020 7935 0189 [email protected]
Pregnancy Care

Mr Miskry delivers babies at the Lindo Wing, a private patient unit within St Mary’s Hospital and the Portland Hospital for Women and Children. Prospective parents are welcome to visit the maternity department of either hospital. To arrange a tour of the Lindo Wing please contact Mary Grafton on 0203 312 6224, for the Portland a tour can be booked online.

Lindo Wing, St Mary's Hospital

We arrange your booking with the maternity unit of your choice at around 20 weeks. Following this you will be contacted by the hospital and provided with their information and an appointment for a midwife booking appointment.

midwife booking appointment
contacting Mr Miskry for appointment

Antenatal Clinics at 148 Harley Street

Tuesday 09.00 to 13.00

Wednesday 14.00 to 17.00 alternate weeks

Thursday 10.00 to 13.00

Friday 09.00 to 13.00 alternate weeks

As you might imagine, occasionally Mr Miskry is called away during a clinic. Although this does not happen often we thank you for your understanding in this situation. Depending on the nature of the emergency your appointment may be delayed or re-scheduled.

Contacting Mr Miskry

If you have an urgent query during office hours (Monday to Friday 09.00 – 16.00) Mr Miskry can be contacted via the office on 0207 935 0189. If your query is non urgent then please email [email protected] and Mr Miskry will answer the next time that he is in the office. Alternatively you may wish to wait until your next appointment to discuss in person.

For emergencies out of office hours please call the Lindo Wing labour ward on 0203 312 1608 or the Portland labour ward on 0207 390 8395 where a midwife can immediately provide medical advice and will contact Mr Miskry.

During your pregnancy you may expect to have the following routine appointments and tests. This is assuming an uncomplicated pregnancy. Additional appointments/tests may be indicated on an individual basis. Our clinics are very busy, if your availability is restricted please make appointments well in advance.

8 weeks Booking appointment and 1st  trimester bloods
10 weeks NIPT prenatal screening
12 weeks Appointment and NT scan
16 weeks Appointment
20 weeks Appointment and Anomaly scan
24 weeks Appointment
28 weeks Appointment and 2nd trimester bloods
32 weeks Appointment
34 weeks Appointment and Fetal Growth Scan
36 weeks Appointment and 3rd trimester bloods and swab for GBS
37 weeks Appointment
38 weeks Appointment
39 weeks Appointment
40 weeks Appointment

8-12 weeks Initial Appointment

At your first antenatal consultation Mr Miskry 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 Miskry 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.

In women with an irregular menstrual cycle or who are uncertain of their dates it may be necessary to arrange a formal ‘dating scan’ which would normally be at Ultrasound Diagnostic Services (UDS) (www.uds.uk.com) which is located in the same building.

Routine blood tests in the first trimester

Full blood count (to check for anemia)
Blood Group
Vitamin D levels (important for fetal bone development and maternal health)
Haemoglobin electrophoresis (to exclude thalassaemia or sickle cell disease)
Infection screen:
– hepatitis B and C
– HIV
– Syphilis
– Cytomegalovirus (CMV)
– Toxoplasmosis

Rubella and varicella (confirm immunity to rubella and chicken pox)
Thyroid function tests (as the baby totally relies on the mother’s thyroid production in the first trimester)

Additional blood tests may be indicated or requested depending on individual circumstances.

Genetic tests

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 Miskry 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.

 

10/12 weeks Screening for Down’s syndrome and other chromosomal disorders

Non Invasive Prenatal Test (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.

NIPT

  • Is non-invasive so no risk of miscarriage
  • It is a blood test taken from the mother (in addition to the routine first trimester blood tests) any time after 10 weeks of pregnancy.
  • The test 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
  • There is a small failure rate (ie not possible to give a result due to insufficient fetal DNA in the sample)

 

12 week Appointment

12 Week Appointment

Usually immediately before your appointment with Mr Miskry 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.

When noninvasive testing has identified a baby as being at high risk of a chromosomal problem many couples will wish to consider an invasive test such as amniocentesis or chorionic villus sample (CVS) despite the small risk of miscarriage in order to have a definitive result.

For more information about Down’s syndrome screening and the tests available visit Ultrasound Diagnostic Services (www.uds.uk.com) or the Royal College of Obstetricians and Gynaecologists website (www.rcog.org.uk).

We typically arrange NIPT and NT testing with UDS or the Fetal Medicine Centre 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 Miskry will go through the first trimester blood tests, answer questions and plan the next steps.

 

16 week Appointment

Routine check with Mr Miskry

 

20 week Fetal Anomaly scan + appointment

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.

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 week Appointment

Routine check with Mr Miskry

 

28 week Appointment

Routine blood tests:

Full Blood Count – to check again for evidence of anaemia

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 Miskry to discuss the results with you.

 

32 week Appointment + fetal wellbeing scan

All women are recommended to have a formal scan at 32-34 weeks of pregnancy to objectively assess fetal growth and wellbeing.

 

34 week Appointment

Routine check with Mr Miskry

 

36 week Appointment

Routine blood tests and GBS screen
Full blood count – a final check for anaemia
Blood group and antibody screen
Toxoplasmosis – for those non-immune at first or second trimester screening

Infection 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 and clearly most do not suffer any ill effects. However, although only a small number of babies develop infection (about 1 in 2000) this can be life-threatening. In view of this it is recommended that women known to carry GBS should be offered intravenous antibiotics in labour to prevent infection.

For further information see the Group B Strep Support website (www.gbss.org.uk)

Weekly appointments from now until delivery

Please note: Mr Miskry advises vaccination against flu (at any point in pregnancy) and whooping cough after 20 weeks. Please arrange with your GP.

During routine appointments at 148 Harley Street Mr Miskry may carry out a mini-scan. This provides a relatively low resolution image but allows him to show you your babies heart beat and position if indicated. This carries no additional cost.

 

24 hour Emergency Cover

During your pregnancy you will have consultant availability for emergencies 24 hours a day, 365 days a year.

Mr Miskry is on call the majority of the time, but clearly he needs to take some time off which may be at short notice. On average he has a weekend off every month and one night during the week. 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 Miskry.

We do not book patients who are expected to deliver during any pre booked weeks of annual leave. Dates of annual leave can be checked with Gail.

Antenatal Classes

Antenatal classes can be very useful in preparation for your birth. They are also a great way to meet other prospective parents in your area. Classes often get fully booked in advance so it is wise to book early. Please make your own enquiries and arrangements for classes.

The Lindo Wing

Main Office 0203 312 6224

The Portland Hospital

Theresa Walsh
[email protected]

Link to website
http://www.theportlandhospital.com/maternity/antenatal-and-postnatal-care/antenatal-classes/

National Childbirth Trust

www.nct.org.uk

Lolly Stirk & Associates

[email protected]
www.lollystirk.co.uk

New Baby Company

www.newbabycompany.com

Request an appointment

Clinics are three times a week and Gail will help you arrange a time to see Mr Miskry and if necessary a scan on the same day.

If you are pregnant, you can expect to have a number of routine tests and appointments and you can find out more about the schedule of care here.

Appointments can be arranged by phone or email.

Book an Appointment

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What our patients say about us

thank you so much for the fantastic care both before, during and after Alice’s birth…we felt in extremely safe and capable hands at the time of her delivery, which was a huge relief. Many, many thanks for your skill and dedication

thank you for your care, advice and skilful surgery

you were so reassuring and I really appreciate how patient you were with me always…you made everything so easy

thank you so much for the medical expertise and all the care you have given us over the last 6 years

thank you for all of your support, patience, good humour and, above all, exceptional knowledge and skill during the pregnancies and births of our children

a heartfelt thank you for everything you’ve done…and delivering our precious baby safely. We found you to be extremely professional, caring and reassuring at an extremely difficult time for us

we will always appreciate the great care and support you have given us through all our pregnancies

this was a very difficult time for us, often filled with anxiety and worry and we could not have wished for a better obstetrician to guide us through this

I couldn’t have asked for a better surgeon

thank you so much! From my first appointment with you to the last you filled me with confidence and made me feel at ease

FAQs

These are some of our most commonly asked questions, but you can see all of them here

Do I need a GP referral for private treatment?

No. However if you have private medical insurance please check with your insurer as they may require a GP referral in order to provide cover.

Where does Mr Miskry see patients?

All clinics are held at 148 Harley Street.

Where does Mr Miskry perform operations?

The Lindo Wing, St Mary’s Hospital and The Wellington Hospital.

If I have a private consultation will this alter my care in the NHS?

No. Your treatment or position on an NHS waiting list will not be affected by having had a private consultation/surgery.

Are tests included in my consultation fee?

Any tests Mr Miskry recommends as part of your care are payable directly to the clinic/lab/hospital where they are carried out and are not part of our fees.