• Clare O'Connor, Peter McParland, Darach Crimmins, John Caird, Barbara Cathcart, Heather Hughes, Gabrielle Colleran, Rhona Mahony, Shane Higgins, Stephen Carroll, Jennifer Walsh, and Fionnuala M McAuliffe.
• Fetal Medicine, National Maternity Hospital, Dublin 2, Ireland.
• Ir J Med Sci. 2022 Feb 1; 191 (1): 407-412.

BackgroundA specialist fetal neurosurgical clinic was set up in order to improve patient care in a tertiary referral fetal medicine centre. The clinic provides a targeted clinical service for women diagnosed with fetal neurological abnormalities. The service consists of fetal MRI, fetal ultrasound and joint assessment and counselling from neurosurgery and fetal medicine teams.AimsWe aimed to review this service that provides MDT expertise directly to parents and record the cases and pregnancy outcomes involved.MethodsThis is a prospective study of clinic data from Jan 2013 to Dec 2017. Information includes ultrasound scan findings, MRI results, karyotype results and pregnancy outcome data including post mortem results and data from the paediatric neurosurgery service at the affiliated children's hospital.ResultsFrom 2013 to 2017, there were 1852 major fetal anomalies diagnosed antenatally at the tertiary referral fetal medicine service and n = 306/1852 [16%] were primarily neurological in origin. The neurosurgical clinic reviewed 125 patients since 2013. The most common reasons for referral were spina bifida, n = 60 [48%] and isolated ventriculomegaly n = 43 [34%]. Other reasons for referral include agenesis of the corpus callosum n = 4 [3%], encephalocoele n = 5 [4%] and intracranial mass lesions n = 3 [2.4%]. Cases with borderline ventriculomegaly and cases with known chromosomal or genetic abnormalities were not typically referred to the clinic. Full outcome data were available on 110 of 125 women seen. Thirty-two women [29%] underwent invasive testing and 14 women [12.7%] had a termination of pregnancy.ConclusionMultidisciplinary antenatal counselling supported with in utero MRI provides families with optimum information to inform them of likely neonatal outcome.© 2021. Royal Academy of Medicine in Ireland.

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