Prenatal Diagnosis and Treatment

Finding out about a medical problem during pregnancy can be challenging and scary. At Seattle Children’s, our Prenatal Diagnosis and Treatment team cares for you during your pregnancy if your developing baby has a known or suspected problem.

We help you understand your baby’s condition, and we guide you through the complex medical care they may need. We are here to answer your questions and help you make the decisions that are right for your family.

Together, our experts in maternal, fetal, neonatal and pediatric health provide state-of-the-art diagnostic testing and comprehensive counseling. 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.

  • Our prenatal team has many years of experience working with families for a broad range of reasons, including:

    • 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  or prenatal screening tests. (Tests may show your baby has a chromosome abnormality, like Down syndrome, or increased risk for a condition, like a neural tube defect.)
    • Suspected structural abnormalities, like heart defects or craniofacial conditions, found by imaging studies during pregnancy.
    • A parent’s health condition or exposure during pregnancy that may affect the baby.
    • We offer second-opinion consultations with our multidisciplinary team of experts in Seattle via telemedicine. The multidisciplinary team available to meet with you includes pediatric experts from Cardiology, Maternal Fetal Medicine, Cardiothoracic Surgery, General Surgery, Neurosurgery, Neurodevelopmental, Urology, Neonatology and Social Work.
    • 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 second opinion, email the Prenatal Clinic.
    • 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.

“When I was 22 weeks along, we were referred to Seattle Children’s for a consult with the Prenatal Diagnosis and Treatment team...we felt really loved and cared for — they explained everything so well and prepared us for what was to come.”

– Laurina Barker

Why choose Seattle Children’s Prenatal Diagnosis and Treatment Program?

Consistently ranked one of the nation's best children’s hospitals by U.S. News and World Report.

    • Caring for you and your baby during a complicated or high-risk pregnancy takes providers with a range of skills and knowledge. Our program brings together the experienced specialists you need, all in one place. We do all we can to make sure your care is well coordinated and as easy as possible for your family.
    • Your care team is based on your unique needs.
      • Prenatal 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.
      • Maternal-fetal medicine specialists check to make sure both you and your baby are healthy during pregnancy. Our program partners with maternal-fetal medicine specialists from the University of Washington.
      • Pediatric medical and surgical specialists advise you during pregnancy — and, if needed, treat your baby during infancy and childhood. They may include specialists in cardiology and cardiac surgery, pediatric surgery, ear-nose-throat, genetics, neurodevelopmental, neurology and neurosurgery, nephrology, urology and other fields.
      • 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.
      • Skilled teams, including neonatologists, in our Level IV Neonatal Intensive Care Unit (NICU) care for your newborn. 
    • As needed, your baby will also get care from Seattle Children’s experts in other areas of healthcare, like nutrition, feeding therapy, pediatric anesthesia, respiratory therapy, extracorporeal life support, physical therapy and others. All are trained in their specialty and in the unique needs of babies and families.
    • To diagnose or rule out fetal conditions, we use the most advanced imaging studies, genetic testing and genetic counseling. Our imaging techniques include fetal MRI (magnetic resonance imaging), fetal echocardiography as early as 14 weeks, ultrasound and 3-D imaging.
    • We work with pregnancy care providers and pediatric subspecialists around the region. If you live outside the Seattle area, we also offer telemedicine visits to provide as much of your care as possible close to home.
    • Before your first visit with us, a dedicated prenatal 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.
    • 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.
    • Some families need only 1 visit to confirm or rule out a diagnosis before returning to care with their pregnancy care provider. Many families have more visits with us to check their baby’s condition until birth and receive treatment before birth or after.
    • A nurse care coordinator partners with you throughout the whole process to help you move seamlessly from one step to the next with confidence.
    • For some 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 care your baby will need. 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 includes doctors, nurses and respiratory therapists who are national leaders in moving fragile newborns between hospitals. They bring more than 500 critically ill babies to Seattle Children’s every year by ambulance, helicopter or airplane.

    • Seattle Children’s and UW Medical Center (UWMC) work together to manage your and your baby’s health. Our goal is to ensure both you and your baby get the highest level of care, 24 hours a day, 7 days a week.
    • Based on your and your baby’s medical needs, we may recommend you deliver at UWMC. This way your baby can be quickly transferred to Seattle Children’s, less than 1 mile away, by our highly skilled neonatal transport team.
    • Neonatologists and maternal-fetal medicine specialists care for our patients at both Seattle Children’s and UWMC. Both you and your baby are cared for before, during and after delivery.
    • UWMC delivers babies with complex needs — including babies with a serious prenatal diagnosis — every day. They have the experience to handle anything that arises.
    • Teams at both hospitals talk often about your care. Everything is designed to make the experience as smooth, safe and seamless as it can be for your baby and your family.
    • After delivery, we give you time with your baby whenever possible before we transfer them to Seattle Children’s. We know how important these early moments of connection can be.
    • UWMC Lactation Services provides support so, if you are able and would like, you can pump and store breastmilk for your baby.
    • Another parent or caregiver can come to Seattle Children’s with your baby right away after the baby is born. Often, a parent who gave birth is ready to leave the hospital and joins the baby at Seattle Children’s within a couple of hours (it can be a few days after a cesarean section). Phone and video chats are important ways to connect during any time you might be in separate places.
    • Members of Seattle Children’s Prenatal Diagnosis and Treatment team do research to better understand prenatal conditions. We work to advance standards of care and offer hope to families everywhere.
    • Our newborn care specialists lead important research to improve the outcome for babies born very early or with complex conditions. Read 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 patients with immune system disorders (systemic lupus erythematosus or Sjögren syndrome).
    • Our cardiologists are studying how babies respond if they have transposition of the great arteries and their moms are put on oxygen before the babies are born. The goal is to better predict if babies need treatment quickly right after birth or if they can safely stay with mom longer.
    • Drs. Kim Riehle and Bhawna Arya are studying how to better predict the severity of congenital diaphragmatic hernia to plan the care these babies need.
    • Dr. Sunny Juul leads national studies of how to protect the brains of babies who were born very early or did not get enough oxygen during birth. 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.
    • We also do research on ways we can best support families to improve resilience and achieve even better outcomes for children.

Dr. Riehle holding Summer as a baby

“Dr. Riehle was one of the first people to make me feel like a mom. She made me feel confident in my instincts, strong in my convictions, and reminded me that this is my child and I could absolutely handle anything for Summer.”

– Cassie Fannin, whose daughter Summer is living a beautiful life after treatment at Seattle Children’s for congenital diaphragmatic hernia

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 a baby’s belly (abdomen) does not fully form during pregnancy. This causes a hole in the muscles and skin that cover the baby’s belly. There are 2 main types. Gastroschisis is when a baby’s intestines are outside the body without any covering. An omphalocele is a gap in the muscles and skin, with a sac over the organs that stick out of the body. We see many babies with these abdominal wall defects.

  • Anorectal malformations are problems with the way a baby’s anus or rectum forms before birth. This can mean the digestive tract ends in a closed pouch inside the body. Or the rectum (the end of the large bowel before the anus) may connect to the skin or urinary tract. Seattle Children’s Reconstructive Medicine Program provides complete care for babies born with these conditions. Read more.

  • An arrhythmia is an abnormal heartbeat. This can mean the heart beats too quickly or too slowly or without a regular pattern. If an arrhythmia of your baby’s heart is found during pregnancy, we recommend a fetal echocardiogram to learn more. You may receive a home heart rate monitor if we need to check your baby’s heart rate more closely. We teach you how to use the monitor, and our fetal cardiologists are available 24/7 to help with any concerns. Sometimes we give medicine to pregnant patients to treat the baby’s rhythm condition. We also can place small pacemakers specially designed for newborns.

  • Chromosomes are the parts of cells that contain genetic information. When the number or structure of chromosomes is not normal, it can cause health problems. For example, in Down syndrome, extra genetic material causes developmental delays and birth defects that need medical care. Seattle Children’s specialists from many areas of healthcare are experienced with caring for babies, children and teens who have chromosomal conditions.

  • 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. We have treated many babies with this rare condition at Seattle Children’s. We have a comprehensive program to care for them starting before birth and going through childhood. Read more.

  • If the heart does not form normally during pregnancy, a baby will be born with a congenital heart defect. There are many types.

    Heart defects and problems with the heart muscle or heart rhythm can cause heart failure. Heart failure happens when the heart cannot pump enough blood to the body’s other organs. Sometimes heart failure is caused by blood vessel problems in other organs.

    The cardiologists in our Prenatal Diagnosis and Treatment Program are able to make fast, accurate prenatal diagnoses. By combining our expertise with the latest technologies, we can detect congenital heart defects as early as 14 weeks’ gestation. Whether your child needs a simple repair, a complex procedure or a heart transplant, our heart surgery outcomes are among the best in the nation year after year.

  • 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. Learn more about our craniofacial surgery outcomes, which are among the best in the nation.

  • A cyst or mass in your baby’s belly (abdomen) may show up on a prenatal ultrasound. These are among the more common conditions we see. Using imaging, like ultrasound and fetal MRI (magnetic resonance imaging), and sometimes other testing, our team will diagnose the type of cyst or mass your baby has. We look at how it affects your baby and plan any care they may need before or after birth.

  • Changes to genes play a role in genetic conditions. Sometimes these changes are passed from parents to children (inherited). Sometimes a child has a new change that was not passed down (called de novo). Genetic conditions can cause birth defects, developmental delays and other health issues that need care. If doctors find that your baby has a birth defect, we will check whether it is caused by a genetic condition.

  • Intestinal atresia happens when part of your baby’s bowel (intestine) does not form completely. Instead of being an open tube, it 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. Your baby will need surgery. Our surgeons are very experienced at repairing the bowel so your baby can thrive. In rare cases when babies do not have enough intestine, our Intestinal Rehabilitation Program provides long-term comprehensive care to offer the best possible outcome. 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 congenital pulmonary airway malformations (CPAMs). 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. We work with families to tell whether their child can benefit from surgery to remove this tissue. 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.

  • Sometimes imaging studies during pregnancy show a baby has something that is not normal about their brain or spine. Fetal neurological conditions can include brain malformations, ventriculomegaly, congenital hydrocephalus, spina bifida and other neural tube defects, like myelomeningocele. Our neurodevelopmental pediatrician and pediatric neurologist review the available information and talk with you about the possible effects on your child. We have the most experienced neuroradiologist in the region. Our craniofacial and neurosurgery outcomes are among the best in the nation.

  • Urologic conditions affect the system that makes, stores and drains pee (urine). Renal conditions affect the kidneys. We work with experts in Urology and Nephrology to care for babies with these problems.

  • Problems with the way a baby’s skeleton forms include clubfootdwarfism and missing bones. Seattle Children’s Orthopedics team cares for babies, children and teens with these conditions, and they offer prenatal consultations. Please contact Orthopedics directly about skeletal concerns before birth.

  • Vascular anomalies are abnormal blood vessels or lymphatic vessels. They range from simple birthmarks to large, deep clusters of tangled vessels. Sometimes they are a sign of an underlying condition that affects many parts of the body. The Prenatal Diagnosis and Treatment team can help diagnose vascular anomalies and find out how these affect your baby. Our Vascular Anomalies Program is one of the largest and most experienced programs in the United States. We offer a wide range of treatments. Read more.

Diagnostic Tools

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

  • 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 (CVS) 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 (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 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.

  • 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 (CVS) checks 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.

See the services we offer at our different locations.

Scheduling an Appointment With the Prenatal Diagnosis and Treatment Program

Participate in Research

Help us answer questions about childhood health and illness, and help other children in the future. Learn more

Contact Us

Contact the Prenatal Diagnosis and Treatment Program at 206-987-5629 for an appointment, second opinion or more information.

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