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Fetal Evaluation and Treatment Alliance (FETAL)


The FETAL Center at Children’s Medical Center Dallas is the only program in North Texas offering a full continuum of specialized care for pregnant women diagnosed with a fetal anomaly. Patient families and their referring providers receive prenatal conferences with a highly specialized multidisciplinary team, all in one location, that brings the expertise of UTSW subspecialists to the affected baby at risk.
A personalized approach addresses each in utero diagnosis to determine  the best strategy for pregnancy, delivery and continuity of care after birth. Receiving care through the FETAL Center provides access to maternal fetal medicine specialists, a world renowned neonatal resuscitation team as well as a complete range of pediatric and surgical subspecialists who work together to deliver the highest level of comprehensive care.

Why Children's Health℠?

Children’s Health offers a comprehensive and fully integrated Fetal-Neonatal program. The highly skilled team members include board-certified neonatologists, perinatologists, radiologists, general and subspecialty surgeons and pediatricians, as well as nurses with advanced neonatal training.

Our physicians are faculty members at UT Southwestern, many of whom have performed research leading to publications, and who practice improvements that have had a direct effect on patient care locally, nationally, and across the globe. The team members work together to develop a treatment plan that ensures the best medical outcomes, especially for infants with anomalies and those at high risk for long-term disabilities.

The members of the fetal-neonatology program at Children’s Health will provide outstanding care for your baby and support you and your family throughout treatment.  Our full range of support services include those provided by case managers, child life specialists, financial counselors, social workers, and pastoral care.

Many birth anomalies will be treated in our state-of-the-art 47-bed NICU, which offers access to a full range of neonatal therapies as well as the 24/7 availability of pediatric subspecialty support.  There, highly trained physicians and nurses are dedicated to providing outstanding specialized care to the tiniest babies — infants who can’t be cared for elsewhere with the same level of  expertise. The NICU at Children’s Health is designated a Level IV NICU, meaning it meets the highest standards set by the American Academy of Pediatrics and is equipped and staffed to provide expert care for infants with the most complex or acute conditions.  Children’s Health is the only hospital in North Texas with a NICU program academically affiliated with UT Southwestern Medical Center, one of the top biomedical institutions in the world,  where the Division of Neonatal-Perinatal Medicine is one of only 17 centers nationwide participating in the National Institutes of Health Neonatal Research Network.

The division has provided care for newborns for more than 30 years. 
Comprehensive care for infants diagnosed with congenital heart defects is provided by our nationally recognized Heart Center.

U.S. News & World Report has ranked Children’s Health among the best pediatric hospitals in the United States, and among the best in the nation for neonatology, acknowledgment that we meet and exceed the highest standards of care for newborns.

Conditions We Treat

Among the many birth defects treated through our Fetal Neonatal service line are:

  • Abnormalities of the head and neck such as
    • Cleft lip/palate: an opening between the upper lip and the nose (lip) or between the roof of the mouth and the nasal cavity (palate)
    • Esophageal atresia/tracheoesophageal fistula: the incomplete development of the esophagus
    • Head and neck masses: lumps or cysts on the face neck, scalp or ears
    • Pierre Robin syndrome/severe micrognathia: a condition characterized by an abnormally small lower jaw
  • Abnormalities of the chest such as
    • Cystic adenomatoid malformation: a rare defect in lung formation
    • Diaphragmatic hernia: the protrusion of some of the abdominal organs into the chest due to a defect in the muscle layer between the abdomen and the chest
    • Heart defects: when any part of the heart forms abnormally
    • Mediastinal masses: growths in the middle of the chest—the area that separates the lungs
    • Pleural effusions: abnormal accumulation of fluid in the chest cavity
    • Pulmonary sequestration: a malformation of the lower respiratory tract
  • Abnormalities of the abdomen such as
    • Abdominal masses: growths in the abdomen
    • Bowel atresia: a blockage or narrowing of the bowel
    • Gastroschisis and omphalocele: protrusions of the intestines into the abdomen due to a defect in the abdominal wall
    • Abnormalities of the urinary tract and genitourinary system
    • Ambiguous (or atypical) genitalia: when the baby’s genitals are not clearly male or female
    • Bladder/cloacal exstrophy: a condition that results when the bladder is exposed because the skin  that should cover it does not form correctly
    • Bladder outlet obstruction: a blockage at the base of the bladder that hinders the flow of urine
    • Hydronephrosis: when one or both kidneys trap urine and cause it to drain abnormally slowly into the bladder
    • Renal malformation: abnormal development of the kidneys
  • Abnormalities of the nervous system such as
    • Arteriovenous malformations: defects in the blood vessels
    • Encephalocele: a gap in the skull through which brain material may protrude
    • Hydrocephalus: a buildup of cerebrospinal fluid that can cause pressure on the brain
    • Myelomeningocele (spina bifida): abnormal development of the back bones as well as the spinal cord and the nerves and fluid-filled sac that surround it
  • Other Genetic and Metabolic Disorders
    • Cystic fibrosis: a disease that causes body secretions to be thick and sticky and damages the lungs and digestive system
    • Duchenne muscular dystrophy: a progressive weakening of the muscles
    • Dwarfism: abnormally small stature
    • Hemophilia: a rare bleeding disorder that can cause prolonged bleeding
    • Neural tube defects: abnormalities in the brain, spine, or spinal cord
    • Sickle cell disease: a hereditary form of anemia
    • Tay-Sachs disease: a disorder involving the accumulation of a fatty substance in the nervous system
    • Muscular disorders, such as hypotonia, or low muscle tone

What are birth anomalies?

Birth anomalies are health problems that are evident at the time a baby is born and in many cases can be diagnosed in utero. They’re sometimes called congenital anomalies or abnormalities, congenital meaning present at birth. Every year, approximately 150,000 babies are born with birth defects.  Congenital anomalies may be structural—involving a missing or malformed body part, such as a heart defect or cleft palate. Others are metabolic— disorders of body chemistry, such as Tay-Sachs disease.

These anomalies may be mild and may not greatly interfere with a baby’s well-being or they may be severe problems that last throughout life. In some cases, they may even be even life-threatening. Some birth defects cannot be cured, but many can be treated or managed. Children’s Health is a leader in providing neonatal care for such complex diseases and disorders and has all the resources necessary to diagnose and manage your baby’s condition.

It’s not always clear why birth anomalies occur. Many times they result from genetic factors. They may be inherited or they may result from a defect in one or more genes. In some cases, anomalies are caused by exposure to teratogens, agents in the environment to which a mother may have been exposed during pregnancy, such as medications, alcohol, infections, or street drugs. In many cases, a variety of factors cause these congenital conditions, often a combination of genetic and environmental influences.

How are birth anomalies diagnosed & treated?

Birth anomalies are often diagnosed before birth using tests such as fetal ultrasound, a variety of blood tests,  chorionic villus sampling (a prenatal sampling of placental tissue), and amniocentesis (a sampling of amniotic fluid surrounding the fetus). Congenital defects are not always detected during pregnancy, however, and may not be apparent until the baby is born and examined. If a birth defect is suspected upon physical examination, blood tests, chromosomal analyses, hormone studies, and, in some cases, biopsies, may confirm the diagnosis.

The purpose of the Fetal Evalutation and Treatment Alliance (FETAL) is to determine the best strategy for delivery and continuity of care after birth for pregnant women diagnosed with a fetal anomaly.