Fetal Care Center

Yale Medicine doctors are leaders in fetal surgery and were the first in Connecticut and the surrounding region to perform in utero repair for myelomeningocele, a form of spina bifida in which the spine and spinal canal do not close properly before birth. When appropriate, surgery performed before 26 weeks of pregnancy can improve outcomes.

Common conditions we treat include cleft lip and palate, congenital heart defects, fetal anemia, gastroschisis, hydrocephalus, intra-abdominal masses, spina bifida, and twin-to-twin transfusion syndrome.

For more than 40 years, Yale Medicine physicians have provided innovative fetal therapy at Yale New Haven Children’s Hospital, helping to shape how fetal medicine is practiced today.

Our clinicians helped pioneer the nation’s first neonatal intensive care unit (NICU). Today, Yale New Haven Children’s Hospital remains among the few hospitals in the country to offer couplet care, allowing mothers and babies to stay together whenever possible.

Many widely used fetal diagnostic and treatment approaches were developed at Yale School of Medicine, including noninvasive assessment of fetal anemia, percutaneous umbilical blood sampling, in utero fetal blood transfusion, fetoscopy, and fetal surgery. Our physicians are also leaders in research, furthering care for future families.

A dedicated fetal therapy coordinator supports you throughout your care—from referral through pregnancy, delivery, and often beyond. The coordinator helps schedule appointments, arrange testing, connect you with specialists, and guide you through your care plan.

We work closely with your obstetrician or maternal–fetal medicine provider and keep them informed at every step. Depending on your needs, care may be co-managed to ensure seamless coordination.

Your visit may include maternal–fetal medicine specialists, a nurse coordinator, sonographers, nurses, and other support staff. Pediatric specialists are involved as needed based on your baby’s diagnosis.

Our team uses state-of-the-art imaging and prenatal diagnostic tools to evaluate fetal conditions. Test results are reviewed promptly, and findings and next steps are discussed with you so you can make informed decisions.

Diagnostic and treatment options may include:

• Ultrasound, including 3D- and 4D imaging
• Fetal MRI and fetal echocardiography
• Genetic and chromosomal testing, including cell-free fetal DNA testing, karyotype analysis, and chorionic villus sampling
• Amniocentesis and percutaneous umbilical blood sampling
• In utero treatments such as fetal blood transfusion, shunt placement, and laser therapy for twin-to-twin transfusion syndrome

Not every patient needs every test. Your care team recommends only what is appropriate for you and your baby.

Our Fetal Care Center offers access to a wide range of medical and surgical specialties involved in fetal and newborn care. This collaborative approach ensures every aspect of your baby’s care is thoughtfully planned and seamlessly coordinated.

Genetic counseling and prenatal testing help families understand potential risks and make informed decisions. Our board-certified genetic counselors consider family history, blood tests, ultrasound findings, age, and other factors when guiding care.

They explain available testing options, review results, and discuss what findings may mean for your current or future pregnancies. If a structural or genetic condition is identified, counselors provide clear, supportive guidance tailored to your preferences.

Testing options may include microarray analysis, whole exome sequencing, and targeted gene testing.

Neonatologists—pediatricians with specific training in caring for newborns—play a key role on the Fetal Care Center team. They provide prenatal consultations and help families plan for newborn care after delivery.

When specialized newborn care is anticipated, delivery at Yale New Haven Hospital allows immediate access to Yale New Haven Children’s Hospital’s NICU, one of the most advanced in the country. Neonatologists oversee care in close collaboration with pediatric subspecialists.

Fetal cardiologists care for babies before birth who are affected by, or at risk for, heart conditions such as congenital heart disease or abnormal heart rhythms. They work closely with the Fetal Care Center team to evaluate diagnoses and guide care planning before and after delivery.

If surgery is needed before or after birth, care is provided by an experienced multidisciplinary team. Our fetal surgery program collaborates with pediatric specialists in cardiology, neurosurgery, orthopaedics, plastic and craniofacial surgery, urology, and other surgical fields.

Care is supported by anesthesiologists, advanced practice providers, nurses, social workers, nutritionists, and child life specialists. Yale New Haven Children’s Hospital offers in utero fetal surgery, providing access to highly specialized care close to home.

When a pregnancy is affected by a life-limiting condition or families face difficult decisions, our Perinatal Palliative Care Program provides compassionate, individualized support. Care begins at diagnosis and continues throughout pregnancy and beyond, honoring each family’s values, culture, and wishes.

Genetic counseling and prenatal testing are among the most valuable tools to help prospective parents make important decisions regarding a current or future pregnancy. Many things are taken into consideration including family medical history, blood test results, ultrasound measurements, age, and ethnicity, to name a few. Our board-certified genetic counselors help families understand their test results and the impact on their current or future pregnancies. They also provide education on which tests are available and explain the results. If there is a detection of a structural abnormality or concerns about a genetic syndrome, the genetic counselor will ensure the family understands the potential prognosis and provide counseling based on the family’s preferences.

Some of the advanced testing options include:

• Chorionic villus sampling (CVS)
• Amniocentesis
• Karyotype analysis (chromosomal analysis)
• Microarray analysis
• Whole exome sequencing
• Specific gene testing

Neonatologists are pediatricians with advanced training and expertise in the care of sick newborns and play an integral role on the Fetal Care Center medical team. They offer comprehensive consultations following diagnoses and assist the family in establishing an individualized care plan for their newborn. We recommend infants requiring special medical attention be delivered at Yale New Haven Hospital to facilitate immediate access to Yale New Haven Children’s Hospital’s Neonatal Intensive Care Unit (NICU), one of the most advanced in the country. Neonatologists oversee the care of all patients in the NICU, in coordination with a full range of pediatric subspecialists.

As part of the Fetal Care Center, fetal cardiologists care for babies in the womb who may be at risk for or are affected by congenital heart disease or abnormal heart rhythms. They collaborate with a multidisciplinary team at the Fetal Care Center, including physicians from maternal-fetal medicine, neonatology, and pediatric cardiothoracic surgery, as well as social work and genetic counselors. This special team will help identify causes and customize treatment options. Learn more about our fetal cardiology services including fetal echocardiograms.

In the event a developing baby requires surgery to treat a condition, either while in the womb or after birth, families can rest assured knowing that they’ll receive the greatest of care. Our expert surgical team is made up of a renowned fetal surgery team and pediatric specialists in cardiology, craniofacial and plastic surgery, gynecology, neurosurgery, ophthalmology, orthopedics, otolaryngology, pediatric general surgery, transplantation, and urology. Additional members of the team include anesthesiology, advanced practice providers, nurses, social workers, nutritionists, and child life specialists. Yale New Haven Children’s Hospital is the only hospital in Connecticut offering in utero fetal surgery.

At times, pregnancy may result in a life-limiting condition or families are confronted with the difficult decision to end the pregnancy. Our Perinatal Palliative Care program is here to support families through these challenging times. Our compassionate team works with pregnant patients and their families to develop a culturally sensitive and individualized care plan that respects the wishes of the family. Families receive palliative care beginning with the medical diagnosis, throughout and following pregnancy. Learn more about our Perinatal Palliative Care program.