Early Diagnosis, Treatment & Follow-Up
At Nemours Perinatal Program, our goal is to ensure that every child has the opportunity to achieve their full potential in life. Conditions diagnosed before birth and treated at or soon after delivery often can be corrected.
Perinatal Testing: What to Expect
We know that going through any kind of medical testing during pregnancy can be stressful and emotional. That's why we do everything we can to make sure you feel safe and comfortable during our diagnostic testing. We'll make sure you understand what will happen during the test and give you the opportunity to ask any questions before we start. Our goal is to provide a stress-free, relaxing environment for fetal diagnostic testing.
If you’re pregnant and carrying a baby that may have a congenital condition, our perinatal coordinator will schedule all fetal testing and visits with appropriate specialists at Nemours Children’s Hospital, Delaware. Our coordinator is available to guide you through our facility and services, and is never more than a phone call away.
We also know that waiting for test results and information can add to your anxiety. We will reassure you when diagnostic studies show no cause for concern. When a problem is detected, we're committed to providing diagnostic information and an individualized plan for perinatal care, delivery and options after birth for every newborn in a timely manner.
A fetal MRI is an advanced form of fetal diagnostic testing often used to pinpoint brain, neck, chest, abdominal or orthopedic problems. A fetal MRI, which is safe and painless, provides more detailed information and greater insight into structural abnormalities than can be found on ultrasound.
At Nemours Children’s Hospital, Delaware, we have five experienced radiologists who specialize in fetal imaging, including a sub-specialized pediatric neuroradiologist. Fetal MRI was pioneered in Delaware in 1996 by a member of our team, who brought this advanced diagnostic capability to Nemours Children’s Hospital, Delaware in 2007.
What Happens During a Fetal MRI?
A fetal MRI is performed using a large doughnut-shaped scanner with a tunnel in the center, which utilizes a magnetic field and radio waves to produce detailed pictures of your baby’s organs and internal structures. Generally speaking, your head won't be in the scanner.
We take special precautions to keep mothers and babies safe, following strict screening protocols, monitoring maternal oxygenation, and adhering to MRI safety principles. Unlike a CAT scan, a fetal MRI doesn’t require radiation. And we don't use any injections, contrast or sedatives. Special preparation is required for mothers with diabetes.
A registered nurse (RN) will be there to monitor you during the whole procedure.
When Can I Get a Fetal MRI?
We don't perform fetal MRIs in the first trimester. The ideal time for a fetal MRI is late in the second trimester, if it was recommended by your perinatologist/maternal-fetal medicine specialist or obstetrician-gynecologist (OB-GYN).
A fetal echocardiograph (or "fetal echo") is a type of fetal diagnostic testing that uses an in-depth cardiac ultrasound study to allow Nemours pediatric experts to view the structure, function and rhythm of a baby’s heart while still in the mother’s womb during pregnancy. The ultrasound uses high-frequency sound waves to "echo," or bounce, off the body and create a picture.
Our fetal cardiologists and sonographers (trained technicians with specialized ultrasound training) can perform these special ultrasounds:
- at Nemours Children’s Hospital, Delaware (in our state-of-the art Cardiac Center)
- at Nemours Children's Health locations in Pennsylvania and New Jersey
- in consultation with maternal-fetal medicine specialists at two of our collaborating hospitals, Nemours Children's Health at Thomas Jefferson University Hospital (in Center City Philadelphia) and Nemours Children's Health at Lankenau Medical Center (in Wynnewood, Pa.)
What Happens During a Fetal Echo?
A special jelly is applied to the skin of your abdomen, and a wand-like instrument (called a "transducer") is positioned over it. Sound waves are generated and reflected back to the transducer as electric impulses, which produce an image of your baby's heart on a computer screen.
When Can I Get a Fetal Echo?
If your perinatologist/maternal-fetal medicine specialist or obstetrician-gynecologist (OB-GYN) recommended it, you can get a fetal echo as early as the 18th week of your pregnancy.
Once You Have a Diagnosis: What to Expect
We consider you — the parents — the most important members of your baby’s care team. We want you to be an active participant in the diagnostic and planning process. That’s why we’ll take the time to explain the diagnosis in understandable terms, present all of the options available, and make sure you know what's happening at every step.
Once you have a diagnosis, we'll coordinate consultation appointments with any and all of the specialists who will potentially be involved in your child’s care after birth. Our specialists will help you understand what's going on with your baby and come up with a plan of coordinated care for after your baby's birth. Collaboration among specialists is especially important if your baby may have multiple anomalies (defects).
Our team includes a perinatologist, cardiologists and cardiac surgeons, general surgeons, nephrologists, neurologists, neurosurgeons, ophthalmologists, orthopedic specialists, plastic surgeons and urologists, as well as pediatric anesthesiologists, neonatologists, imaging specialists and geneticists. Our Palliative Care team can also help you through your fears, goals, hopes and wishes once you receive a diagnosis.
Having information about your baby’s condition and what to expect can help you prepare, mentally and physically. Parents often feel more comfortable when they’ve met the people who will be caring for their child, learned about support services available, and toured the places the newborn might receive care after birth. Knowing there are experts standing by who are aware of your baby’s unique situation may bring peace of mind in even the most difficult situations.
Our collaboration, as a team, extends to our referring physician partners and hospitals. This unique model allows us to work closely with your obstetrician and/or perinatologist/maternal-fetal medicine specialist, who will continue to provide the best care for you while our Nemours specialists consult on the best options for your newborn after delivery.
We'll continually communicate with you and your referring doctors with ongoing progress reports. We also use a fully integrated electronic health record system, so information and expertise are available quickly and from any location.
Your health and your baby’s condition will be major factors in determining if the Advanced Delivery Program is right for you.
If you are referred into the program, you will visit with the Advanced Delivery Program team to plan for your delivery. They will answer all of your questions and work with you and your doctor every step of the way.
When it’s time to deliver, the Advanced Delivery team will oversee the care for both your and your baby in a comfortable, caring environment at Nemours Children’s Hospital, Delaware. That means providing you with a highly personalized delivery experience that keeps you together with your newborn in the same location, while you both receive the very best care from our team of experts.
Our Critical Care Transport Team can safely and promptly transfer your baby by ambulance or helicopter to Nemours Children’s Hospital, Delaware for care or surgery with the specialists you’ve been working with already.
Cardiac Intensive Care Unit (CICU)
If your baby's born with congenital heart disease (also known as a "congenital heart defect"), the Nemours Cardiac Center has a 14-bed cardiac intensive care unit (CICU), which offers a full complement of specialists and equipment to monitor your baby and adjust treatment at all times. Nursing care is provided 24 hours a day at your baby’s bedside, and nurses typically have only one or two patients to care for in the CICU.
Neonatal Intensive Care Unit (NICU)
In our Neonatal Intensive Care Unit (NICU), we use the most up-to-date and innovative techniques available to provide immediate, highly skilled, 24/7 in-house coverage by a board-certified neonatologist for newborns with a wide range of medical and surgical conditions. Providing the highest level of care for critically ill newborns, we have the only Level IV NICU in the state of Delaware.
Expanded ECMO Program & ECMO Transport
We're pleased to offer neonatal and pediatric intensive care ECMO (extracorporeal membrane oxygenation) to complement our existing cardiac ECMO service. The expanded ECMO program provides mechanical life support to infants and children with respiratory failure in our NICU and Pediatric Intensive Care Unit (PICU), as well as those with cardiac failure in the CICU.
We're also the only pediatric hospital in the region with ECMO transport. The Nemours ECMO transport team can place an unstable patient on ECMO at a referring hospital and transport the child to Nemours Children’s Hospital, Delaware in a stabilized condition for as long as needed.
If an operation is necessary once your baby's born, you’ll be able to meet with your surgeon 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 who are dedicated entirely to pediatric surgery, for even the tiniest of patients.
Surgical Services at Nemours Children’s Hospital, Delaware
If surgery is necessary, it's usually performed at Nemours Children’s Hospital, Delaware. In some cases, our specialists can address the problem at one of our collaborating hospitals. If needed, our Critical Care Transport Team can also safely and promptly transfer your baby by ambulance or helicopter to Nemours Children’s Hospital, Delaware from most area hospitals, so your newborn can receive care from the specialists you’ve seen during your pregnancy.
At Nemours Children’s Hospital, Delaware, we strive to create a calming experience for patients and families. From the comfortable, attractive setting to the services available, we're sensitive to your needs.
Our Many Family-Friendly Amenities
We offer private rooms with bathrooms and ample space for your family, free parking (and $5 valet parking), as well as a rooftop Healing Garden, serenity rooms, playrooms, pocket parks, family solariums, lactation rooms, a washer and dryer on every unit, and plenty of healthy onsite dining options.
And our Family Resource Center offers families a place to relax during their child’s hospital stay, along with a library and business center, kitchenette and laundry room. The Ronald McDonald Family Room provides sleep rooms and showers on site, and the Ronald McDonald House of Delaware is across the street.
Involving Your Whole Family Every Step of the Way
Families are part of the diagnostic and planning process. All members of your family, including grandparents and other important family members, are encouraged to ask questions and share concerns. Our Child Life department also works with siblings. Taking an active role in the process often gives families a sense of control and reassurance.
Our care certainly doesn’t end after your child is born. 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 care and support as long as necessary to give your baby the best chance at a healthy future.
More Preparation Means Less Stress
“Parents who are prepared for a problem are much calmer and more organized than those who discover it at birth... When we have a plan, parents are less stressed and [there are] no delays in treatment."
— Sharon Lehman, MD, pediatric ophthalmologist, Nemours Children’s Hospital, Delaware