Many (but not all) congenital heart abnormalities can now be diagnosed before birth. A very small number can be suspected as early as 13-14 weeks into the pregnancy during the ‘booking’ scan, or following the nuchal translucency test (detection of increased neck skin fold thickness) at around that time. More will be picked up on the ‘detailed’ anomaly screening scan performed at around 20 weeks of pregnancy. When a heart abnormality is suspected, or when there is a higher risk that a baby may have a heart problem for other reasons, the expectant mother is referred to our EMCHC fetal cardiac service, led by Professor Frances Bu'lock (pictured).
We aim to see all women in whom a fetal heart problem is suspected, within 24-48 hours of referral. We carry out over 600 fetal cardiac scans a year at Leicester Royal Infirmary and Glenfield. We aim to expand the service to provide 3 clinics a week in Leicester’s maternity units as well as an enhanced service at Glenfield in Spring 2011.
When a fetal heart problem is suspected, as detailed a diagnosis as possible is made, and this is explained to the prospective parents, using diagrams and additional written information as available. We provide ongoing local support and parents are encouraged to ask as many questions as they need and a second opinion is always supported if requested. Parents also receive a copy of the letter to their referring unit which details what has been found and discussed and what the future options are so they can refer back to this in future if needed as well.
We accept referrals from anywhere in the East Midlands, including Lincolnshire, Derbyshire, Nottinghamshire, Peterborough and Northamptonshire. In general most referrals come via local obstetric or fetal medicine teams or specialist midwives and sonographers, but we also accept GP referrals when appropriate.
When a heart problem is diagnosed, parents are usually offered additional cardiac scan appointments around 28 weeks gestation to monitor any changes in the fetal heart condition as the baby develops, usually in the LRI clinic. A further appointment at around 34-35 weeks at EMCHC is also usually offered when the baby is likely to need inpatient management at Glenfield soon after birth, to allow parents chance to look around the wards and parents accommodation and address more practical issues related to the time after baby's birth.
Many babies can safely deliver normally at the normal time, even quite long distances from Glenfield, as we are able to transfer these babies very safely after birth. This minimises disruption to families, but also removes worries about travelling distances ‘in labour’. However, a small number of babies will need to have their delivery planned to be in Leicester.
Some problems cannot be either completely diagnosed before birth, nor indeed completely excluded, and this is explained to prospective parents. Where a repeat scan is needed after birth, parents are fully informed of what needs to happen and when.
For further information, contact the cardiac liaison team on 0116 256 3338.