The early diagnosis of fetal abnormalities and their consequent management comprise a relatively new specialty, which has developed to a large extent from the advances in and availability of ultrasound imaging techniques. The Women's and Children's antenatal diagnosis and counselling service (ADACS) is composed of a multidisciplinary group of health professionals and deals with issues relating to pre-pregnancy counselling, fetal diagnosis of abnormalities and the management of these conditions, including all aspects of pregnancy loss. Detailed minutes are recorded for each case and key information is stored in a relational database. Weekly meetings are held to discuss selected cases and, where possible, are presented to the group by the referring practitioner, either in person or using the telemedicine facilities. Telemedicine has provided a significant enhancement to the ADACS service.