Conditions we treat
A vast range of conditions can be treated before birth because of the expertise at Texas Children's Fetal Center
While most birth defects are best managed with medical therapy during pregnancy or with surgery immediately after birth, an increasing number of anatomic abnormalities can be corrected before birth to reduce some of the life-threatening or devastating consequences of the defect.
Our experienced team of experts evaluate and treat the following conditions:
Abdominal wall defects
Gastroschisis
An anomaly of which there is a defect in the anterior abdominal wall of the fetus and intestines protrude through this defect and are free floating in the amniotic fluid.
Omphalocele
A condition in which there is a defect in the anterior abdominal wall, and internal organs (intestines, stomach, liver, bladder, etc.) protrude through the defect but are contained in a transparent sac.
Amniotic band syndrome
Sheets or strands of the membranes surrounding the fetus (amnion) may be wrapped around parts of the fetus restricting the growth and development of these areas. These bands may wrap around extremities limiting blood flow and resulting in amputation. Other parts of the fetus may also be affected.
CNS lesions
Anencephaly
Encephalocele
Holoprosencephaly
Hydrancephaly
Hydrocephalus
Congenital airway obstruction (CHAOS)
A condition where the upper airway (larynx or trachea) of the fetus is either absent or blocked. This results in accumulation of fluid in the fetal airway with massively enlarged lungs, a flattened diaphragm and fluid in the abdomen.
Congenital diaphragmatic hernia (CDH)
A defect in the formation of the diaphragm (the muscle that separates the chest from the abdomen) during development, resulting in a hole in the diaphragm that allows passage of abdominal organs into the chest. CDH is typically associated with small, poorly formed lungs.
Craniofacial anomalies
Cleft lip
A defect in the formation of the lip during development, typically involving the upper lip and can affect one or both sides. Cleft lip may occur alone or along with cleft palate.
Cleft palate
A defect in the bones that form the upper part of the mouth. May occur along with cleft lip.
Duodenal and intestinal atresia
Blockage in the intestines beyond the stomach.
Esophageal atresia with tracheoesophageal fistula
Blockage in swallowing tube (esophagus) with or without an abnormal communication with the breathing tube (trachea).
Fetal cardiac conditions
Congenital heart block
This is a cause of fetal bradycardia (slow heart rate). Normally, the electrical signal for the heart to beat starts in the sinus node in the right atrium (collecting chamber). After signaling the atria to beat, the electrical impulse crosses the AV node to signal the ventricles to beat. In Congenital Heart Block, the AV node cannot conduct the electrical beat, so the sinus rhythm cannot get through to the ventricles. A slow “escape” rhythm is generated by the conduction system below the block, but is much slower than sinus rhythm. Therefore, this may not be fast enough to maintain good cardiac output, and the fetus can develop hydrops.
Congenital heart disease
Any structural or functional heart defect that is present before birth.
Fetal cardiac arrhythmias
An abnormality in the fetal heart rhythm. The rhythm can be irregular, slow (bradycardia) or fast (tachycardia). The most common cause of irregular fetal heart rhythm are premature atrial contractions -- early beats coming from somewhere in the atria other than the sinus node that are often benign. The most common fast fetal arrhythmia is supraventricular tachycardia (SVT). Sustained SVT can cause congestive heart failure with hydrops in the fetus. Irregular bradycardia can be from blocked premature atrial contractions -- early beats that are unable to get conducted to the ventricles.
Fetal chylothorax or hydrothorax
Fetal chylothorax or hydrothorax is a condition in which fluid accumulates in the fetal chest, in the space between the lungs and the chest wall (known as the pleural space). Read more
Giant neck masses
Rarely, a mass may be found on the fetus’ neck. Most often this condition is due to problems called either lymphatic malformation or teratoma. In other circumstances, the mass may be a more rare abnormality (such as neuroblastoma, cervical thymic cyst, hemangioma or other lesion). Read more
Lung lesions/CCAM
An abnormality may be detected in the fetus’ chest or lung. In some instances the lesion may look like a mass, and in other cases the lesion looks more cystic (containing fluid-filled spaces). Many doctors may use the term “CCAM”, which stands for congenital cystic adenomatoid malformation, to refer to many lung masses in the fetus. Read more
Maternal immune disorders affecting the fetus
Platelet Alloimmunization
Red Cell Alloimmunization
Myelomeningocele (spina bifida)
Myelomeningocele, the most common form of spina bifida, is in a class of problems referred to as open neural tube defects (ONTD). Spina bifida is one of the most common birth defects. Read more
Non-immune hydrops
The term hydrops fetalis, or fetal hydrops, refers to a condition in which the fetus shows signs of fluid accumulation in the body. Hydrops is defined as the presence of abnormal fluid in at least 2 spaces where it is not supposed to be, such as in the abdominal cavity (ascites), chest cavity (pleural effusion), cavity around the heart (pericardial cavity) or in the skin or scalp (referred to as edema). Read more
Sacrococcygeal teratoma
Tumor in the lower back or buttock, derived from the 3 germ cell layers.
Skeletal dysplasia
There are more than 350 different types of skeletal dysplasia disorders, but it generally means that some or all of the fetal bones are smaller than expected for the fetal age. Read more
Twin abnormalities
Selective Intrauterine Growth Restriction (sIUGR)
TRAP Sequence (Acardiac Twin)
Twin-Twin transfusion syndrome (TTTS)
A complication seen in approximately 10-15% of twins who share a common placenta (monochorionic) where there is unbalanced blood flow from one twin (donor) to the other (recipient). If left untreated, pregnancy loss may occur from lack of adequate blood flow to the donor, too much flow to the recipient, or maternal complications associated with the excess fluid accumilation.
Urinary tract obstruction
Bladder outlet obstruction
A rare condition caused by an obstruction in the fetal urinary system where the fetus is unable to empty its bladder. This can lead to a variety of problems for the fetus ranging from damage to the kidneys from back-pressure to under-development of the lungs due to lack of amniotic fluid.
Hydronephrosis
A manifestation of blockage in the fetal urinary system where the urinary back-pressure leads to the dilation of the structures within the genitourinary system and can sometimes lead to long-term complications, including renal failure.
