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117 Maternity and Obstetrics NMH Annual Rep t | 2020 referred to either centre. This has resulted in a single team approach to all such cases, regardless of which of the two hospital locations at which such patients are seen. During 2020, a total of 21 cases of severe twin-to-twin transfusion syndrome were managed by the Dublin Fetal Surgery Group by means of fetoscopic laser ablation of placental vessels. Amongst these 21 pregnancies, 11 resulted in survival of both fetuses, and 7 resulted in survival of one fetus, overall 29/42 babies (69%) survived. By the end of 2020, the group had treated 228 fetuses with laser surgery for severe TTTS, with at least one survivor occurring in 81% of cases (186/228). These results are consistent with the results at the major international centres providing this advanced fetal therapy. This approach to a complex but relatively rare, fetal problem is an excellent example of a joint collaborative management strategy that successfully optimises care for these patients. National Fetal Neurosurgery Programme. (Prof Fionnuala McAuliffe and Prof Peter McParland) There are fortnightly fetal neurosurgical clinics with Mr Darach Crimmins, Mr John Caird and the Neurosurgery specialist nurses from Children's University Hospital, Temple St. Cases are presented to a multidisciplinary team with ultrasound and fetal MRI images disussed. Following this the patients are seen and jointly counselled by the neurosurgery and fetal medicine teams. Women with pregnancies with fetal spina bifida are offered referral to Leuven Belgium to explore the option of fetal NTD repair. Dr Gabrielle Colleran and Dr Ian Robinson jointly review the fetal MRI images and provide an excellent service. In 2020 35 cases were seen and assessed at the clinic, though a number of other cases were discussed at the fetal neurosurgery multidisciplinary rounds, without the patient being seen in clinic. Details of cases seen in the joint clinic with one diagnosis per patient are: twelve fetal spina bifida, two occipital encephalocele, sixteen ventriculomegaly (11 severe, 3 moderate and 3 mild), three absence of corpus callosum with moderate ventriculomegaly, one intracranial tumour and one partial vermian agenesis. This service is coordinated by Heather Hughes and Barbra Cathcart. The programme receives referrals from all over Ireland and is the only clinic of its kind in Ireland. Haemolytic Disease of the Newborn Routine antenatal prophylaxis with Anti-D at 28 weeks was introduced in May 2015 and should further reduce the number of cases seen (see Pathology & Laboratory Medicine Chapter). There were 6 pregnancies that required 7 transfusions and all had good outcomes. Table 5 outlines the numbers attending for IUT over the past ten years. This hospital has been generally recognised as the national referral centre for this disease for many years. Education/Appointments The Fetal Medicine Unit continues to play an active role in teaching with both UCD and RSCI undergraduates in attendance. NCHDs are encouraged to attend for basic training by observing initially, followed by hands on experience. The midwifery staff continue to play a major role in both the theoretical and hands on components of the MSc in Diagnostic Imaging (UCD). Sue O'Callaghan completed a Masters in Ultrasound at UCD. The Midwifery staff presented papers at the annual British Medical Ultrasound Society (BMUS). study day. The unit hosted the first International Society of Ultrasound & Gynaecology (ISUOG) approved course in Ireland entitled "Dublin First Trimester Symposium"; there were delegates and overseas speakers from 12 different countries. We continue to be recognised for full sub-specialty training in Maternal Fetal Medicine by the RCOG making this the only centre in Ireland for full training. Dr Clare O'Connor completed her training and we welcomed Dr Gillian Ryan who commenced her training. Both contributed significantly to both the clinical and research output of the unit. The workload of the unit remains busy in both volume and complexity. I would like to acknowledge the stewardship and contribution to ongoing development by Valerie Spillane (CMM3) and to all the team who every day go above and beyond to provide a safe, high quality and compassionate service to women and families. The Fetal Medicine Unit continues to play an active role in teaching with both UCD and RSCI undergraduates. NCHDs are encouraged to attend for basic training by observing initially, followed by hands on experience.