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Prenatal Diagnosis and Treatment

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Seattle Children's Prenatal Diagnosis and Treatment Program provides care for pregnant women and their families when the pregnancy is complicated by known or suspected conditions in the developing fetus. Our program integrates obstetric and pediatric specialty care for families facing complicated pregnancy management or decision-making. When a disorder is detected before birth, outcomes may be improved by treating the fetus or by condition-specific management of the pregnancy, labor and delivery.

Reasons for referral include abnormal prenatal screening or chromosome analysis, suspected fetal structural abnormalities, risks identified through genetic testing or genetic counseling, maternal health conditions which may affect the fetus and family history of a child with a congenital abnormality or genetic disorder.

Conditions We Care For


We see many conditions that are present before birth, including:


Abdominal wall defects (gastroschisis and omphalocele)

Abdominal wall defects occur when the baby's abdomen, or belly, doesn't fully form as the child develops during pregnancy. As a result, the child's intestines can form outside of the abdomen. There are several types of abdominal wall defects. An omphalocele occurs at the spot where the umbilical cord comes out of a baby's belly. Gastroschisis is when a baby's intestines stick out of the body through a hole in one side of the umbilical cord.

Brain malformations

Structural abnormalities of the brain, spine and/or fluid spaces within the brain can be detected during pregnancy and are associated with a range of impact upon a child's development. Our neurodevelopmental pediatricians review the information available during pregnancy and talk with families about the potential impact and available management strategies.

Cardiac arrhythmias

An arrhythmia is an abnormal heartbeat. This can mean the heart is beating too fast or too slow, or is beating with an irregular pattern. If an arrhythmia of the fetal heart is detected during pregnancy, a fetal echocardiogram is recommended to further evaluate.  Arrhythmia, Fetal Echocardiogram

Chromosomal conditions

Chromosomes are the part of cells that carry information passed from parent to child (genetic information). Abnormalities in their number or structure can cause health problems. For example, Down syndrome is a condition in which extra genetic material causes delays in the way a child develops, and often leads to mental retardation.

Cleft lip and palate

Cleft lip and palate are conditions where the upper lip and the roof of the mouth (palate) do not form right, leaving a gap in the lip or palate. Children's Plastic Surgery Clinic repairs cleft lip and soft palate problems early in life. Oral and Maxillofacial Surgery provides later repairs. These repairs include bone grafting for cleft upper jaw and correction of jaw size deformities. To arrange for prenatal consultation, please contact the Craniofacial Center directly. Read more.

Congenital heart disease

These conditions are abnormalities in the structure of the heart. The problems occur during heart development, and are present at birth. Examples include double outlet right ventricle, hypoplastic left heart syndrome, tetralogy of Fallot, truncus arteriosus, ventricular septal heart defect, transposition of the great arteries, AV canal defect and heterotaxy syndrome. Read more.

Diaphragmatic hernia

A diaphragmatic hernia is a hole in the thin muscle called the diaphragm that separates the chest from the belly (abdomen). Organs that should be in the abdomen can slip through the hole into your baby's chest. These organs take up space that should be available for your baby's lungs to grow. As a result, babies born with congenital diaphragmatic hernia have smaller lungs than normal. Some of these babies also have trouble with high blood pressure in their lungs (pulmonary hypertension). This can keep blood from getting to the lungs easily to pick up oxygen. Read more.

Intestinal atresia

Intenstinal atresia (IA) is a condition that occurs when part of your child's intestine doesn't form completely. Instead of being an open tube, the intestine is closed off in one or more places. Some children are missing segments of the intestine between the closed spots. Intestinal atresia prevents food and stool (feces) from moving all the way through your child's body. The severity of intestinal atresia varies. Your child may have just a small blockage, or they may be missing large segments of intestine. Read more.

Lung lesions

Congenital lung lesions are malformations in the lungs that occur during lung development. There are many types of these lung lesions. Some occur within the normal lung and some sit adjacent to normal lung. In all cases they represent an area of abnormal, non-functional lung tissue. The term CPAM (congenital pulmonary airway malformations) has recently been applied to describe this group of malformations. Detection during pregnancy can help plan for care after birth, occasionally including urgent respiratory support for the newborn.

Multiple anomalies occurring together

When more than one anomaly or condition is detected during pregnancy, families can come to the Prenatal Clinic for coordinated consultation and care planning with multiple specialty providers.

Neck masses

Large neck masses can be detected in the developing fetus during pregnancy. Most common are lymphatic malformations, which involve the body fluid system (lymph system). Staff from Seattle Children's Otolaryngology Department and Craniofacial Center meet with families during pregnancy to evaluate the potential impact the mass may have upon the ability for the newborn to breathe right after birth. A coordinated delivery plan is made with the obstetric team to support and treat the newborn.

Skeletal abnormalities

Skeletal abnormalities are problems with the way a child's skeleton forms, such as clubfoot, dwarfism and missing bones. To arrange for prenatal consultations, please contact Orthopedics directly.

Spina bifida and other neural tube defects

Spina bifida is a neural tube defect. The neural tube is located along the back of an unborn baby. It eventually develops into the baby's brain and spinal cord. Spina bifida occurs when the neural tube fails to close. There are many neural tube defects, and they vary greatly in their severity. The most severe form, meningomyelocele, often causes loss of muscle use (paralysis) in the leg, bowel and bladder, along with learning disabilities. Read more. (PDF)

Urologic abnormalities

Urologic abnormalities are problems in the system that makes, stores and drains urine. These include structural problems in the kidneys, bladder and tubes that drain urine.

Services We Offer

Care coordination for pregnancy, delivery and newborn care

Our program links you and your OB team with experts at Seattle Children's to provide coordinated care for you during your pregnancy and for your child after birth. High-risk obstetricians from the University of Washington join us on-site at Children's when requested for consultation or local delivery coordination.

Fetal diagnosis

Diagnosis or rule out of fetal conditions through fetal MRI, fetal echocardiogram, obstetric ultrasound, amniocentesis, maternal-fetal medicine consultation and genetic testing

Fetal echocardiogram, including early fetal echocardiogram beginning at 14 weeks gestation when indicated

A fetal echocardiogram is a specialized ultrasound that uses sound waves to view and make pictures of a developing baby's heart during pregnancy. In some cases, fetal echocardiogram as early as 14 weeks can be done to look for major structural anomalies, and is followed by a fetal echocardiogram at the standard 18 to 20 weeks to confirm anatomy. Indications for early echo include abnormal CVS results, abnormal NT screening or a prior child with major structural heart disease.

Genetic counseling

A genetic consultation helps answer questions about your health, your developing baby's health or your family's health. During a consultation, you will meet with a genetics counselor to discuss many topics, including whether a health condition is passed from parent to child (genetic), why it happens, whether it can happen again and where to go for help. Read more.

Genetic tests and amniocentesis

Some tests can be done before birth to help determine whether a developing child may have genetic disorders or birth defects. In amniocentesis, healthcare providers take a small amount of fluid from the sac surrounding the developing baby and test it for signs of genetic disorders. Other tests can be done during pregnancy using blood samples from one or both parents.

High-risk obstetrical ultrasound

An ultrasound is an exam that uses sound waves to view and make pictures of parts of the body. Our program provides ultrasounds of developing babies during high-risk pregnancies.

Maternal-fetal medicine (high-risk obstetrics) consultation with our colleagues from the University of Washington

We work closely with maternal-fetal medicine specialists throughout the region. High-risk obstetricians from the University of Washington join us on-site at Children's when requested for consultation or local delivery coordination.

Pediatric surgical and medical consultation

Our specialists can talk with you and your family during your pregnancy about surgery and other treatment that may be needed after your child is born. Specialists include those in cardiology, general surgery, genetics, neonatology, neurodevelopmental, neurosurgery, otolaryngology, urology, social work and more.

Regional care

Comprehensive services are offered in Seattle, with regional availability of the following services:

  • Bellevue: fetal echocardiogram with cardiology consultation; fetal MRI; urology consultation
  • Tacoma: fetal echocardiogram with cardiology consultation
  • Tri-Cities: fetal echocardiogram with cardiology consultation
  • Everett: fetal echocardiogram with cardiology consultation; urology consultation
  • Yakima: fetal echocardiogram with cardiology consultation
  • Anchorage: fetal echocardiogram with cardiology consultation

  • Fetal MRI

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