Management in a Fetal Medicine Clinic

Abstract

The clinical problems which are encountered in referrals to a fetal medicine clinic vary according to the gestation, and their management will be discussed under these gestation headings: during the first trimester (usually 8–13 weeks gestation); the second trimester (usually about 19–20 weeks gestation); and the third trimester (usually 28–30 weeks gestation). To be effective, a fetal medicine clinic must have ready access to a team of experts who do not need to attend every time, but who can join the team when appropriate. The core of the team is formed by an obstetrician trained in fetal medicine, supported by a senior midwife with experience of ultrasound scanning and of counselling. Other key members of the team are the medical geneticist and the consultant radiologist who is able to offer a second opinion on difficult sonar scans. A neonatal paediatrician, paediatric cardiologist and paediatric surgeon come whenever they are needed, to advise parents on the management and prognosis of those babies likely to survive. Finally, the work of the clinic generates a great deal of administrative work and adequate secretarial support is essential.