Antenatal
Initial 'get to know you' consultation
In this session, both parents-to-be and Professor Savvidou will discuss due dates, concerns and delivery options. A quick scan may well be indicated if the pregnancy is deemed to be around 7 weeks.
Antenatal consultations take place within the state-of-the-art Kensington Wing
Consultations:
The appointments with Professor Savvidou are every 2-4 weeks, depending on the circumstances, up until 32 weeks, when visits increase to every 2 weeks. At 36 weeks, consultations move to weekly until delivery.
The following are the standard appointment times. Additional visits are always arranged throughout the pregnancy to ensure the ongoing wellbeing of both mother and baby.
First Visit 6-10 weeks
During this "getting to know you" session, medical history, due dates are discussed along with any concerns and planned care during pregnancy and delivery. A 'viability & dating' scan may be offered or arranged. Recommended blood screening tests will be explained to you, and samples taken with your consent.
From 10 weeks the NIPT (Non-Invasive Prenatal Testing) can be offered. Non‑Invasive Prenatal Testing (NIPT) is a highly accurate screening test that analyses small fragments of fetal DNA circulating in the mother’s blood. It estimates the chance that a baby has certain chromosomal conditions, including:
• Trisomy 21 (Down syndrome)
• Trisomy 18 (Edwards syndrome)
• Trisomy 13 (Patau syndrome)
NIPT is a simple blood test and is completely safe for both mother and baby. It provides early reassurance in pregnancy, with detection rates above 99% for Down syndrome. Parents can also choose to find out the baby’s sex.
It is important to remember that NIPT is a screening test. It cannot confirm or exclude a condition with certainty. If the result indicates a high chance of one of the above conditions, further diagnostic testing may be recommended.
11-13 weeks
Ultrasound and blood screening for chromosomal disorders are performed. A nuchal translucency scan is part of the screening for Down's syndrome and puts the baby at no risk.
Flu vaccination will also be discussed.
16 weeks
Mother and baby wellbeing visit. This includes reviewing the blood and scan results and checking that you and your baby are doing well. Whooping cough (pertussis) vaccination can be administered.
19-22 weeks
Mid-pregnancy mother and baby check. A detailed anatomy scan will be arranged. If all well, antenatal classes can be booked.
25-26 weeks
Mother and baby wellbeing visit. Routine blood tests will be discussed and arranged. RSV vaccination is also discussed at this stage.
28-30 weeks
Mother and baby wellbeing visit. Further routine blood tests will be taken to check haemoglobin levels and your blood group. A glucose test will also be performed to check for the development of gestational diabetes. If your blood group is Rhesus negative (which we will know from your first blood tests), you will be advised to have an Anti-D injection.
32-34 weeks
Mother and baby wellbeing visit. A fetal growth scan will be advised.
36 weeks
Mother and baby wellbeing visit. Signs of labour and birth plan are discussed around this time. Screening for Group B streptococcus is offered.
37, 38, 39, 40 & 41 weeks
Mother and baby wellbeing visits. Options for on-going pregnancy care, and/or make plans to start labour if appropriate are also discussed in these visits.
Antenatal classes are strongly recommended, especially for first time parents. There are many options open to mothers both for individual or group classes. The Kensington Wing offers regular birth preparation workshops for couples and can be arranged directly with the unit. Price is by arrangement with individual practitioners.
Scans:
All women are offered at least two ultrasound scans in pregnancy: a nuchal translucency scan at 11–13 weeks (as part of Down syndrome screening) and a detailed anomaly scan at 19–22 weeks. An early viability scan is advisable to confirm the location of the pregnancy. Further growth and reassurance scans will be arranged during pregnancy.
Blood and urine tests:
It is recommended to have routine urine and blood screening tests, which include testing for anaemia, blood group, congenital infections and diabetes . Some of these tests are repeated later in pregnancy and occasionally additional tests may be required.
Full blood count
This test is to check for anaemia, lack of enough healthy red blood cells . If anaemia is discovered, iron supplements and further blood tests are often recommended. This test is repeated at 26-28 weeks.
Electrophoresis
This test is to test for hereditary forms of anaemia, mainly sickle cell and thalassaemia. These forms of anaemia are more common in black, Mediterranean or oriental people. If you are found to be a carrier it will be recommended that your partner be also tested. If both parents are found to be carriers, there is a chance that the baby may be affected by the disease and further tests will be offered.
Blood group and antibodies
It is important to know your blood group and whether you have antibodies in case you need a blood transfusion. About 1 in 6 people are Rhesus negative. If you are Rhesus negative you will need Anti-D injections to prevent the development of antibodies that can cause fetal anaemia.
Hepatitis B and C
These infections cause liver damage. They can be transmitted in several ways - sexually, contact with blood or other blood fluids or from mother to baby. Some people are not severely ill but become carriers of Hepatitis and are still infectious. If Hepatitis is diagnosed then further follow up and investigations are appropriate, mainly so the baby can be protected against Hepatitis B by immunisation soon after birth.
Syphilis
This is a rare sexually transmitted infection, which women may have without knowing. It can cause abnormal development of the unborn baby. Treatment with antibiotics early in pregnancy can prevent harm to your baby.
Rubella (German measles)
Immunity to Rubella is important as this infection can cause severe abnormalities of the unborn baby. Most people are immune to Rubella, either through vaccinations or a previous infection. If immunity is not present then rubella contact should be avoided and a vaccination will be offered to you following the delivery.
HIV (Human Immunodeficiency Virus)
This virus infects and damages the immune system and can cause HIV related illnesses, such as AIDS. HIV can be passed from mother to baby during pregnancy, at birth or during breastfeeding. If you are HIV positive and receive no treatment during pregnancy and breastfeed, the risk of the baby becoming infected is about 20%. With the appropriate drug treatment and not breastfeeding, the risk is reduced to less than 1%.
Glucose
This is a test for diabetes during your first visit. Some women develop mild diabetes during pregnancy and this can be potentially problematic for both mother and baby. If the sugar test is abnormal, further blood tests will be indicated (mini glucose challenge test or full glucose tolerance test). A routine glucose test will also be offered at around 28 weeks. Most cases of diabetes in pregnancy (Gestational Diabetes) can be controlled by appropriate diet. Rarely tablets or insulin injections may be required.
Group B Streptococcus (GBS)
Group B Steptococcus is a kind of bacteria that many people harbour in their intestinal tracts. The bacteria may also inhabit (or "colonise") the vagina and be passed to the baby during labour and birth. Approximately 10% to 30% of pregnant women carry GBS in the vagina or surrounding area. If this is the case, then IV antibiotics will be needed during labour.
Further Information: http://gbss.org.uk/
