Consultant in Obstetrics & Gynaecology
Associate Professor of Obstetrics & Gynaecology, RCSI
Maternal fetal medicine specialist – special interest, thyroid dysfunction in pregnancy; diabetes in pregnancy; ultrasound specialist; prenatal diagnosis of congenital heart disease; multiple pregnancy.
Private: 01 402 2540
As a certified specialist in Maternal Fetal Medicine at the Rotunda, Professor Breathnach’s practice focuses on obstetric care, particularly on obstetric ultrasound. Her clinical areas of interest include high risk pregnancy, prenatal screening and diagnosis, and twin pregnancy. Her practice offers prenatal screening for chromosomal abnormality, prenatal diagnostic techniques including amniocentesis, chorionic villus sampling (CVS), non-invasive prenatal testing (NIPT) and advanced prenatal ultrasound services.
She is the lead obstetrician in the combined obstetric-endocrine service at the Rotunda. Together with a consultant specialist endocrinologist, dietician and specialist midwives, this team provides coordinated prenatal and postnatal care for women with diabetes in pregnancy. She completed her doctorate thesis on thyroid function in pregnancy.
Fionnuala also offers integrated prenatal care to women whose pregnancies have been complicated by a prenatal diagnosis of fetal congenital heart disease. This service is coordinated with our paediatric cardiology colleagues in Our Lady’s Children’s Hospital, Crumlin.
Professor Breathnach graduated from Trinity College Dublin in 1997. She pursued higher specialist training in obstetrics and gynaecology at the Rotunda Hospital, Coombe Women and Infants’ University Hospital and St. James’s Hospital in Dublin. She worked as assistant master at the Rotunda from 2004 to 2005 before completing a maternal fetal medicine fellowship programme in the Rotunda Hospital and in Columbia University Medical Center, New York.
Clinical Areas of Interest
As lead obstetrician in the Obstetric-Endocrine service at the Rotunda hospital, Prof Breathnach has played a key role in establishing care pathways for women attending the Rotunda Hospital whose pregnancies are complicated by diabetes. She set up the ‘Breakfast Club’ service in 2013, with the goal of avoiding the need for women with uncomplicated gestational diabetes to attend a specialist Endocrine service. An advocate for self-monitoring and self-management of uncomplicated gestational diabetes, she is the recipient of a European research grant award targeted at developing Artificial Intelligence solutions to Gestational Diabetes care. She is also leading a HRB-funded national study on aspirin use in type I and type II diabetes.
For women with type I or type II diabetes who are pregnant, Prof Breathnach’s office should be contacted early in gestation (ideally before 6 weeks’ gestational age) in order to set up an early glycaemic control surveillance plan. For women who have risk factors for gestational diabetes, screening will happen later in pregnancy, but prevention strategies can be put in place early in pregnancy, and these can be discussed with Prof Breathnach in clinic.
Prof Breathnach completed her doctorate thesis on the subject of subclinical hypothyroidism in pregnancy. If you have a thyroid disorder, a surveillance plan will be put in place early in pregnancy in order to ensure that your thyroid hormone levels remain within-range through pregnancy. This is particularly important in the first half of pregnancy. Many women who are taking eltroxin pre-pregnancy will require a small escalation in dose in the first trimester, which will be maintained throughout. One of the most important aspects of thyroid management is to ensure that thyroid hormone levels are normal in the postnatal period.
High Risk Pregnancy
There are many situations that are considered to render a pregnancy ‘high risk’, a term which is really intended to reflect ‘increased risk’ in comparison to pregnancies unaffected by that risk factor, rather than absolute risks being ‘high’. Irrespective of that risk factor, it is important to be mindful that the vast majority of women and babies have a successful outcome, although a heightened prenatal surveillance strategy (for example, increased frequency of ultrasound scans) may be required.
Prenatal Screening and Advanced Ultrasound
A range of prenatal screening tests can be obtained in order to answer questions that can impact fetal and paediatric health, for example, is there a high likelihood of a chromosome abnormality, or is there possibly a fetal problem that may need attention from Paediatricians or may need surgery in the newborn period? These questions can be explored by considering a range of available screening tests, and of course a wealth of information can be obtained from detailed ultrasound, which will be performed at each clinic visit.
Prof Breathnach has led internationally-renowned research in the area of twin pregnancy management and is the author of the national guideline on Management of Multiple Pregnancy. A more intensive schedule of visits will be required if you have a twin or triplet pregnancy, the frequency of which will be decided based on the complexity of the pregnancy. Delivery will usually take place at least 2-3 weeks prior to your due date, and antenatal classes with the Irish Multiple Births Association are usually recommended.