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Fetal Medicine Unit (FMU)

We are a multi-disciplinary team of professionals, with a team of consultants and fetal medicine specialists and specialist midwives based at the Royal Berkshire Hospital.

The team comprises of the following specialist staff:

  • Fetal medicine specialists
  • Obstetric consultants trained in advanced ante natal care - who run SGA clinics
  • Fetal medicine specialist midwives.

We work closing with a large team of specialists including:

  • Maternity team of sonographers
  • Screening team
  • Neonatologists
  • High risk maternal medicine specialists at RBH
  • Rainbow and bereavement team of midwives
  • Palliative team at RBH
  • Tertiary level fetal medicine unit at Oxford university hospital
  • Geneticists at Oxford university hospital
  • Antenatal results and choices
  • Maternity Voice Partnership

What we do

In approximately two to three in every 100 pregnancies the baby is affected by a condition which requires specialist care before or after birth.

The fetal medicine unit at the Royal Berkshire hospital provides diagnosis, support and counselling, prenatal diagnostic tests (where required) and makes a plan for care during pregnancy and labour. We aim to see pregnant women within 48 working hours following a referral to us. Our experienced professionals deliver specialist ultrasound care in a compassionate and supportive environment.  We work closely with the Maternity Voices Partnership and provide the use of a dedicated quiet space (the Meadow room), to offer support and counselling for women and their families.  We signpost women and their families to relevant support organisations such as Antenatal Results and Choices (ARC) and The Willows Support Group. A team of fetal medicine specialist midwives offer midwifery support to help women and their families navigate what can be a challenging journey. 

Our services

We hold 8 clinics per week (Monday PM, Tuesday AM, Wednesday & Thursday AM & PM, Friday AM).

If a problem is suspected during a routine scan, a referral is made to our fetal medicine unit and a scan is offered by one of the fetal medicine specialists. Most babies however do not need a specialist fetal medicine scan.

1-2 clinics per week - alternate Mondays AM and alternate Mondays PM.

We have a dedicated clinic where we monitor babies who are detected small for their gestational age, detected late (from 32 weeks) in pregnancy, so that we can plan the appropriate time for birth. The scans are performed either by fetal medicine specialist or by obstetricians who are trained in advanced ante natal care.

Specialist fetal echo scans are done by fetal medicine specialists - to diagnose conditions that might require referral to the fetal medicine unit in Oxford. These scans are done at the same appointments as fetal medicine scans, so that women do not have to come to hospital more than necessary.

We offer specialist ultrasound scans carried out by fetal medicine specialists when we suspect abnormally invasive placenta or abnormal cord insertions. If necessary, you will be referred early to Oxford university hospital to give birth.

We offer care for complicated twin pregnancies and low risk triplet pregnancies. Dichorionic (separate placentae), diamniotic (separate amniotic sac) twins have scans once in 4 weeks by our maternity sonographers and monochorionic twins (sharing a placenta) get scanned once in 2 weeks by the sonographers. They are referred to fetal medicine specialists early if there is any suspicion of growth restriction and or twin to twin transfusion.

Monoamniotic twins (sharing the same amniotic sac) and triplets (trichorionic triamniotic, triplets having their own placenta and in their own sacs) are scanned by fetal medicine specialists – these are arranged alternately between us at the Royal Berkshire hospital and at Oxford university hospital

Antenatal or obstetric care is provided by fetal medicine specialists in their respective ante natal clinics.

  • Care schedule for twin pregnancy
  • Birth of twins - what you need to know

We provide diagnosis and prevention of inherited and genetic fetal conditions. Women are offered appointments early in the first trimester and where required geneticists are contacted to discuss the required prenatal diagnostic tests (blood/ invasive diagnostic tests/ cord blood tests)

These are tests where a thin needle is inserted into the womb to obtain a sample of amniotic fluid (amniocentesis), placenta (chorionic villous sample (CVS)).

  • Screening amniocentesis and CVS testing

This test has recently been rolled out in the NHS and we offer this test for women who have a high chance result following the combined screening or quad test.

We offer surveillance and relevant treatment (progesterone pessaries / cervical stitch) to prevent premature birth in women with a previous premature baby, or those who have risk factors for preterm birth.

  • Preterm birth clinic leaflet

We offer surveillance and doppler scans relevant to placental function to pregnant women who have suffered pregnancy loss related to placental or unknown issues. Extra support and care is provided by the rainbow team of midwives and a consultant obstetrician.

  • Rainbow clinic leaflet

Women who have abnormal antibodies in their blood, which need extra care during their pregnancy, are discussed at virtual clinic with the fetal medicine specialist midwives and the blood transfusion team. 

This clinic occurs once in a month on a Friday morning. Women whose babies require special care after birth are seen in this MDT clinic. Women get scanned by one of the fetal medicine specialists which is followed by discussion of care of pregnancy and discussion of follow up plan for their babies (including new born checks and relevant scans for newborns where required or blood tests where indicated) with our neonatal consultant.

This virtual clinic occurs once every week, on Friday afternoons. Interesting fetal medicine cases from Berkshire, Oxfordshire & Buckinghamshire are discussed in this meeting and a  joint plan of care is made (virtually) for women who require combined fetal medicine care at Oxford and the appropriate district general hospital such as RBH. Besides the fetal medicine specialists and sub specialists from every unit, this meeting is also attended by paediatric cardiologists and geneticists.

 

This clinic is arranged for women whose babies have an antenatal diagnosis of a confirmed or potentially life-limiting condition and who have decided to continue their pregnancy. Women are seen by a team which includes a fetal medicine specialist along with a neonatal consultant, a paediatric palliative consultant and bereavement team members to discuss their care during pregnancy and labour and to discuss advanced care and symptom management of their baby after birth.

Women who choose to discontinue pregnancies for confirmed life limiting fetal abnormality are offered medical termination of pregnancy at the Royal Berkshire hospital. Women who choose surgical TOP are referred to British Pregnancy Advisory Service. Feticide is performed (in relevant cases).

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