A fetal medicine specialist is a medical consultant whose area of expertise is in the care of the pregnant woman, fetus and neonate (newborn baby) during and immediately after pregnancy and birth. The health of the fetus and mother is closely linked, and fetal medicine is sometimes called, or heavily overlaps with, maternal-fetal medicine. These doctors have very specialized training to ensure the best expert care in and around pregnancy. Not all pregnancies require close monitoring by fetal medicine consultants, and many low risk pregnancies are entirely midwife-led. Obstetricians and maternal-fetal medicine specialists are usually only consulted when the pregnancy is high risk or where pregnancy monitoring and scans have highlighted an area for concern.
Pregnancies where there is a high risk of inherited conditions may require extra testing including genetic testing, counselling, and a plan of action for when the baby is born.
Fetal medicine uses modern technology like ultrasound scans in 2D, 3D, or 4D (where you see a 3D video, rather than a series of still pictures) to examine the fetus in utero without having to do any invasive testing. At least two ultrasound scans are recommending in all pregnancies, and these can help spot abnormalities for early intervention. If a problem is noticed in one of these scans, a team of doctors can help make decisions about the best way to manage any concerns and anticipate any special care the baby may need.
Fetal medicine specialists are likely to be involved in pregnancies that are considered high-risk because of health concerns surrounding the mother, for example where there are pre-existing serious medical conditions such as poorly-controlled diabetes mellitus or kidney disease. The expectant mother may need extra health checks for herself, regular blood tests, and scans to monitor the development of the fetus and progress of the pregnancy. They are also involved in pregnancies where there are fetal health concerns to monitor or treat.
An appointment at a fetal medicine specialist clinic is likely to start with some basic observations like blood pressure and heart rate, which may be taken by a nurse or health care assistant. They may take a urine sample and blood tests. An ultrasound scan of the fetus will then be done by a member of the maternal-fetal medicine team. In lower risk pregnancies this can be done by a qualified sonographer, and in higher risk pregnancies a more detailed scan may be done by the consultant. The scan is painless, non-invasive and safe for mother and baby. The ultrasound scan is to make sure that everything seems normal in the pregnancy; they will look at the position of the placenta, umbilical cord, the quality of the amniotic fluid and the fetus, and visualize and measure some of the fetal organs. Some of the things they look for in a scan vary depending on the stage of pregnancy. You will be able to watch and ask questions, and some scan photographs can be printed out for you to take home.
A thorough medical history will be taken during your visit, and you may have to wait a short while for test results before your doctor can diagnose or put together a treatment plan.