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Fetal Diagnostic and Treatment Services

Our specialists use an array of diagnostic, therapeutic and surgical services to diagnosis, monitor, and treat conditions during pregnancy. This comprehensive team approach allows for evaluation, precise diagnosis, and management of complicated conditions, maintaining consistency in care that extends from the time of diagnosis to delivery and into the newborn period.  Our services include the following.

Care coordination for pregnancy, delivery and newborn care
The FDTG connects you and your team of OB specialists with experts at Women and Children’s Hospital to provide coordinated care for you during your pregnancy and for your child after birth. High-risk obstetricians are on-site for consultation and/or delivery coordination.

Fetal diagnosis
The team works together to diagnose fetal conditions through a number of procedures including fetal MRI, fetal echocardiogram, obstetric ultrasound, amniocentesis, maternal-fetal medicine consultation and genetic testing.

Fetal echocardiogram
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.

Fetal MRI
CAMC Women and Children’s Hospital is the only hospital in the state to offer Fetal Magnetic resonance imaging (MRI).  Fetal MRI uses a strong magnetic field, radio waves and computers to take a series of detailed pictures of a developing baby. These pictures can provide useful information about the fetal brain, chest and abdomen. Fetal MRI scans take about 20 to 40 minutes, and are safe and beneficial. They do not use radiation and have no known effects on a developing baby.  

Genetic counseling
A genetic consultation helps answer questions about a mother’s health, her developing baby's health or the health of the family. During a consultation, families meet with a genetics counselor to discuss many topics, including whether a health condition is passed from parent to child, why it happens, whether it can happen again and where to get help.

Genetic tests and amniocentesis
Tests can be done prior to birth to help determine if a developing child may have genetic disorders or birth defects. An amniocentesis is a procedure in which health care providers take a small amount of fluid from the sac surrounding the developing baby and test it for signs of genetic disorders. Blood samples from one or both parents also can be used for other tests during pregnancy.

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

Maternal-fetal medicine (high-risk obstetrics)
High-risk obstetricians are on-site at Women and Children's Hospital when requested for consultation or delivery coordination.

Pediatric surgical and medical consultation
Our specialists can speak with families during pregnancy about surgery or other treatment that could be needed after a child is born. Specialists include those in cardiology, general surgery, genetics, maxillofacial, neonatology, urology, social work and more. 

Through these services, we treat the following conditions:

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

Brain malformations
Structural abnormalities of the brain, spine and/or fluid spaces within the brain associated with a range of impact upon a child's development can be detected during pregnancy. Neurodevelopmental pediatricians review available information during pregnancy and talk with families about the potential impact these conditions may have on them.  They also discuss management strategies that are available.

Cardiac arrhythmias
An abnormal heartbeat, or arrhythmia, can mean the heart is beating too fast, 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 for further evaluation.  

Care coordination for pregnancy, delivery and newborn care
The FDTG connects you and your team of OB specialists with experts at Women and Children’s Hospital to provide coordinated care for you during your pregnancy and for your child after birth. High-risk obstetricians are on-site for consultation and/or delivery coordination.

Chromosomal conditions
Chromosomes are the part of cells that carry genetic information, which is information passed from parent to child. Health problems are caused by abnormalities in their number or structure. Down syndrome is an example of 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 palate (the roof of the mouth) do not form correctly, leaving a gap. Maxillofacial surgeons repair cleft lip and soft palate problems. These repairs include bone grafting for cleft upper jaw and correction of jaw-size deformities.

Congenital heart disease
Congenital heart defects are abnormalities in the structure of the heart. The problems are present at birth and occur during heart development. Examples include, but are not limited to, the following:
     • Double outlet right ventricle - a condition where the pulmonary artery and the aorta both arise from the right ventricle.
     • Hypoplastic left heart syndrome - a condition in which the left side of the heart is critically underdeveloped and the left side of the heart can't
effectively pump blood to the body.
     • Truncus arteriosus - a condition in which a baby has only one great blood vessel leaving the heart, which then branches into blood vessels
that go to the lungs and the body instead of having a separate pulmonary artery and aorta.
     • Ventricular septal heart defect - a hole in the wall separating the two lower chambers of the heart.
     • Transposition of the great arteries - In cases of transposition of the great arteries, the aorta and the pulmonary arteries are "transposed"
        from their normal positions so that the aorta arises from the right ventricle and the pulmonary artery from the left ventricle.
Diaphragmatic hernia
A diaphragmatic hernia is a hole in the thin muscle that separates the chest from the abdomen, known as the diaphragm. Organs that should be in the abdomen can slip through that hole into a baby's chest and take up space that should be available for its lungs to grow. As a result, babies born with a congenital diaphragmatic hernia have smaller lungs than normal, and can develop pulmonary hypertension.

Intestinal atresia
Intenstinal atresia (IA) is a condition in which part of a child's intestine doesn't form completely, and the intestine is closed off in one or more places instead of being an open tube. Some children have missing segments of the intestine between closed spots. IA prevents food and stool from moving all the way through a child's body, and its severity varies.

Lung lesions
Congenital lung lesions are abnormalities that take place during lung development. There are many types of lung lesions. Some occur within the normal lung and some sit beside the normal lung. In all cases they represent abnormal, non-functional lung tissue. The term CPAM, which stands for congenital pulmonary airway malformations, has been applied to describe this group of malformations. Revealing these conditions during pregnancy can help plan for care after the baby is born, which occasionally includes urgent respiratory support for the newborn.

Multiple anomalies occurring together
When more than one condition is detected during pregnancy, families can request to be evaluated by the FDTG for coordinated consultation and planning with multiple specialists.

Neck masses
Large masses in the neck can be detected during pregnancy in a developing fetus. The most common neck masses are lymphatic malformations, which involve lymph system, or the body fluid system. The Women and Children’s Hospital FDTG consult with families during pregnancy to evaluate the possible impact a mass may have upon a newborn’s ability to breathe correctly after birth. After consultation, a coordinated plan for delivery is made with the obstetric team for the support and treatment of the baby. 
Renal and urologic abnormalities
Problems in the system that makes, stores and drains urine represent urologic abnormalities. These abnormalities include structural problems in the kidneys, bladder and tubes that drain urine.

Skeletal abnormalities
Skeletal abnormalities are problems with the way a child's skeleton forms. These abnormalities include clubfoot, dwarfism and missing bones. The FDTG consults with someone in orthopedics to develop an action plan for babies who experience one of these conditions.

Spina bifida and other neural tube defects
Neural tube defects (NTDs) are serious defects of the central nervous system that are present at birth. Location of the defects include the spinal cord, skull and brain. They are caused from failure of the neural tube to close during the first 30 days of fetal development. There are three main types of NTDs:
     • Anencephaly - an underdeveloped brain and skull. Most babies born
       with this do not survive more than a few hours after birth.

     • Encephalocele - the brain and membranes that surround the central nervous system stick out through a defect in the skull. Most babies born
        with this either do not live or are severely disabled. However, early surgery can increase the chance of survival

     • Spina bifida – A baby born with this literally has a split spine. The term covers a wide range of vertebral defects and NTDs resulting from
        failure of the vertebral arch to fuse.