prelabour rupture of membranes)
- had a late miscarriage
- a cervical cerclage (cervical stitch) in a previous pregnancy
- an usually shaped uterus (womb)
- had surgery to the cervix after an abnormal smear test
- had a caesarean section when you were fully dilated
We’ll also see you if the sonographer thinks your cervix looked short on your ultrasound scan.
How do I get a referral?
From your GP, community midwife, hospital doctor, or sonographer at scan. Talk to your midwife if you think you need a referral to us.
When during my pregnancy will you see me?
This depends why you’ve been referred to us. Your first appointment may be from 14 to 18 weeks. We see some people regularly up until about 24 weeks.
What happens during my appointment?
- take your medical history and talk through your pregnancy care plan
- send a urine sample to the lab to check for infection
- offer an internal scan to measure the length of the cervix (neck of the womb) and monitor changes which can sometimes lead to preterm birth
- consider taking a vaginal swab test to help predict your risk of an early birth (preterm birth)
- review if you need to take medication or have a stitch to help keep your cervix closed
Our team will make a plan of when we to see you next in our clinic, or when your midwife or other specialist doctor needs to see you.
We’ll monitor you closely in the first two thirds of your pregnancy and give you treatment to help prevent premature labour.
Usually we discharge you after 25 to 26 weeks. At that stage, your midwife, GP or general obstetrician will look after you.
How often will you see me?
This depends on your reason for coming to the clinic and what we find at each visit. We’ll base your care plan on your needs and talk you through everything.
We offer individualised care for you and your family if you’re expecting twins, triplets or more.
There are two types of twins depending on the number of placentas.
Dichorionic diamniotic (DCDA) twins
Each has their own separate placenta with its own separate amniotic sac.
We see DCDA pregnancy patients on Monday mornings at Stoke Mandeville Hospital.
Your twins aren’t at risk of twin to twin transfusion syndrome (TTTS) so we scan your babies every 4 weeks.
Monochorionic (MC) twins
There are two types of MC twins.
Twins will share a single placenta with two separate amniotic sacs (MCDA) or they will share the same amniotic sac (MCMA).
All appointments from 16 weeks will be in the fetal medicine clinic.
What happens if my babies are MCDA?
You’ll need more scans and monitoring. This helps us find any problems as early as possible such as twin to twin transfusion syndrome (TTTS). If your twins have TTTS, we’ll offer you a treatment called laser ablation at our regional referral centre.
If you’re carrying MCMA twins you’ll also have regular scans. With this type of twins, there’s often some cord entanglement so we recommend delivery at 32 to 33 weeks.
We provide additional ultrasound scans to identify placental dysfunction. Scans also detect complications earlier in a later pregnancy following baby loss. This helps us to plan further monitoring and birth.
Ultrasound scanning methods help us look at the placenta, and the blood flow to and from the placenta in more detail.
What we do
- a personalised care plan to address the cause(s) of your previous baby loss
- an ultrasound scan tailored to your clinical circumstances
- consultant led care with midwifery support
- discussion about timing and method of birth.
We also give continued care and additional psychological support. Our specialist midwives are closely involved in providing care in your pregnancy which helps reduce anxiety and stress levels during pregnancies after the loss of a baby.