Prenatal Diagnosis and Treatment
We know how challenging and scary it can be to find a medical problem during pregnancy. Seattle Children’s Prenatal Diagnosis and Treatment team cares for pregnant women and their families when their developing baby has a known or suspected problem.
Depending on your baby’s condition and when it is diagnosed, your family may have a range of care options. We provide information and compassionate support to guide you in finding the care that is right for your family.
Our program links you and your obstetric team with experts at Seattle Children’s to coordinate care during your pregnancy. We make clear plans and help you and the teams prepare for special medical care or surgery your baby may need after birth.
To see how one family faced their baby’s prenatal diagnosis, read Starting Out Strong.
Why choose Seattle Children’s Prenatal Diagnosis and Treatment Program?
Caring for a complicated pregnancy takes providers with different skills and knowledge. Our prenatal program brings together these specialists to manage your pregnancy and to make treatment plans:
- Prenatal diagnosis experts give you the best information about the condition that affects your baby.
- High-risk obstetricians check the health of both mother and baby during pregnancy. Maternal-fetal medicine specialists from the University of Washington consult with us as needed.
- Pediatric medical and surgical specialists advise you during pregnancy and treat your baby during childhood.
- Prenatal genetic counseling helps you explore your family health background and explains testing options.
- Social Work provides emotional and practical support.
- Skilled teams care for your newborn.
We work together with you and your pregnancy care team for the best outcomes for you and your baby.
If you would like a referral to our Prenatal Diagnosis and Treatment Program, talk to your pregnancy care provider. If you have any questions or already have a referral, please call 206-987-5629 (866-987-2000 toll-free) to schedule an appointment.
Taking a Second Opinion to Heart
A second opinion and treatment at Seattle Children’s turned a devastating diagnosis before birth into hope for a bright future. Read how.
To diagnose or rule out fetal conditions, we use the most advanced imaging studies, genetic testing and genetic counseling. We work with you to create a personalized plan informed by these tests. Our imaging techniques include:
- Fetal MRI (magnetic resonance imaging)
- Fetal echocardiography. We can find congenital heart defects as early as 14 weeks of pregnancy.
- 3-D imaging
See data on the accuracy of our prenatal diagnosis of heart defects.
We see families for many reasons, including:
- Risks or conditions found through genetic testing and genetic counseling
- Abnormal results from prenatal screening tests. Tests may show a baby has a chromosome abnormality (like Down syndrome) or an increased risk for a condition such as a neural tube defect.
- Suspected structural abnormalities, like heart defects, found by imaging studies during pregnancy
- Health conditions of the mother or exposures during pregnancy that may affect the baby
- Already had a child with a birth defect or genetic disorder that is known to have a greater chance of happening again
- Desire for a second opinion
We make sure both you and your growing baby get the right care. Our team works closely with pregnancy care providers around our region. We bring together the specialists you need, all in one place.
- To make it easier on you, we schedule appointments with multiple providers on the same day at Seattle Children’s. When needed, high-risk obstetricians from the University of Washington take part.
- We regularly check your baby’s condition and provide treatment before birth as needed. For example, if a baby is diagnosed during pregnancy with a very fast, abnormal heart rhythm, we can treat the baby by giving medicine to the mother. For certain conditions, surgery during pregnancy may be an option. If the surgery cannot be done in the Seattle area, we help connect you to another center.
- We work with your birth hospital to plan for a safe delivery and the specialized care your baby will need at birth and as a newborn. If your baby is likely to need complex care or surgery soon after birth, we arrange their transfer to Seattle Children’s.
- Our transport team of doctors, nurses and respiratory therapists are national leaders in safely moving fragile newborns. They bring more than 500 critically ill babies to Seattle Children’s every year by ambulance, helicopter or airplane.
- We plan for total expert care. This includes the best type of breathing support and special care your baby may need after birth.
Your team at Seattle Children’s will include specialists in newborn care (neonatologists) and others as needed, such as hearts (cardiology), lungs (pulmonary medicine) and the brain and nervous system (neurosciences). These programs are top-ranked in the Northwest and rated among the nation’s best in 2018 by U.S. News & World Report.
- Our Neonatal Intensive Care Unit (NICU) is the first Level IV NICU in the state.
- For babies with hearts or lungs that are not working well, we have an Extracorporeal Life Support Program (ECLS) for heart-lung bypass support. Our ECLS team has some of the nation’s best outcomes.
- Seattle Children’s specialists do more complex surgeries and heart procedures in newborns than at any other hospital in Washington, Alaska, Idaho and Montana. Our outcomes for heart surgery are consistently among the best in the nation.
- As needed, your baby will also get care from experts in nutrition and feeding therapy, anesthesia, respiratory therapy, physical therapy, neurodevelopmental, social work and other specialties.
- We work with you on a treatment plan that respects your beliefs and values. If your baby needs heart surgery and you strongly prefer that they not receive blood products or a blood transfusion, “bloodless surgery” may be a safe option. Read about our Cardiology Blood Conservation Program.
As you meet with our team, you can get to know the experts who will take care of your baby. Visiting our hospital lets you see where we will care for your baby. You will also find out about our services for families.
- We take time to explain your child’s condition and answer all your questions. We help you fully understand your treatment options and make choices that are right for your family.
- Our doctors, nurses and social workers help your child and your family through the challenges of your child’s condition. We link you to community resources and support groups. We can also connect you with other families.
- Our social work and Guest Services staff will 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.
- While your newborn is in the hospital, our lactation consultants can help with breastfeeding or pumping to provide your baby with breastmilk.
- By combining the knowledge and skills of experts from many specialties, we give your child care to improve their quality of life, not just meet their medical needs. We have programs for comprehensive care through childhood. Examples are the Surgery Pulmonary Follow-Up Clinic, Spina Bifida Clinic, Intestinal Rehabilitation Program and Single Ventricle Heart Program.
- At Seattle Children’s, we work with many children and families from around the Northwest and beyond. We can help with financial counseling, schooling for siblings, housing, transportation, interpreter services and spiritual care. Read about our services for patients and families.
- Seattle Children’s newborn care specialists lead pioneering research to improve the outcome for babies born very early or with complex conditions. See Pushing Limits, Saving Lives.
- Research in the Prenatal Clinic includes a multicenter clinical trial related to heart damage (fetal heart block) in babies of pregnant women with immune system disorders (lupus or Sjögren syndrome).
- Drs. Kim Riehle and Bhawna Arya are studying how to better predict the severity of congenital diaphragmatic hernia to plan the care those babies need.
- Dr. Sunny Juul leads national studies of ways to protect the brains of babies born very early or who did not get enough oxygen during childbirth. She also works to find the safest, most effective ways to reduce stress in the NICU and to ease pain. Learn more about Seattle Children’s neonatology research.
Most prenatal visits happen at our Prenatal Clinic at the Springbrook Professional Center, a block away from our main Seattle hospital campus. Services there include:
- Fetal echocardiogram with cardiology consultation
- Consultations with a doctor who specializes in high-risk pregnancies
- Consultations that include cardiac surgery, pediatric surgery, ear-nose-throat (ENT), genetic counseling, genetic testing, neurodevelopmental, neurology, nephrology and urology. If you need to see more than 1 specialist, we work to coordinate your visits.
We provide fetal echocardiogram with cardiology consultation at 10 regional sites in Washington state, plus locations in Alaska and Montana. See our locations and contact information.
Conditions We Care For
We diagnose and treat many conditions that are present before birth. If your developing baby has more than 1 condition, we coordinate with the specialists you need. Having accurate information can help you decide how best to manage your pregnancy. If you choose to continue your pregnancy, we monitor your baby’s condition and plan for their care.
Abdominal wall defects happen when the belly (abdomen) does not fully form as a baby develops during pregnancy. This causes a hole in the muscles and skin that cover a baby’s belly. There are 2 main types of abdominal wall defects. Gastroschisis is when a baby’s intestines are outside the body. An omphalocele is a sac covering organs that stick out of the belly button.
Sometimes imaging studies during pregnancy show a fetus has abnormalities of the brain or spine. Our neurodevelopmental pediatrician and pediatric neurologist review the available information and talk with you about the possible effects on your child.
An arrhythmia is an abnormal heartbeat. This can mean the heart beats too fast or too slowly or with an irregular pattern. If an arrhythmia of the fetal heart is found during pregnancy, we recommend a fetal echocardiogram to learn more. Sometimes we give medicine to moms during pregnancy to treat the baby’s rhythm condition.
Chromosomes are the parts of cells that carry genetic information passed from parent to child. Abnormalities in the number or structure of chromosomes can cause health problems. For example, in Down syndrome, extra genetic material causes a child to have developmental delays.
A congenital diaphragmatic hernia (CDH) is a hole in the thin muscle (diaphragm) that separates the chest from the belly (abdomen). Organs that should be in the belly can go through the hole into your baby’s chest. This affects how your baby’s lungs grow. Many babies with CDH have high blood pressure in their lungs and breathing problems. Read more.
Every year, our Craniofacial Center treats hundreds of children with conditions from cleft lip and palate to rare syndromes that affect how the skull and face form. Sometimes an ultrasound during pregnancy shows a baby might have a craniofacial condition. Some families are at higher risk of genetic syndromes that affect the head and face. Our Craniofacial Center’s prenatal counseling team can help.
Intestinal atresia happens when part of your baby’s intestine does not form completely. Instead of being an open tube, the intestine is closed off in 1 or more places. Sometimes parts are missing. This condition prevents food and poop (stool) from moving all the way through your baby’s body. Surgery is needed. Read more.
As a baby’s lungs develop before birth, sometimes an area of abnormal lung tissue forms. Lung lesions may form inside the normal lung or next to it. These conditions are often called CPAM (congenital pulmonary airway malformations). Finding these problems during pregnancy can help you and your healthcare team plan for your baby’s care. Some newborns need breathing support soon after birth. Read more.
Sometimes an ultrasound during pregnancy shows the baby has a large lump (mass) in the neck. Most common are lymphatic malformations that involve the body’s system for moving fluid (lymph system). Experts from Seattle Children’s Otolaryngology Department and Craniofacial Center meet with you during pregnancy. We assess whether the mass is likely to affect your baby’s ability to breathe at birth. We make a delivery plan with your childbirth team to support and treat your newborn.
Spina bifida is a problem with how the spine and neural tube develop into a baby’s brain and spinal cord. Spina bifida happens when there is an opening in the spine. Some of the spinal cord nerve material sticks outside. There are many neural tube defects, from mild to very serious. The most severe form, meningomyelocele, affects fluid spaces in the brain, muscle use in the legs, bowel and bladder control and cognitive development. Read more about spina bifida (PDF).
We use these ways to diagnose or rule out fetal conditions and learn more about your baby’s condition:
A fetal echocardiogram 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. We offer a fetal echo as early as 14 weeks in some cases. These cases include having abnormal results from CVS (chorionic villus sampling) or if another child in the family had a major heart defect. We check again at 18 to 20 weeks.
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 information from MRI and ultrasounds helps diagnose certain conditions during pregnancy.
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 to go for help. Read more.
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. We do not do this testing at Seattle Children’s. Amniocentesis checks a small amount of fluid from the sac around the growing fetus. CVS (chorionic villus sampling) uses a small sample of cells from the placenta. Other tests during pregnancy use blood samples from 1 or both parents.
An ultrasound uses sound waves to view and make pictures of parts of the body. Maternal-fetal medicine doctors from the University of Washington and our ultrasound technicians know exactly what to look for during high-risk pregnancies.
Scheduling an Appointment With Prenatal Diagnosis and Treatment
- If you would like a referral to the Prenatal Diagnosis and Treatment Program, talk to your pregnancy care provider.
- If you already have a referral, please contact us at 206-987-5629 to schedule an appointment.
- If you have an appointment, learn more about what to expect.
- Learn about resources such as useful links, videos and recommended reading for you and your family.
- Providers, see how to refer a patient.
Participate in Research
Help us answer questions about childhood health and illness, and help other children in the future. Learn more.
If you have a question about whether you are in labor, please call your obstetrics team or your delivery hospital.
Providers, see how to refer a patient.
Paying for Care
Learn about paying for care at Seattle Children’s including insurance coverage, billing and financial assistance.