Fetal Therapy Program Treatments and Services

Your first visit starts with a full assessment of your unborn baby using the most advanced imaging techniques
Your first visit starts with a full assessment of your baby using the most advanced imaging techniques.

We are the only fetal therapy program between Seattle and San Francisco that combines experts in maternal-fetal medicine with the region’s largest team of children’s specialists.

We offer:

  • Team-based care from the region’s most experienced fetal doctors.
  • Planning for your baby’s delivery based on your needs and wishes.
  • In-house lab and genetic testing services.
  • Minimally invasive techniques to treat certain fetal conditions before birth.
  • A dedicated nurse to coordinate your care.
  • A full range of support and resources.

Team-based care

Our team-based approach means you have access to all the resources and support of Doernbecher and the OHSU Center for Women’s Health.

We will:

  • Coordinate your care so you can focus on your family. You can see all your specialists in the same place, often on the same day.
  • Work with doctors in your community to create a delivery plan close to home, whenever possible.
  • Meet once a week to share our expertise and talk about your care in detail.
Stock photo of a pregnant patient being examined by a health care provider

Your care team

Your team may include:

  • Doctors with expertise in both high-risk pregnancies and genetics
  • Fetal and children’s heart experts
  • Fetal imaging specialists
  • Specialists in birth defects, genetic syndromes and other rare disorders 
  • Specialists in newborn intensive care
  • Children’s surgeons
  • Pediatric anesthesiologists
  • Certified genetic counselors
  • Pediatric palliative care (Bridges Program)
  • Social workers

Learn more:

Our welcoming Center for Women’s Health gives you specialized prenatal care, genetic counseling and support services.

Doctors with board certification (additional training and experience) in both maternal-fetal medicine and genetics coordinate our fetal care. They will give you the answers you need to make the right decisions for you and your family. They lead our weekly team meetings with a focus on patients’ well-being.

Doernbecher fetal and children’s heart specialists offer the region’s highest level of expertise in rare and complex heart conditions. They will thoroughly evaluate your baby’s heart. If needed, they will provide state-of-the-art care before and after delivery.

As soon as we know your fetal diagnosis, we’ll connect you with Doernbecher specialists. As one of the top children’s hospitals in the nation, we have experts in everything from common birth defects to complex genetic syndromes.

Doctors and other providers will talk with you about how the condition affects your baby. They will also work with you to create the best delivery and care plan for you and your family.

If you choose to have your baby at OHSU, we offer a full array of specialists for labor and deliver. They include expert nurses, obstetricians and anesthesiologists. See the "Delivery" section below to learn more about how we honor your wishes and plan the safest-possible delivery.

Specialists in newborn care (neonatologists) from our award-winning Neonatal Intensive Care Unit play an important role. They will help plan a safe delivery and immediate care for your baby. They also provide expert critical care in a comforting environment.

Our team includes Dr. Stephanie Dukhovny, a maternal-fetal medicine specialist (also known as a perinatologist, an expert in pregnancy complications). She has advanced training in fetal therapy.
Our team includes Dr. Stephanie Dukhovny, a maternal-fetal medicine specialist (also known as a perinatologist, an expert in pregnancy complications). She has advanced training in fetal therapy.

Your first visit

Before your visit, our nurse will call you to:

  • Talk about what to expect
  • Answer your questions
  • Offer support and advice on lodging and travel if you need it

When you arrive, you will:

  • Have an ultrasound or other imaging to confirm and better understand your diagnosis.
  • Meet with a doctor to talk about:
    • What your diagnosis means for you and your baby
    • Your options
    • A care plan, through delivery

After your visit, our nurse coordinator will closely monitor and streamline your care throughout your pregnancy.

Complete evaluation

We use the latest tools and technology to assess your developing baby. Our fetal imaging specialists have extensive skill and experience finding complex birth defects and genetic disorders.

Your tests may include: 

Ultrasound: High-resolution 3D and 4D scans use sound waves to give us a clear view of your baby’s moving body on a screen. Specialists in fetal imaging will talk with you during and after the scan about what they see and what it means.

Fetal echocardiogram: This specialized ultrasound helps us look closely at the structure and movement of your developing baby’s heart. A fetal heart specialist will explain your results and options. 

Fetal MRI (magnetic resonance imaging): This imaging test shows clear, moving images of your baby’s brain, heart, lungs and other organs. It can help your care team diagnose complex conditions. An MRI is often most helpful from the 30th to 32nd week of pregnancy.

Genetic testing and counseling: We offer an array of advanced tests to look for chromosomal abnormalities and genetic conditions. Your doctor and a certified genetic counselor can help you choose the best tests. They will also help you understand the results. Genetic tests include chorionic villus sampling (CVS) and amniocentesis.

Photo of a pregnant patient meeting with a maternal-fetal medicine doctor
Patients meet with a maternal-fetal medicine doctor to discuss options.

Advanced care

We offer the latest treatments for complex fetal conditions. They include:

Medications given to you can help your developing baby’s heart beat more regularly and strongly. Heart medication during pregnancy can also help your baby’s heart work better after birth. Some heart rhythm problems go away after delivery.

Medications may be used for:

  • Fast or abnormal heartbeats
  • Blocked electrical systems from lupus (an autoimmune disease)
  • Structural heart defects

What to expect: You may need to stay in the hospital for fetal monitoring when you take these medications.

A shunt is a small tube that drains extra fluid or urine from your unborn baby into the amniotic sac. Excess fluid or urine can damage organs or stop them from growing and working well. Draining the fluid can prevent problems before and after birth.

Shunts may be used for:

  • Fluid around the lungs (pleural effusion): This happens when fluid leaks into the space around the lungs. Causes can include a mass, an infection, heart problems or chromosomal abnormalities. It can cause underdeveloped lungs, heart failure and hydrops (fluid buildup and swelling).
  • Lower urinary tract obstruction (LUTO): This occurs when a flap blocks urine from leaving the bladder, backing it into the kidneys (hydronephrosis). This common birth defect can cause low levels of amniotic fluid and severe kidney damage. It happens mostly in boys

How a shunt is placed: Your doctor inserts a long, thin tube called a catheter into your uterus with a needle. The doctor uses ultrasound images to guide the catheter and place a shunt in your unborn baby. We will numb the area with spinal anesthesia.

We can treat severe fetal anemia (too few red blood cells) with a blood transfusion into your baby’s umbilical cord. Red blood cells carry oxygen to developing organs, and low levels can lead to heart failure and fluid buildup.

How a transfusion is done: Your doctor uses ultrasound images to guide a needle into your uterus and to inject donated blood into the umbilical cord. We use a spinal anesthesia to numb the area.

Open surgery on babies in the womb is rare and not offered at OHSU. We can refer you to a national fetal surgery center for certain conditions, such as spina bifida, heart defects and lung masses.

Delivery

Safety: Many fetal conditions cannot be treated before birth. For these pregnancies, we focus on helping you plan the safest-possible delivery and on caring for your baby after birth.

Your wishes honored: We will discuss your needs and wishes in detail. Our goal is to help you plan the birth experience that works best for you. You may choose to have your baby in your community, for example, or you and your care team may decide you want the specialized care available at OHSU.

Vaginal births: We support vaginal births whenever possible. This includes what’s called a “trial of labor after a cesarean” (TOLAC) for moms who have had a cesarean section. This means we try for vaginal delivery and switch to a C-section only if necessary.

Immediate care: If you deliver at OHSU, specialists will be ready with the technology and treatments you and your newborn need, including:

  • The region’s most advanced critical care for seriously ill newborns and premature babies in our Neonatal Intensive Care Unit (NICU).
  • Medications, procedures and other immediate care that could save your baby’s life.
  • Surgeons skilled in treating newborns.
  • Anesthesiologists with expertise in caring for women with high-risk pregnancies and babies born with a defect or anomaly.
Stock photo of a family waiting in a clinic area

Support services

We offer an array of resources for you and your family, including:

  • Social workers who can help you with housing, transportation and other needs.
  • Child life specialists who can help older children in your family adjust during your hospital stay.
  • Specialists in our Bridges Program (pediatric palliative care) who can provide support for difficult decisions; comfort care; and many other services.
  • Abortion care at our Center for Women’s Health, with our support throughout the process.
  • Mental health experts who specialize in treating women with high-risk pregnancies. Tell your care team right away if you have any questions or concerns about your mental health. We can give you the care you need to feel better.

For families

Call 503-346-0640 to:

  • Request an appointment.
  • Seek a second opinion.
  • Ask questions.

Location

Parking is free for patients and their visitors.

Doernbecher Children’s Hospital
700 S.W. Campus Drive
Portland, OR 97239
Map and directions