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To learn more or schedule an appointment with the Nemours Partners for Perinatal Management Program at Nemours/Alfred I. duPont Hospital for Children, please email perinatal@nemours.org or call the perinatal coordinator at (302) 651-6812.

Common Fetal Diagnoses

Having information about your baby's condition and what to expect before you give birth can help you prepare, mentally and physically. Our experts are dedicated to trying to figure out what, if anything, is going on. If there is a problem, our physicians can care for virtually any medical or surgical condition after delivery. Knowing that we're standing by can give you hope in even the most difficult situations.

Nemours/Alfred I. duPont Hospital for Children, Wilmington

1600 Rockland Road
Wilmington, DE 19803
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Contact Us: To learn more or schedule an appointment, please email perinatal@nemours.org or call the perinatal coordinator at (302) 651-6812.

 
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What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
New Patients

Bring these forms for your first appointment:

Returning Patients
 
Forms & Resources
New Patient Forms
Returning Patient Forms
Resources for Patients & Families
Resources for Perinatal Care

If you’re pregnant and carrying a baby that may have a congenital condition, we'll work with you and your referring doctor to arrange for diagnostic testing (fetal MRI and/or echocardiogram) as well as specialty consultations, if needed.

Nemours Partners for Perinatal Management offers highly specialized care to families and their doctors to provide a comprehensive, interdisciplinary assessment of fetal abnormalities. Our goal is to ensure that every child has the opportunity to achieve their full potential in life.

Please note: We don't deliver babies at duPont Hospital for Children (there are no OB/GYNs or perinatologists on our staff), but we can make arrangements to have your baby delivered here, if needed.

Contact our Perinatal Coordinator at (302) 651-6812, for more information.

Fetal Conditions We Commonly Diagnose

As technologies evolve, our ability to pinpoint fetal conditions during pregnancy and to treat them at or after birth is always expanding. Below are some (but certainly not all) of the more common problems that can be diagnosed before birth.

 
Bladder, Kidney, & Genital Disorders

Urological problems (conditions affecting the kidneys, ureter, bladder, urethra, penis, and testes) can be divided into kidney (renal) and bladder conditions, and genital conditions. And many can be diagnosed in utero (in the womb).

At the Nemours, our team of specially trained pediatric urologists evaluate and treat conditions that include (but aren't limited to):

  • abnormalities of the bladder (such as exstrophy, a defect that causes the bladder to protrude through the abdominal wall)
  • hydronephrosis (the enlargement of one or both kidneys, which may be caused by an obstruction or by a problem in the developing urinary tract)
  • multicystic dysplastic kidney (MCDK, when large cysts develop
    in a kidney that hasn’t developed properly, eventually causing it to
    stop working)
  • vesicoureteral reflux (the abnormal flow of urine from the bladder back into the ureters and sometimes the kidneys)
We also treat genital abnormalities like:
  • ambiguous genitalia (a birth defect in which the outer genitals don't have the typical appearance of either a boy or a girl)
  • hypospadias (a condition in boys in which the opening that carries urine out of the body—the urethra—is on the underside, rather than the tip, of the penis)
  • posterior urethral valves obstruction (PUV — a narrowing or obstruction of the urethra that affects only boys)
  • undescended testes (UDT, also called “cryptorchidism” — when the testes, which form inside the abdomen, fail to move down into the
    scrotal sac)

To diagnose and treat many urological conditions, we use state-of-the-art technology, including minimally invasive techniques.

 
Brain & Nervous System

Babies often need immediate attention after birth if their brain, skull, spinal cord, spinal column, or other parts of the nervous system have abnormalities such as:

  • hydrocephalus (sometimes called, “water on the brain”)—when the cerebrospinal fluid (the clear, water-like fluid that surrounds and cushions the brain and spinal cord) doesn’t drain properly, gets blocked, or too much is produced, so it pools and causes a fluid backup within the brain
  • spina bifida (which comes from Latin and literally means “split” or “open” spine)—the abnormal development of the spinal cord or its coverings, with part of the spinal cord and other structures developing outside of the body
  • encephalocele (when portions of the baby's brain, cerebrospinal fluid, and/or the membrane that covers the spinal cord and brain, the meninges, protude through the skull)

Now, new technology and expertise is giving children with these kinds of conditions more chances to grow into active, independent adults. And the sooner we can identify the problem (even before birth), the better.

 
Cleft Lip & Palate

Having a cleft lip and/or cleft palate means the tissues of the mouth or lip don’t form like they should during fetal development. A cleft lip is a long opening between the upper lip and the nose. A cleft palate is an opening between the roof of the mouth and the nasal cavity.

Clefts of the lip and palate happen in one in about 500 babies in the
United States. Facial clefts may cause various problems ranging from breathing and feeding difficulties in infancy to dental, speech, hearing, and facial growth problems.

Thankfully, though, clefts can usually be diagnosed in utero (in the womb) and corrective surgery is sometimes performed shortly after birth. And a multidisciplinary team approach and comprehensive evaluation by a variety of specialists ensures we meet each child's complex needs.

 
Congenital Heart Defects

When a congenital heart disease (or defect) is diagnosed before birth, we can anticipate problems that may occur during pregnancy and childbirth and plan for the type of delivery and special fetal monitoring you may need. Here at Nemours, we believe that virtually all forms of childhood heart disease, even the most complicated, can be treated and early intervention is key.

Our cardiologists perform in-depth cardiac ultrasounds (fetal echocardiography or “fetal echo"), which allows us to view the structure, function, and rhythm of a baby’s heart while still in the mother’s womb — as early as the 18th week. Our cardiac team also provides first-class open-heart surgery, as well as advanced non-surgical approaches like cardiac catheterization (when a thin plastic, flexible tube — called a “catheter”— is inserted into a blood vessel in the leg that leads to the heart).

In some complex cases, members of our team work together to perform both open-heart surgery and interventional catheterization (sometimes called “therapeutic catheterization”) procedures in the same setting. By offering this kind of combined treatment option (typically called a “hybrid procedure”), we’re improving the outlook for scores of children — all with less discomfort, faster recovery time, and shorter hospital stays. And we’re proud to be one of only a mere handful of centers in the United States where these combo treatment capabilities are available.

Common Heart Defects

Fetal cardiac conditions that can often be diagnosed before birth include
(but aren’t limited to):

  • atrial or ventricular septal defects (ASD or VSD — holes in the wall that separates the heart into left and right sides)
  • hypoplastic left heart syndrome (HLHS — when the side of the
    heart that pumps blood to the body doesn’t develop correctly or
    at all)
  • patent ductus arteriosus (which causes too much blood to flow into the newborn’s lungs)
  • tetralogy of Fallot (a combination of four heart defects that involves restriction in the lungs’ blood flow)
  • transposition of the great arteries (when the aorta and pulmonary arteries — which are the great arteries/the main arteries — are reversed in their positions as they lead from the heart)
  • tricuspid atresia (a problem with the heart valve that causes the
    right ventricle to often be small and have trouble receiving
    blood normally)
  • truncus arteriosus (when a baby is born with one large blood vessel leading out of the heart, when there should be two)
 
Eye (Ophthalmic) Disorders

The ophthalmologists at Nemours are pioneers in diagnosing ophthalmic (eye) disorders in utero (the mother's womb). Eye problems that can be diagnosed before birth include (but aren’t limited to):

  • congenital cataracts (any cloudiness or opacity/whitenes in the normally clear lens of the eye)
  • retinoblastoma (eye tumor)
  • congenital cysts of the eye and eye socket (or "orbit")
  • dacrocystoceles (cysts caused by blockage of the tear ducts)

We can help to pinpoint eye problems before your baby is even born, so your little one can have the very best chance at seeing the new world.

 
Genetic Disorders

Through Nemours Partners for Perinatal Management, we can routinely detect Down syndrome in utero.

Also known as Trisomy 21, Down syndrome is a condition in which
the baby:
  • inherits one too many copies of chromosome 21
  • exhibits a delay in intellectual ability and physical growth
  • has a specific collection of facial characteristics (small chin, unusually round face, protruding or oversized tongue, and almond-shaped eyes)
  • may have shorter limbs, poor muscle tone, and a larger than normal space between the big and second toes
  • may experience other health concerns (such as a higher risk for congenital heart defects, obstructive sleep apnea, thyroid problems, obesity, diabetes, and recurrent ear infections)

If your baby has been diagnosed with Down syndrome, our perinatal coordinator can arrange any appointments you might need with specialists in Genetics, Orthopedics, Cardiology, etc. That way, you’ll know what to expect and have a plan of care for after your baby is born.

 
Infectious Diseases

If prenatal tests have shown you have an infectious disease, you may be referred to Nemours Partners for Perinatal Management since some infectious diseases can be passed on to babies during pregnancy.

Some of the infectious diseases that can commonly be diagnosed in babies during pregnancy include:
  • cytomegalovirus (CMV): the most common (viral) infection passed on to fetuses
  • fifth disease (parvovirus B19): one of the most common causes of rashes in children
  • chickenpox (varicella zoster virus)
  • rubella (German measles): which once caused a variety of birth defects in newborns, but now is rarely seen in developed countries due to widely accessible vaccinations
  • group B streptococcus (also called “group B strep,” “baby strep,” or “GBS”): About 25% of pregnant women naturally carry this bacterium in their bodies and many don’t know it or have any symptoms or problems at all. But Group B strep can be passed on to babies — it’s the most common cause of life-threatening infection in newborns and a frequent cause of newborn pneumonia. Luckily, when it’s diagnosed in pregnant women the remedy is simple: Giving intravenous (IV) antibiotics during labor to kill the bacterium
  • hepatitis B: one of the three hepatitis (inflammation of the liver) viruses
  • toxoplasmosis: an infection caused by a microscopic parasite found in cat and farm animal feces
  • listeriosis and salmonellosis: infections caused by eating food contaminated with bacteria
  • sexually transmitted diseases (STDs): such as syphilis, gonorrhea, chlamydia, herpes simplex virus (HSV), human immunodeficiency virus (HIV), and acquired immune deficiency syndrome (AIDS)

Depending on the disease and when in the pregnancy you’ve been exposed, there may be no serious risk to your baby. Solutions might be as simple as the proper antibiotics or it might entail more involved care.

Either way, it’s best to call our perinatal coordinator as soon as possible. We can connect you to our Infectious Disease specialists who can work with your obstetrician/gynecologist (OB/GYN) or maternal-fetal specialist (also called perinatologist, a board-certified obstetrician with special training in high-risk pregnancies). That way, you’ll know what to expect — and be able to come up with a plan of care for when your baby is born.

 
Orthopedic Problems

Orthopedic problems that can often be diagnosed in utero (in the mother's womb) include (but aren’t limited to):

  • club foot (a group of structural defects of the foot and ankle in which the bones, joints, muscles, and blood vessels didn’t form correctly)
  • hand abnormalities or deformities
  • limb abnormalities (a limb deformity or an inequality in limb length)
  • skeletal dysplasia (a group of conditions characterized by abnormalities in the growth, development, shape, or integrity of the bones and cartilage; the most common feature is dwarfism)
  • spinal defects

Many orthopedic conditions are associated with other system abnormalities, especially heart and kidney problems. If we discover one of these conditions, we look for others. Detecting any or all of these problems before delivery can help you understand what's happening with your baby and what to expect.

 
Pediatric Surgical Conditions

Many congenital (present at birth) problems involving the abdomen and chest can be diagnosed before birth. These include (but aren't limited to) abdominal wall defects such as:

  • bowel atresias (when the bowels don’t form correctly, causing blockage or obstruction)
  • diaphragmatic hernia (a defect in the layer of muscle separating the chest from the abdomen that allows some of the abdominal organs to protrude up into the chest)
  • gastroschisis and omphalocele (defects in the abdominal wall allowing the intestine and other abdominal organs to protrude)
  • masses or cysts in the fetal abdomen and chest

Some of these conditions require immediate attention. Whatever kind of procedure your baby might need, our nationally renowned, senior-level surgeons at Nemours are certified by the American Board of Surgery, with special competence in pediatric surgery. And they'll do whatever it takes to try and give your baby the very best start in life.

Our Perinatal Care Services

Learn more about the perinatal care services we offer at Nemours/Alfred I. duPont Hospital for Children and our team who will be helping you and your family.

 
When It's Time to Deliver (and After)
We Care for Babies Once They're Born

So we don't deliver babies (there are no OB/GYNs or perinatologists on our staff). Moms and babies are usually safest and best-served with their own doctors and hospitals that are best-equipped to take care of them during pregnancy and delivery.

On the rare occasion that your baby may require intervention during or immediately after birth, arrangements can be made to deliver the baby at duPont Hospital for Children.

However, whenever possible, you can deliver at the hospital of your choice, under the care of your personal physician and with the support of your family and friends. But we make sure you and your doctors (here and elsewhere) have all of the information you need for delivery at your local hospital — and that everyone understands the recommendations for getting your baby the most efficient, highest-quality care and treatment.

Critical & Follow-Up Care at duPont Hospital for Children

Our Critical Care Transport Team can safely and promptly transfer your baby by ambulance or helicopter to duPont Hospital for Children for care or surgery with the specialists you’ve been working with already.

But our care doesn’t just stop after the birth. Our team will continue comprehensive follow-up to make sure problems that may not be obvious before or even at birth are detected as soon as possible. And we’ll keep providing you care and support as long as necessary to give your baby the best chance at a healthy future.

 
If Your Baby Needs Surgery

If an operation is necessary once your baby's born, you’ll be able to meet with your surgeon(s) well before the delivery so we can address all of your questions and concerns ahead of time.

Our surgical staff is made up of highly trained pediatric specialists — including board-certified surgeons, anesthesiologists, and nurses — dedicated entirely to pediatric surgery in even the tiniest of patients.

Surgical Services at duPont Hospital for Children

Surgery is usually performed at the duPont Hospital for Children. However, in some cases, our specialists can address the problem at one of our partner hospitals. If needed, our Critical Care Transport Team can also safely and promptly transfer your baby by ambulance or helicopter to duPont Hospital for Children from most area hospitals so your newborn can receive care or surgery from the specialists you’ve been consulting with during your pregnancy.

 
Our Care Team

The heart of our Nemours Partners for Perinatal Management program is our Perinatal Coordinator, who can guide you through the process, as needed, and schedule all fetal testing and consultations with appropriate specialists.

Our multidisciplinary team of doctors includes an entire collection of board-certified pediatric specialists (pediatricians with special training) who may be involved in your child's care:

  • cardiologists
  • cardiac surgeons
  • pediatric surgeons
  • nephrologists
  • neurologists
  • neurosurgeons
  • ophthalmologists
  • orthopedists
  • plastic surgeons
  • infectious disease specialists
  • urologists
  • geneticists
  • medical imaging (also known as “radiology”) specialists