Fetal Medicine Services

Most pregnancies result in the birth of a healthy baby but for some women developments occur that need more specialist help. The Fetal Medicine Team consists of three Obstetric Consultants who specialise in Fetal Medicine, their secretary, Lizzie Hammond, and three midwives.

Consultants

Richard Smith

Martin Cameron

Alastair McKelvey

Midwives

Alison Evans – Lead Specialist Midwife and Antenatal Screening Coordinator

Julie Freschini

Ruth Hooper

Who do we see?

The Team sees women where a problem is suspected on ultrasound, either a structural abnormality such as a cleft lip or cardiac abnormality, or severe growth problems. They also see women who have had babies with abnormalities in the past or where there is a family history of genetic problems. They see women who have an increased risk of chromosome or genetic problems following a screening test i.e. Down syndrome, sickle cell disease. If a woman has had certain infections during pregnancy or developed particular blood group antibodies, they are also monitored by the Team.

Where are we based?

The Fetal Medicine Clinics are held in the Antenatal Clinic, Level 3 West Outpatients. We hold clinics every day of the week apart from Thursday afternoons and Fridays but do hold emergency clinics at these times if necessary. Our appointments can be quite lengthy and please bring your maternity hand held notes to each appointment.

How soon will I be seen?

You will naturally be very worried if the sonographer suspects something unusual when carrying out your scan. You will be referred to see one of the Fetal Medicine Specialists as soon as possible. We work in line with National Standards that say women should be offered an appointment within 5 working days but most women are seen by our Team within 3 working days.

If you are referred to the Fetal Medicine Team you will be given contact numbers for Lizzie Hammond and the Fetal Medicine Midwives office. We will contact you by phone to organise the appointment but if you have not heard after 1 working day please feel free to contact the team by ringing Lizzie Hammond on 01603 286790  or call Fetal Medicine Midwives 01603 286790

Your Fetal Medicine Appointment

Your first Fetal Medicine appointment will be approximately 30-40 minutes long. If a complex problem is confirmed appointments can take longer, allowing the opportunity to meet other specialists who are able to give more information about the problem and the care required. This can cause clinic times to run late. We apologise for any incovenience or anxiety this may cause but each woman will be given the time she needs.

The appointment will involve a detailed scan by the Consultant looking at the baby as a whole, not just the part of the baby where a problem is suspected. The findings of the scan will be discussed with you and there will be plenty of opportunity to ask questions. It may be helpful to write down any questions you may have before you come, so you can be sure you have all the answers you need. You will be given a written report at the end of the appointment detailing the discussion and any information leaflets available that you might find helpful. We will also make sure you have our contact numbers so that you can phone us if you are concerned or have other questions once you are home. If needed we will organise follow up appointments and you will be given these before you leave.

Further tests

Some women will be offered invasive procedures to try and identify if there are certain chromosome or genetic conditions. These include Chorionic Villous Sampling (CVS)  and Amniocentesis. If offered they will be fully discussed with you. Further information can be found on the links to the information sheets by clicking on the names.

Occasionally it is necessary to refer women to other hospitals if highly specialist review or care is required. If recommended, this will be discussed with you fully.

Other Specialists

A lot of Fetal Medicine care is about information and preparation for birth. If a problem is found in your baby you will be offered the opportunity to get more information from other specialist teams. Dependent on the problem found there are many teams that we work with, both at this hospital and other units. The main teams are as follows:-

  • Neonatologists – The Fetal Medicine Team work very closely with the Neonatologists – doctors involved in the care of newborn babies, usually on the Neonatal Intensive Care Unit (NICU). They will talk about what to expect if their input is likely to be required and will organise a plan of care for when the baby is born. If it is likely that your baby will need to spend time on NICU you will be given an opportunity to look round the Unit and see the facilities before your baby is born.
  • Paediatric Surgeons – Certain conditions will require surgery after birth. If this is the case you will be given an opportunity to meet one of the surgical team to discuss what this will involve. There is also a team of nurses on NICU who have a special interest in paediatric surgery and they are happy to talk with you before the baby is born so you know what to expect.
  • Research midwives – The Maternity Unit is involved in a number of research projects, sometimes women attending Fetal Medicine may be appropriate to join in a research trial, either to see if it can help in this pregnancy or to help gain information for the future. If this is the case, the options will be discussed with you by the Fetal Medicine Consultants or one of the research midwives, Elizabeth Turner, Rachel Appleton and Frances Fraser.

If you have been referred from another hospital, these teams will help advise whether it is ok for you to still deliver at your local hospital, which is mostly the case, or whether you will need to deliver at the Norfolk and Norwich because of the specialist services available.

A Specialist Health Visitor and a number of support agencies are available, offering vital support to parents of babies with problems. The Fetal Medicine Midwife will discuss these with you and offer you contact numbers and reliable websites for further information.

The Maternity Unit is involved in a number of research projects, sometimes women attending Fetal Medicine may be appropriate to join in a research trial, either to see if it can help in this pregnancy or to help gain information for the future. If this is the case, the options will be discussed with you by the Fetal Medicine Consultants or one of the research midwives. For more information see the research midwives page.

Difficult decisions 

Very occasionally a baby is identified as having an extremely serious condition. When this happens parents are given as much information as possible to help them make decisions about the pregnancy. We recognise that this is a devastating situation and the Team is there to offer information and support for parents, whatever the decision they make. More information can be found on the difficult decisions page for parents who find themselves presented with these difficult decisions.