Educational clinical resource
Urgent fetal therapy referral: what to send and when to call
A practical referral guide for suspected fetal anaemia, hydrops, TTTS, rapidly changing fluid, and other time-sensitive fetal findings.
- 01Fetal transfusion
- 02TTTS laser
- 03FETO
- 04Shunts & drainage
How to navigate Urgent fetal therapy referral: what to send and when to call
An educational path from the first question to the next step. It does not replace individual assessment.
- 01State the trigger
Give the diagnosis, scan finding, symptom, or clinical question driving referral.
- 02Send the essentials
Include dating, reports, images, results, history, medications, and contact details.
- 03Set the urgency
Separate emergency assessment, time-sensitive specialist review, and planned consultation.
- 04Choose the pathway
Direct the case to diagnostics, multidisciplinary review, or the treatment hub.
- 05Close the loop
Confirm receipt, next action, responsible team, and advice while waiting.
An urgent fetal therapy referral is appropriate when a fetal or placental condition may worsen within days, when an intervention has a gestational-age window, or when delaying expert reassessment could remove a treatment option. “Urgent” does not always mean that a procedure is required; it means the case needs timely specialist triage.
Potential triggers include suspected severe fetal anaemia, new or worsening hydrops, twin-to-twin transfusion syndrome, severe selective growth restriction in monochorionic twins, rapidly increasing pleural fluid, a large fetal bladder with oligohydramnios, or a clinician’s concern that fetal condition is deteriorating.
What the referral should contain
Send the gestational age based on the earliest reliable dating scan, the specific referral question, maternal symptoms and observations, relevant laboratory results, and all current reports. Original images and cine loops are often more valuable than a report alone. For twins, include chorionicity, amnionicity, deepest vertical pockets for each sac, bladder visibility, umbilical and ductus venosus Doppler, middle cerebral artery peak systolic velocity, and growth measurements.
For suspected anaemia, include maternal blood group, antibody identification and titres or quantified levels where available, previous affected pregnancies, recent infection results, middle cerebral artery Doppler, hydrops findings, and fetal heart assessment. For fluid collections, describe laterality, size, progression, mediastinal shift, hydrops, amniotic fluid, and associated abnormalities.
Provide direct clinician contact details and the patient’s current location. State any deadline already discussed, such as a planned repeat scan or delivery decision.
What happens after triage
The receiving team may request immediate attendance, a repeat expert scan within a defined interval, missing investigations, multidisciplinary counselling, or continued local monitoring. A decision to assess does not confirm a procedure. Technical feasibility, maternal safety, diagnostic certainty, gestational age, prognosis, and alternatives must still be reviewed.
Maternal emergencies use emergency pathways
Online referral is not a substitute for acute obstetric care. Heavy bleeding, severe abdominal pain, rupture of membranes, severe hypertension symptoms, collapse, breathing difficulty, or reduced fetal movements requires immediate assessment at the nearest appropriate emergency department. Stabilisation comes before inter-hospital transfer or fetal-therapy planning.