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    Fetal Medicine

    Fetal medicine focuses on the management of high risk pregnancies and includes the assessment of fetal (unborn baby) growth and the diagnosis of fetal illness and abnormality. Fetal medicine can be broadly divided into two branches: prenatal diagnosis and fetal treatment. Prenatal diagnosis is the ability to detect abnormal conditions of the fetus. The most common test used for prenatal diagnosis is ultrasound. Some abnormalities may be identified from additional blood screening or invasive diagnostic tests. Fetal treatment includes a series of interventions performed on the fetus with the aim of achieving fetal wellbeing. These interventions include medical (non-invasive) and surgical procedures.

    Contact details:
    Phone: 01 – 872 6572
    Email: fetalmed@rotunda.ie

    Referral form:

    Fetal Medicine Referral Form.docx

    Please complete the form if you wish to refer a woman to the unit for review or treatment.

    Prenatal Diagnosis Clinic

    The prenatal diagnosis clinic (PNDC) provides pregnancy screening, diagnostic testing, intrauterine therapies, and patient support and counselling. We provide a standard of excellence in the field of prenatal diagnosis and fetal medicine for patients from our own catchment area as well as for women referred to the clinic from other centres around the country. Our ultrasound scans are performed to the highest international standards and women are supported by informative and sensitive counselling services. Women and their partners receive personalised care by a team of specialist doctors and midwives.

     

    Services Provided Include:

    Non-invasive prenatal testing (NIPT) is a screening test that helps to identify if your baby is likely to have a chromosomal condition, for example, Down syndrome (Trisomy 21), Edward syndrome (Trisomy 18) or Patau syndrome (Trisomy 13). The blood test can be performed from 10 weeks of pregnancy onwards.  There is no risk of miscarriage associated with this screening test.  The test can be helpful in deciding if an invasive screening test is required to out rule one of the syndromes mentioned above.

    This test is not carried out routinely on all pregnant women. It is an ‘opt-in’ service and there is a fee for the screening test. Please contact the department for further information.

     

    Diagnosis of Chromosomal and Genetic Conditions

    Chorionic villus sampling (CVS) is a test where a small sample of tissue is taken from your baby’s placenta, which is tested for chromosomal or genetic abnormalities. The test is performed between 10 weeks + 5 days and 14 weeks gestation. Amniocentesis involves taking a small amount of amniotic fluid from the pregnancy sac around the baby in the womb, which is tested for chromosomal or genetic abnormalities. This test is performed after 16 weeks of pregnancy.

    Please follow these links for information on these diagnostic tests:
    Chorionic villus sampling
    Amniocentesis

    Fetal Cardiology

    If you have a family history of certain heart conditions or if your baby is suspected of having a heart problem on ultrasound scan you will need to attend the clinic for a fetal cardiac echo (scan) with a fetal medicine consultant. You may be referred to a special cardiac clinic in the Coombe hospital where you will meet a paediatric cardiologist. If there is an abnormality they will support and counsel you and will discuss the plan of care which is best for you and your baby.

    Monitoring Fetal Growth and Wellbeing

    Sometimes babies do not grow at the appropriate rate for their gestation. If this happens we will need to investigate the cause and monitor your baby more frequently with ultrasound scans during the remainder of your pregnancy.

    Complicated Multiple Pregnancies

    If you have a twin or triplet pregnancy you will attend a special clinic to monitor your babies’ growth and wellbeing. Sometimes babies share amniotic fluid sacs and placentas, which makes the pregnancy more complicated. However there are some treatments available if complications develop, including laser ablation.

    Intrauterine Therapies

    Some babies require treatment while they are still in the womb. These may include intrauterine transfusion, laser ablation, vesicocentesis and cordocentesis. We will provide you with information on any treatments you may require.

    PLEASE NOTE

    We will need to know your blood group if you are having any invasive procedure. Therefore, if you are not attending the Rotunda for antenatal care please bring details of your blood group with you. If you are on any medications, please contact us a couple of days before your appointment as you may need to stop or reduce your medication before the procedure.

     

    How we will support you if there is an abnormality or problem identified with your baby

    While most women give birth to healthy babies, about 3% will have a major birth defect. Most of these result from either a genetic or chromosomal disorder. When this happens we will provide parents with expert personal counselling and support and detailed information so that they can be involved in making decisions about their care. We will support you no matter what decisions you make about your pregnancy.

    All the doctors and midwife specialists who work in the fetal medicine centre have had special training in diagnosing abnormalities and in supporting couples who are attending the clinic. They work very closely with the paediatric team, specialist consultants in the paediatric hospitals and with the bereavement support team, where appropriate. Weekly multidisciplinary team meetings are held to discuss patients and assist with planning the management and care for the pregnancy and birth. We will provide you with the contact details and information on the relevant support groups and organisations.

    Please see the following websites for information on some genetic or chromosomal conditions:

    Down’s Syndrome www.ntqr.org PatientVideo
    Support Organisation for Trisomy 13/18 (SOFT) www.softireland.com

    If we know that a baby may be stillborn or may not live for long after birth, parents may also wish to contact a bereavement support organisation when the diagnosis has been made. They provide helpful and important information to help and support parents at the time they are told the sad news that their baby has died or is expected to die shortly after birth.

    Please see the following websites for information on these bereavement support groups and to view their information booklets.

    A Little Lifetime Foundation www.alittlelifetime.ie
    Anam Cara www.anamcara.ie
    Féileacáin www.feileacain.ie

    in Fetal Medicine