posted 5 April, 2018

Fetal Cardiology

Both Dr Gladman and Dr Jones, Fetal Cardiologists, are based at Alder Hey Children’s Hospital in Liverpool where all the surgery and intervention are provided for the North West, North Wales and Isle of Man region. They diagnose and treat children with a wide range of heart problems but also specialise in fetal cardiology.

The fetal cardiologists, in conjunction with the specialist midwives from Saint Mary’s Hospital and specialist nurses from Royal Manchester Children’s Hospital, work together to provide support for families throughout the pregnancy.

Conditions dealt with

Many congenital heart conditions (CHD) can now be picked up before birth by performing a detailed scan (fetal echocardiogram), though some conditions remain difficult to detect.

You may be referred to the team for an echocardiogram after your sonographer had suspected a problem on the routine 20 week scan.  We see a wide range of problems that can develop when the heart is not formed properly early in pregnancy.  Many congenital heart problems can be treated, usually with surgery to repair the heart and create a normal circulation.  However, there remain a number of complex CHD where we cannot fix the heart, but only offer surgery to re-direct the blood and use the heart in a different way.  In rare severe cases there may be no treatment possible.

A proportion of babies diagnosed with CHD may have an underlying genetic or chromosomal problem or other abnormalities in other parts of the body.  When we see a significant heart problem we usually recommend a detailed scan with a fetal medicine specialist to check the rest of the baby and often discuss the option of an amniocentesis test to look for genetic problems.

For pregnant women at slightly higher risk of having a baby with CHD, a specialist echocardiogram is also recommended.  For families where the mother, father or a previous child has a congenital heart condition, this can be a worrying time.  After assessment, we can, in many cases, reassure the family that the baby’s heart is normal.  In a small number of cases a problem with the heart may be detected.

What is offered to patients?

Following a diagnosis of CHD our team will then explain the diagnosis, further tests that might be recommended or offered and discuss all options with the family.

Pre-natal diagnosis gives time for the family to learn more about the heart condition and prepare themselves for the treatment or surgery that might be required after birth.  Following repeat assessments we can then decide on the best place to deliver the baby, depending on their heart problem and whether early treatment may be required in the first hours or days after the baby is born. This means that we can keep the baby as safe and well as possible prior to any treatment or surgery they may require.

We work closely with the cardiac specialist nursing team at Royal Manchester Children’s Hospital, who can arrange to meet up with families to discuss diagnosis and treatment and support parents before and after their baby is born. Where early surgery is required, some families may want to visit the surgical centre, Alder Hey in Liverpool and meet with the cardiac team.

What else?

Congenital heart care and treatment in the UK is monitored nationally and this information is collected centrally by NICOR (National Institute for Cardiovascular Outcomes Research).  They are now beginning to collect information on which heart conditions are diagnosed before birth; it is hoped that this will help improve pre-natal diagnosis rates across the country.

The fetal cardiologists provide training across the North West for sonographers to improve skills as well as participating in research studies.

Location

Clinics are held in the Fetal Medicine Unit (within the Ultrasound Department) at Saint Mary’s Hospital in Manchester.

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How can I access this service?

Your local obstetrician, midwife, sonographer, cardiologist or GP can refer you for a specialist fetal echocardiogram by contacting the specialist midwives at the Fetal Medicine Unit on (0161) 276 6385.

Contacting the Fetal Cardiology Team

Saint Mary’s Hospital

Fetal Medicine Unit – (0161) 276 6385:

  • Consultant Fetal Cardiologists – Dr Gordon Gladman*; Dr Caroline Jones*
  • Clinical Lead Fetal Medicine – Dr Phil Bullen
  • Specialist Midwives – Lynn Kirby; Della Carr; Jen Easton

 

Royal Manchester Children’s Hospital

Cardiac Liaison Nursing Team – (0161) 701 0664

  • Clair Noctor; Tessa Latimer; Laura Jole

 

Alder Hey Children’s Hospital

Cardiac Liaison Nursing Team – (0151) 252 5291

  • Gill McBurney; Mary Murray; Helen Walker; Amanda Haworth; Marie Murphy; Michelle McLaren

 

Liverpool Women’s Hospital

Fetal Medicine Unit – (0151) 702 4072

  • Consultant Fetal Cardiologist – Dr Joyce Lim*
  • Clinical Lead Fetal Medicine – Dr Devender Roberts
  • Consultant in Fetal Medicine – Dr Umber Agarwal

*All the fetal cardiology consultants are currently based at Alder Hey but can be contacted through the specialist midwifery team or specialist nurses to arrange a further consultation or to discuss questions.