Leeds Fetal Medicine Unit

Introduction

We appreciate that being referred to Leeds Fetal Medicine Unit may be a worrying time for you. As a team we will ensure you feel supported and receive all the appropriate advice and information you require. We hope you find this information useful as you start your Fetal Medicine journey.

If you need any support regarding your baby’s diagnosis, decision making or anything else, please do not hesitate to contact the Fetal Medicine team.

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Getting to Leeds Fetal Medicine Unit

Address

Fetal Medicine Unit, Antenatal Clinic, A Floor, Clarendon wing. Leeds General Infirmary, Belmont Grove, Leeds, LS2 9NS

By Road

• The main entrance to Leeds General Infirmary is located on Great George Street.
• The entrance to Clarendon Wing (where the Fetal Medicine Unit is located) is on Belmont Grove. You can also walk through the hospital to Clarendon Wing from the main entrance.
• The hospital can be accessed via the A6120 to the north, taking the exit on to Otley Road and continuing onto Headingley Lane and Woodhouse Lane, or from the M621 to the south. taking the exit on to the A643 and continuing onto the A58, Westgate and Calverley Street.
• For sat nav location enter LS1 3EX.

• Patient and visitor car parking is available within the multi-storey car park, which is located along Clarendon Way, at the front right side of the hospital grounds.
• There are clearly marked Blue Badge bays located within the multi-storey car park.
• There are also marked Blue Badge bays located in front of the entrances to each individual wing.
• Blue Badge parking is free.

By Train

• Leeds Train Station (LS1 4DY) is located in the centre of Leeds. Leeds General Infirmary (LGI) is a 10-15 minute walk from Leeds Train Station and there are buses every 10 minutes from outside the station that drop off at the LGI.

By Bus

• Many buses coming to Leeds stop on the Headrow. This is a short walk from the hospital.
• The LGI is on a main bus route and the West Yorkshire Metro website can be used to plan your journey.

Why you have been referred to Leeds Fetal Medicine Unit

There are a few reasons why you may have been referred to Leeds Fetal Medicine Unit which are outlined below.

A possible abnormality has been found on an ultrasound scan

You have been advised that a potential abnormality has been identified when scanning your baby. When this happens, it can be unexpected and often a worrying time for you and your family. Leeds Fetal Medicine Unit will be able to support you and your family and answer any questions you may have.

You have received a higher chance screening result and would like invasive testing

Your local screening team have contacted you to inform you of a higher chance result for Down Syndrome, Edwards Syndrome or Pataus Syndrome. Following your discussion with them they have referred you to Leeds as you have chosen to have invasive testing. This is undertaken in Leeds as this is a specialist procedure.

Your baby is at higher chance of a genetic or chromosomal difference

Through previous experience or testing you may be aware that you and/or your partner are carriers of a condition, or that you may be likely to have a baby with a genetic or chromosomal condition. If you have chosen to find out whether your baby is affected through invasive testing, then you will need to come to Leeds. Leeds performs invasive testing for the region due to this being a specialist procedure. In this instance you will have possibly had a discussion with a genetic counsellor before being referred to Fetal Medicine.

Who will care for you when you attend?

The Fetal Medicine team consists of:

• Fetal Medicine consultant obstetricians – These are the doctors who will perform your ultrasound scan, any invasive testing or procedures and counsel you regarding any diagnosis or choices. They are the experts in the region for Fetal Medicine.
• Sub-speciality trainees – These are very experienced obstetric doctors who are nearing consultant level. They have specialised in Fetal Medicine therefore are essential to supporting you and the Fetal Medicine team.
• Fetal Medicine midwives – These are midwives who have chosen to specialise in Fetal Medicine. They feel passionate about ensuring you feel supported throughout your Fetal Medicine journey and are often your first point of contact for support and advice outside of your appointment. They have specialist skills and knowledge to be able to provide you with high quality care throughout your appointment.
• Maternity Support Workers (MSWs) – MSWs may perform some clinical procedures and tests whilst you are in your appointment including blood taking and blood pressure. They may also discuss other aspects of care with you such as infant feeding. MSWs are often the members of the team who initially will answer if you contact Fetal Medicine via phone. They are integral to the running of the team and are sensitive to the nature of the care we provide therefore will support and assist you throughout your time in Fetal Medicine.
• Other relevant professionals – In some cases you may also have contact with another professional who will give you further information and advice. These professionals may include, but are not limited to:
  
  – Neonatologists (Doctors specialising in the care of sick newborn babies)
  
  – Fetal cardiologists (Doctors specialising in heart conditions of babies diagnosed in
  pregnancy)
  
  – Fetal cardiac nurse specialists (Nurses specialising in heart conditions of babies
  diagnosed in pregnancy)
  
  – Neonatal surgeons (Doctors specialising in surgery of newborn babies)
  
  – Neonatal nurses (Nurses specialising in the care of sick newborn babies)
  
  – Paediatric urologists & Nephrologists (Doctors specialising in the care of babies and
  children with kidney, bladder or urinary tract problems)

Getting to other useful departments in Leeds

During your Fetal Medicine journey, you may be advised to visit some of our other departments. Below is a list of these. Some departments are in Leeds General Infirmary (LGI) and some are in St James’s University Hospital (SJUH). Both hospitals are one trust, situated at either side of Leeds city centre.

How and when will you receive an appointment for Leeds Fetal Medicine Unit?

A member of the Fetal Medicine Unit team will ring you to book your appointment. We aim to ring and inform you of your appointment within 2 working days of receiving your referral.

The timing of your appointment will depend on why you have been referred. For example, if you have been referred for an invasive test then these are done at certain weeks of pregnancy. Or you may have been referred due to an unexpected scan finding and we would aim to see you as soon as possible at our next available appointment.

It is important for you to be aware that we are only able to process your referral if we receive all the information we require from your local hospital and without this there may be a delay. All referrals are triaged by a consultant or specialist midwife to ensure that you receive the most appropriate appointment.

Important information about your appointment

You are able to attend your appointment with up to two supportive adults of your choice who will be able to stay with you throughout your appointment. We appreciate that having support at this time is important therefore we encourage you to choose people who will be able to provide that support to you. If you need to come alone to your appointment, please be reassured that our team will support you throughout your appointment.

We encourage you to not attend with any children you may have. This is to allow the doctor and specialist midwives to concentrate when scanning in a darkened room and performing additional tests. It is also because you may be given a lot of information and the appointment can be a challenging time for you. If you do not have childcare for your appointment please discuss this with the member of staff calling you to book the appointment.

It is important you bring any handheld antenatal notes and a urine sample to your appointment. You can get a bottle for this from your local maternity unit, community midwife or GP surgery. Please do not worry if you are unable to bring a urine sample, you can provide one at your appointment if needed.

If you are under 20 weeks of pregnancy, please try to attend with a full bladder as this can help the doctors when scanning your baby.

What to expect when you attend your appointment

When you arrive in Antenatal Clinic at the LGI, let the reception team know you are here for a Fetal Medicine Unit appointment and they will direct you to the waiting area.

Throughout your appointment you may have contact with one of our Fetal Medicine maternity support workers. They will take your blood pressure, test your urine and/or perform other checks or tests that have been recommended.

You will be invited into a scan room for your consultation. This will be led by one of our specialist Fetal Medicine consultants and sometimes a sub-speciality doctor. A Fetal Medicine midwife or MSW may also be in the scan room during your appointment. Sometimes, other professionals may be present if required, such as a neonatal consultant.

Medical and midwifery students may occasionally be present in Fetal Medicine however if you do not wish for them to be in your consultation, please inform the consultant or midwife.

When in the consultation room the team would like to perform an ultrasound scan of your baby. They will then discuss the findings with you. This discussion will include your options for further testing to allow you to make a fully informed choice for your individual management plan. Your plan may include further appointments in the Fetal

Medicine Unit or it may be that you will receive care back in your local hospital, or often a combination of both.

You may be offered Invasive Testing at your appointment. Invasive testing is done to allow genetic testing of your baby and will test for possible chromosome or genetic conditions such as Down’s syndrome, Edwards syndrome and Pataus syndrome.

The invasive testing you may be offered include: Amniocentesis (sampling the amniotic fluid surrounding your baby) and Chorionic Villus Sampling (CVS) (taking a sample of your placenta).

For more information about these tests follow the links below:

You may also be offered other invasive procedures whilst on your Fetal Medicine journey. These may include:

• Intrauterine blood transfusion (transfusing blood to your baby in the womb)
• Amnio drainage (draining off some of the water around baby)

Additionally, you may be offered blood tests which may test for infection. Any tests you are offered will be discussed with you including any risks, benefits and alternatives to help you make a fully informed decision.

The team will advise you when your results are expected to be available. We would aim to ring you with your results when we have them. Please ensure we have an up to date telephone number for you.

At the end of your appointment, you will be given a scan report and have the opportunity to have a further discussion with a specialist Fetal Medicine midwife. We will endeavour to ensure that you leave your appointment feeling fully informed and supported. You will also have our contact details should you require our support after your appointment. A copy of your scan report will also be sent to your local hospital’s screening team so they are aware of the care you have received.

If you have been advised to birth your baby at Leeds Teaching Hospitals

Sometimes we recommend your baby is born in Leeds. This is because Leeds is a regional centre for neonatal cardiology, neonatal surgery and complex neonatal care. If you have been advised this then the specialist Fetal Medicine midwives will be your point of contact through organising this care. If you agree to your baby being born in Leeds, the Fetal Medicine midwives will arrange a telephone appointment with you to complete a booking appointment for Leeds Maternity. At this appointment they will ask you about medical, pregnancy and social history to ensure we have the correct information on our electronic record system to care for you and your baby.

The team will provide you with information about giving birth in Leeds and answer any of your questions or concerns. We will also give you information about parts of your care such as: the neonatal unit, infant feeding, and induction of labour. You may be offered a planned induction of labour or caesarean section for the birth of your baby. We recommend your birth is planned in advance to ensure the most appropriate neonatal teams are available to care for your baby after birth. This will be discussed with you to allow you to make a fully informed decision.

If it is recommended your baby is born in Leeds, it is important you still continue your antenatal care with your local hospital and community midwife.

Who should you contact if you have any concerns in your pregnancy?

If you have any urgent pregnancy concerns we recommend you contact your local Maternity Triage or Assessment Centre, even if you are not planning to have your baby at your local maternity unit.

You should contact your local Maternity Triage or Assessment Centre:

• If you have concerns about your baby’s movements
• If you have any vaginal bleeding
• If you think your waters may have broken
• If you have any abdominal pain
• If you think you may be in labour
• If you have any other concerns

We advise you contact your local hospital as this is the safest option for you and your baby.

If you are in labour when you arrive at your local hospital and are now due to give birth in Leeds, they will aim to transfer you to Leeds if it is safe to do so. However, if it is not deemed a safe option then they will transfer you and your baby after the birth. It is safer for your baby to be born in a hospital rather than on the journey when you are trying to get to Leeds.

Further support and information