Fetal Diagnosis Program

• The experts you need are here
  • Seattle Children’s fetal diagnosis experts give you the most accurate and complete information about your baby’s condition so you can prepare for your child’s needs and future needs.
  • To diagnose or rule out fetal conditions, we use the most advanced imaging studies, genetic testing and genetic counseling. We also do fetal blood tests and fetal skin biopsies.
  • Your care team is based on your unique needs. Fetal, neonatal and pediatric medical and surgical specialists are here to advise you. If needed, we provide care before birth and during infancy and childhood.
  • A prenatal genetic counselor helps you explore your family’s health background, talks with you about genetic conditions, explains testing options, coordinates testing (if you want it), reviews test results and provides information, support and resources.
  • A social worker provides emotional and practical support.
• Available when you need us
  • When there’s a chance your developing baby has a medical problem, it’s important to get timely access to skilled, experienced doctors. We get you in for a visit promptly based on your situation.
  • Before your first visit with us, a dedicated fetal coordinator reviews your referral to understand your health and your baby’s health. Then we design and schedule your first visit to match your needs.
  • We offer some fetal diagnostic visits and consultations at sites around the region. Learn more about services we offer at our different locations.
  • We offer second-opinion consultations with our team in Seattle via telemedicine. The virtual format is helpful for families who live outside of Seattle and would benefit from connecting with us before starting in-person care in Seattle. For more information and to request a telemedicine consultation, you can email the Fetal Care and Treatment Center. A member of our team will contact you within 2 business days to begin coordinating your consultation.
  • Read how a second opinion and treatment at Seattle Children’s turned a devastating diagnosis before birth into hope for a bright future.
• We guide you step by step
  • At your first visit, you will have advanced imaging and meet with your care team to discuss the findings and what they mean.
  • We will bring your team members together — at the same time in the same room — to make sure we understand how to take care of all your needs and wants. We take time to explain your child’s condition and answer all your questions. Together, we then build a care plan for you and your child.
  • By the end of your first visit, our goal is to give you a complete understanding of your baby’s diagnosis and care so you can make informed choices that are right for your family.
  • Your care team will work with you and your family to plan your prenatal and newborn care, transition your baby smoothly to pediatric care and get the best outcomes for you and your baby.
  • For conditions that need intervention or surgery before your baby is born, our experienced specialists offer a range of services. Read more.

We use these ways to diagnose or rule out fetal conditions and to learn more about your baby’s health and the care they may need before or after birth:

• Fetal blood sampling

  Taking a sample of blood from your developing baby lets us check their level of blood cells (like red blood cells and platelets) and check how some of their organs are working. We take a sample using a needle that goes through your belly and womb and into the umbilical cord.

• Fetal echocardiogram, as early as 14 weeks

  A fetal echocardiogram (fetal echo) is a specialized ultrasound. It uses sound waves to view and make pictures of a developing baby’s heart.

  Usually, we do a fetal echocardiogram 18 to 22 weeks into the pregnancy. In some cases, we offer a fetal echo as early as 14 weeks. These cases include having abnormal results from chorionic villus sampling or if another child in the family had a major heart defect. We check again at 18 to 20 weeks.

  See data on the accuracy of our prenatal diagnosis of heart defects.

• Fetal MRI

  Fetal MRI (magnetic resonance imaging) uses a strong magnetic field, radio waves and computers to take a series of detailed pictures of your developing baby. These pictures show your baby’s structures from different angles. Fetal MRI scans take about 20 to 40 minutes. They are safe and beneficial. They do not use radiation and have no known effects on your developing baby. Combining details from MRI and ultrasounds helps diagnose certain conditions during pregnancy. Seattle Children’s has doctors who specialize in fetal MRI.

   

• Genetic counseling

  A genetic counselor helps answer questions about your health, your developing baby’s health or your family’s health. We talk about whether a health condition is passed from parent to child (inherited), why it happens, whether it can happen again and where you can find more help for your family. Read How to Handle a Difficult Prenatal Diagnosis by our genetic counselor, and read more about genetic counseling at Seattle Children’s.

• Arranging for genetic tests, including amniocentesis

  We talk with you about tests that can be done before birth to help tell if a developing baby may have problems caused by changes in genes or chromosomes. If we recommend testing for you, we help arrange the tests. Amniocentesis checks cells from a small amount of fluid from the sac around the growing fetus. Chorionic villus sampling checks a small sample of cells from the placenta. Other tests during pregnancy use blood samples from 1 or both parents.

• High-risk obstetrical ultrasound

  An ultrasound uses sound waves to view and make pictures of parts of the body. Maternal-fetal medicine doctors from UW Medicine and our ultrasound technicians know exactly what to look for during high-risk pregnancies.

• Embryoscopy for fetal skin biopsy

  In this procedure, doctors insert a thin tube into your womb through a tiny cut (incision) in your belly. The tube has a light and camera so doctors can use it to see your baby. Doctors can also pass small tools through the tube to take a sample of cells, such as skin cells for biopsy. If you had an amniocentesis that showed your baby might have genetic problems, your doctors might recommend a skin biopsy to get more details about your baby’s condition.

If you already have an appointment, learn more about what to expect and how to prepare.

• Before your appointment
  • Ask your pregnancy care provider to fax us records about your pregnancy, including lab results, ultrasound reports, MRI (magnetic resonance imaging) and your health history. Our fax number is 206-985-3407. Often, medical offices can also send us ultrasound images electronically.
  • Before your first visit, a dedicated fetal coordinator will review your referral to understand your health and your baby’s health. Then we will design your first visit to match your unique needs.
  • Try to limit caffeine on the day of your visit because it can affect your heart rate.
  • You do not need a full bladder for this appointment.
  • Arrive 15 minutes early to register. If you are more than 20 minutes late for your appointment, we may have to reschedule.
  • Learn more about what to do before your appointment.
• Who does the Fetal Diagnosis Program see?

  We see patients whose pregnancy is complicated by:

  • Family history of a birth defect or genetic disorder that has a chance of happening again
  • Risks or conditions found through genetic testing and genetic counseling, prenatal screening tests or chromosome analysis
  • Suspected structural abnormalities found by imaging studies during pregnancy
  • Other suspected problems that can happen during pregnancy
  • A parent’s health conditions or exposures during pregnancy that may affect the baby
• Who will I see?

  The specialists you see at your first visit depend on the medical concern. A fetal coordinator will review your referral before we schedule your visit so we can choose the team that best matches your family’s needs.

  You may meet with:

  • Pediatric medical or surgical specialists from Seattle Children’s.
  • A maternal-fetal medicine specialist from UW Medicine.
  • A genetic counselor, who can:
    • Explain genetic conditions, prenatal or newborn testing (if you are interested in testing) or results of tests you already had.
    • Talk with you about how this pregnancy fits into the context of your family and what you might expect for future pregnancies.
    • Help your family and child with information, emotional support and resources about genetic conditions.
  • A social worker, who helps your family deal with the emotional and practical challenges of a complicated pregnancy. Our team provides support as you make care plans that are right for your family.
  • Clinic nurses, who will answer your questions and help you keep track of the providers you see and the purpose and results of appointments. They also help coordinate next steps.

  Learn more about the Fetal Care and Treatment Center team.

• What happens during a clinic visit?
  1. During your first visit, we will take a detailed heath history and review the medical records sent to us.
  2. You might have imaging studies to help diagnose or check your baby’s condition (ultrasound, fetal echocardiogram or fetal MRI scan). We will tell you before your visit whether you will have any imaging.
  3. You will meet with your care team to discuss the findings from your tests and what they mean. We bring your team members together — at the same time in the same room whenever possible — to talk with you as a group.
  4. We will work to clarify or to rule out certain medical conditions. We will give you as much information as we can about your baby’s condition and your treatment options.
  5. We will try to answer all your questions. Please ask if anything is not clear.
  6. By the end of your first visit, our goal is to give you a complete understanding of your baby’s diagnosis and care so you can make informed choices that are right for your family.
  7. We will work with you and your providers to make a plan for the next steps in your pregnancy care. A nurse care coordinator helps you move from one step to the next. We also connect you with other support and services you and your family may need.
• How long is a first visit?

  Plan to be at the clinic for 1 to 4 hours, depending on how many diagnostic exams you will have and how many specialists you will see.

• What to bring
  • Your appointment reminder notice.
  • Your insurance cards/Medicaid medical coupon.
  • Your medicines or a list of them. Include nonprescription items like vitamins and herbs. Include the name, dose and instructions.
  • Any forms that might need to be signed by our providers.
  • Snacks and drinks for yourself.

  Due to COVID-19, pregnant patients can bring only 1 healthy adult to their appointment at the Fetal Care and Treatment Center. Children are not allowed at these visits right now.

• Will we have a diagnosis after the first visit?

  Most of the time the team will be able to talk with you about a likely diagnosis at your first visit. Sometimes providers cannot tell exactly what is wrong until your baby is born. There can be several reasons, including: 

  • Limits of current technology and testing during pregnancy
  • The nature of different body tissues before birth
  • Differences in how the body works when connected to the placenta during pregnancy compared to how the body works after birth
• After the appointment
  • Some patients come to our clinic only once. Others return for more appointments. Before you leave, we will give you detailed instructions about any future appointments. We will tell you what will happen next.
  • Each provider who sees you will write notes for your medical chart. After the visit, we will send a copy to your pregnancy care provider. Our nurses also write notes for you to go home with so you do not have to memorize everything during your visit.
  • Between clinic visits, you can call 206-987-5629 if you have questions for your team.
  • See Common Questions After Your Prenatal Visit (PDF) (Spanish).
• How will we find out about test results?
  • For a fetal echocardiogram or ultrasound, the doctor will review the results with you soon after the exam, before you leave the clinic.
  • For fetal MRI scans, usually you will have an appointment with the doctor to review results about a week after the MRI. If you are a Seattle Children's MyChart member, you can check online for some of your results.
• What if I need to cancel or reschedule an appointment?

  Call 206-987-5629 as soon as possible.

• Directions, parking and entering
  • Find your location in our map and directions section.
  • Arrive 15 minutes before your appointment to allow time for registration.

As you get ready for delivery, many details need to align for both you and your baby to have a seamless transition. Our team will guide you through each step. Here are some of the ways we help you and your family prepare.

• Introduce you to our social worker
  • Our social worker provides emotional and practical support.
  • The social worker will link you with community resources and support groups and can connect you with other families.
  • The social worker will also help you plan and find resources for living in the Seattle area while your baby is in the hospital. For some families, the medical plan may include moving to Seattle before delivery.
• Set you up with our pregnancy tracking app
  • It will help you keep track of your complex pregnancy care and newborn appointments.
  • You can use the app to manage your “to do” lists, before and after birth, more easily.
• Invite you to a prenatal hospital tour
  • We hold group tours for families if your newborn will need to stay in Seattle Children’s Hospital after delivery.
  • Our goal is to ease any fears and unknowns so you can focus on advocating for your baby’s needs.
  • We give you an overview of the resources and services available to your family while your baby is in the hospital.
  • During your hospital tour, you will meet with Lactation Services, the Critical Care Transport team and Child Life specialists.
  • Tours are offered 1 to 2 times a month for 2 hours. To sign up, call our nurse care coordinators at 206-987-0134.
• Connect you with a lactation consultant
  • You will have the chance to meet with a Neonatal Intensive Care Unit (NICU) lactation consultant before and after birth.
  • Our lactation consultants can help with breastfeeding or pumping to provide your baby with breastmilk.
• Provide details about our transport services
  • Some babies with a medical problem need to come to Seattle Children’s right after they are born. Our Critical Care Transport team coordinates and provides transport services for newborns who need critical care or specialty care at Seattle Children’s or any other facility in Western Washington.

  Learn more about your baby’s trip to Seattle Children’s (Video. 5:10)

• Tell you about our sibling support program
  • At Seattle Children’s, we believe in caring for your entire family. We understand that siblings of babies born with congenital problems might have trouble coping with and understanding what is going on.
  • Our Child Life Department can work with your other children to provide support, education and coping skills to help make your family’s experience at the hospital a positive one.
  • We also offer Sibshops for siblings of children with special health and developmental needs.