End of Pregnancy, Decisions for Fetal Anomalies

Unfortunately, some pregnancies do not progress as planned. Some babies are found to have serious anomalies. Anomalies can be found on an ultrasound scan or on diagnostic testing during the pregnancy. Some babies have more than one anomaly. Depending on the extent of an anomaly parents could be faced with very difficult decisions and options about ending the pregnancy.

Throughout this time and indeed when an anomaly is first confirmed it is very common for parents to feel a range of emotions including a deep sense of sadness, anger and guilt although it is recognised that how parents react is very individual. Parents are encouraged to access information by a charity called Antenatal Results and Choices (ARC). Parents are usually given an information leaflet from ARC by the screening team.

Throughout this time parents are always given time to think about their decisions and will have opportunities to have questions answered. Equally parents are always supported by a team of staff, including specialist midwives, consultants and chaplaincy if wished. This helps parents to make decisions about various issues such as how the pregnancy is ended, making memories of their baby and further investigations.

There are different ways to end a pregnancy. This can be done either with an operation or medication. All relevant options are discussed with parents and the choice is very individual. Staff who are caring for parents understand how making the decisions and going through the process can be very upsetting.

Follow up Care

After pregnancy has ended, parents are offered a sensitive appointment with the Fetal Medicine Consultant and the Bereavement Midwife Advisors. This is usually six weeks, (however this can take longer when awaiting results) after the pregnancy loss and takes place at the hospital. At this appointment parents are given the opportunity to ask any further questions and discuss results of the investigations. Some parents wish to discuss trying for another baby and the implications the anomaly may have on this. However other parents may feel they need more time before they can do this. It is recognised the grieving process following the end of pregnancy for an anomaly is very individual.

You will have some blood tests, vaginal swabs and swabs of the placenta as well as urine tests to determine if there were any infections or blood disorders that could have led to you losing the baby. The results of all of these will be discussed with you at your follow-up appointment with the Fetal Medicine Consultant and Bereavement Midwife Advisors.

Histological Examination

The placenta will be sent for examination to determine if there are any abnormalities or signs of infections which may help to explain why the pregnancy loss occurred.

Cytogenetic Testing

Cytogenetic testing will be offered to all parents who have suffered a late miscarriage. A small sample of placenta and cord will be sent to the specialist hospital for analysis.

The results can take from 6-12 weeks to be available and will be sent to the Fetal Medicine Consultant and discussed with you at the Sensitive Clinic appointment.