More to consider
Initial Appointment - Before 12 weeks
At your first antenatal consultation Mr Fernando will take a comprehensive history, discuss your needs, and how your care is organised. If you have known medical problems and are under the care of a medical specialist please bring copies of correspondence and results of tests.
At this visit Mr Fernando usually performs a mini-scan to demonstrate that your pregnancy is progressing normally. This scan is non-invasive and allows your baby to be seen by placing the ultrasound probe on the tummy. It is helpful (at less than 12 weeks) to come with a full bladder as this allows a better view.
Routine blood tests in the first trimester –
Charged separately by the provider lab:
- Full blood count (to check for anaemia)
- Blood Group
- Vitamin D levels (important for fetal bone development and maternal health)
- Haemoglobin electrophoresis (to exclude thalassaemia or sickle cell disease)
- Full blood count (to check for anaemia)
- Infection screen:
- hepatitis B and C
- Cytomegalovirus (CMV)
- Rubella and varicella (confirm immunity to rubella and chicken pox)
- Additional blood tests may be indicated or requested depending on individual circumstances.
* You may require or request additional blood tests depending on your individual circumstances.
Although there are a large number of genetic tests that are now available they would not be regarded as routine tests due to the rarity of the conditions.
Clearly, in some cases, for example couples with a family history of genetic disorder then further investigation sometimes in conjunction with genetic counselling needs to be considered.
Genetic screening may also be indicated in couples with certain backgrounds (eg those with an Ashkenazi background may wish to have screening for Tay-Sacks and other associated genetic problems).
Most of these tests are screening tests (ie they are not definitive but allow identification of high risk or low risk of a problem) and all have implications so if you think that they may be appropriate for you please discuss this with Mr Fernando at your appointment.
These are usually done at The Doctors Laboratory (76 Wimpole Street); you will be given a form to take to the lab. You do not need an appointment; it is a drop in system. Opening hours and directions are on the form.
Results will normally be discussed at your next appointment unless urgent action is required.
Screening for Down’s syndrome and other chromosomal disorders
Non-invasive prenatal tests (NIPT)
Whilst most pregnancies are normal there is a risk of Down’s syndrome (or other chromosomal disorders) which increases with maternal age (this is often called background risk).
Currently the best tests to assess the actual risk of Down’s syndrome are the NIPT tests. There are a number of these tests eg SAFE, Harmony and Panorama which all rely on assessing fragments of fetal DNA in the mother’s circulation.
From 10 weeks of pregnancy sufficient fetal DNA can be detected from a simple blood test from the mother. These tests are screening tests (ie they do not give a ‘yes’ or ‘no’ answer but instead stratify into high or low risk) with a negative (low risk) result meaning less than 1:10000 chance of the baby being affected by Down’s syndrome.
- is non-invasive so no risk of miscarriage
- is a blood test taken from the mother (in addition to the routine first trimester blood tests) any time after 10 weeks of pregnancy
- identifies more than 99% of babies affected by Down’s syndrome, 98% with Trisomy 18 and 80% with Trisomy 13
- although a high risk result is worrying it does not mean that the fetus is definitely affected and most people will choose to have further testing by CVS or amniocentesis
- can normally tell you whether the baby is a boy or girl
- typically takes 5-7 days for results to come through
- has a small failure rate (ie not possible to give a result due to insufficient fetal DNA in the sample)
12 weeks: Regular appointment and NT scan
12 week Appointment
Usually immediately before your appointment with Mr Fernando you will have a formal ultrasound scan for measurement of the nuchal translucency (NT – fluid at the back of the baby’s neck) which also screens for chromosomal and cardiac problems as well as potentially identifying other problems
NT measurement in combination with measurement of early pregnancy hormones and maternal age is an alternative method of screening for chromosomal problems but has a slightly higher false positive rate (ie the screening test says high risk when in fact the baby is normal) and poorer detection rate when compared with NIPT testing.
We typically arrange NIPT and NT testing with the Fetal Medicine Centre (link) or UDS (Link) in Harley Street. Scanning can take up to 40 minutes. You will have already received your NIPT test results directly from the scanning unit.
If you have chosen not to do NIPT testing then combined testing takes up to 24 hours for a result to be available. As well as discussing your chromosomal screening results, Mr Fernando will go through the first trimester blood tests, answer questions and plan the next steps.
16 weeks: Routine appointment scan
16 week Appointment
Around 16 weeks, you will have a routine check with Mr Fernando. This is a good opportunity to discuss any challenging pregnancy symptoms you have been experiencing and to ask questions about the coming months.
20 weeks: Fetal anomaly scan appointment
20 week Appointment after Fetal Anomaly scan
Although the majority of babies are normal, up to 1% may have a serious congenital abnormality.
Ultrasound assessment at about 20 weeks of pregnancy would be expected to pick up 70% of these babies by careful examination of structures such as the heart, face, brain, kidneys and skeleton. In addition ultrasound assessment of the blood flow pattern in the uterine arteries (which supply the placenta) can assess the risk of pre-eclampsia or fetal growth problems in later pregnancy.
Measurement of the length of the cervix (neck of the womb) can potentially identify women at risk of pre-term delivery when other risk factors are present (such as previous surgical treatment to the cervix).
At this scan the position of the placenta is noted and where requested the sex of your baby can usually be determined.
Anomaly scan will be done at the Fetal Medicine Centre (www.fetalmedicine.com) or UDS (www.uds.uk.com). You will be given the ultrasound report to bring to your 20 week appointment which would normally be immediately after the scan. If a MAT B1 form is needed in order to claim Statutory Maternity Pay from your employer please ask for one. It is valid after 20 weeks.
24 weeks: Routine appointment
24 week Appointment
Around 24 weeks, you will have another routine check with Mr Fernando. You can discuss how any bothersome symptoms have developed or abated since your last appointment. It is also another opportunity to ask questions about the coming months.
28 weeks: Appointment and blood test
28 week Appointment and Blood tests
Around 28 weeks, you will need another round of routine blood tests.
Charged separately by the provider lab
- Full Blood Count – to check for anaemia
- Checking your Blood group – to screen for atypical antibodies that may cross the placenta and cause jaundice or anaemia in the baby
- Toxoplasmosis – for those who are non-immune at the first trimester screen
- Diabetes screen
Diabetes that develops during pregnancy is called gestational diabetes and does not normally have symptoms. It may be associated with increased birthweight of your baby and a number of other problems
As a result all women are offered screening. This involves drinking a set amount of a sugary drink at the laboratory (which provides a sugar ‘load’) and taking blood to measure sugar levels an hour later.
Women with a higher than expected result will be asked to do a more formal ‘glucose tolerance test’ to establish whether they actually have gestational diabetes.
.If possible please have this test a few days prior to your 28 week appointment to enable Mr Fernando to discuss the results with you.
32 weeks: Appointment and fetal wellbeing scan
32 week Appointment and fetal wellbeing scan
We recommend that all women have a formal scan at 32-34 weeks of pregnancy to objectively assess fetal growth and wellbeing. This will be done at the Fetal Medicine Centre (www.fetalmedicine.com) or UDS (www.uds.uk.com)
34 weeks: Routine appointment
34 week Appointment
Routine check with Mr Fernando.
36 weeks: Appointment, blood tests and GBS screening
36 week Appointment
At 36 weeks Mr Fernando will take a Vaginal Swab and sent for microbiology to detect Group B Streptococcus. You may need another round of blood tests.
- (If indicated) Full blood count – a final check for anaemia
- (If indicated) Blood group and antibody screen
All women are offered a swab test to check for the presence of group B streptococcus (GBS). GBS is just one of the many bacteria that can be present in our bodies. Up to 1 in 5 pregnant women carry GBS and in the majority of cases this does not cause disease.
During childbirth babies become colonised by GBS, but most do not suffer any ill effects. However, although only a small number of babies develop infection (about 1 in 2000), it can be life-threatening. In view of this, we recommend that women carrying GBS should be offered intravenous antibiotics in labour to prevent infection.
37 weeks onwards: Weekly appointments from now until delivery
37 weeks onwards: Weekly appointments from now until delivery
During routine appointments at the Lindo Wing, Mr Fernando may carry out a mini-scan. This provides a relatively low resolution image but allows him to show you your baby's heartbeat and position if indicated.
This carries no additional cost.
Mr Fernando will see you around 6 weeks after the delivery of your baby for a postnatal checkup. However if you have any problems or questions before this appointment you can contact Mr Fernando through his secretary Abe or through the Lindo Wing postnatal ward (Tel: 020 3312 1624).
During the postnatal visit Mr Fernando will answer your questions and examine the perineum / caesarean section wound. He will also discuss about getting back to normality, exercises and contraception.
Babies rarely arrive on schedule. Which means occasionally, your antenatal appointments may need to be delayed or rescheduled as Mr Fernando may be delivering and/or assisting another patient giving birth. In such cases, your patience is much appreciated.
Mr Fernando will endeavor to inform you as early as possible of holidays — and you can rest assured that you will be well cared for should Mr Fernando be unavailable for any reason.
This will allow you to have antenatal consultations whenever they will be needed or whenever you like. And since no baby or mother is the same, your consultations will be tailored to suit your needs, so you have the time to ask all the questions you need.
Please note: Mr Fernando advises vaccination against flu, Covid (at any point in pregnancy) and whooping cough after 20 weeks. Please arrange these at an alternative time with your GP.
24 hour emergency cover
During your pregnancy, you will have a consultant available for emergencies 24 hours a day, 365 days a year. Mr Fernando can be contacted by phone, text or by email most of the time or via the Lindo Wing labour ward (Telephone: 020 3312 1608).
Mr Fernando is on call the majority of the time, but of course does need time off or may be attending to another patient giving birth. On average, he has one weekend off every month and one night during the week when he is not on call. He is also occasionally required to be out of London at medical conferences. During these times, consultant cover is provided by a small group of colleagues providing the same level of care given by Mr Fernando.
Mr Fernando dose not book patients who are expected to deliver during any pre-booked weeks of annual leave. Dates of annual leave can be checked with Mr Fernando’s personal assistant Abe.
Book an appointment
To get in touch, please fill in the contact form and one of our team will get back to you as soon as possible.
The Lindo Wing, Imperial Private Healthcare, St Mary’s Hospital, South Wharf Road London W2 1NY
Wednesday PM and Friday PM
The BMI Clementine Churchill Hospital, Sudbury Hill, Harrow HA1 3RX
Wednesday AM and Thursday AM