Pediatric development specialists in Dallas

We address children's developmental issues to help your child function as well as possible.

At Fetal Care Center, we treat abdominal, chest, neck and respiratory issues in children, as well as cysts and tumors. Depending on the specifics of your child's condition, our personalized treatment process may begin before or after birth.

Scheduling an appointment

Before you and your child visit us, we encourage you to discuss specifics about your situation with one of our experienced pediatric specialists.

To inquire about our pediatric services or treatments, or to make an appointment, please call (972) 566-5600.

Conditions treated by our pediatric specialists

Our specialized doctors and surgeons work together to provide advanced treatment for numerous pediatric conditions, including:

  • Abdominal wall abnormalities
  • Ambiguous genitalia
  • Amniotic band syndrome (ABS)
  • Anomalies of monochorionic twins
  • Bladder issues
  • Campomelic dysplasia
  • Choledochal cyst
  • Chorioangioma
  • Colonic atresia
  • Conjoined twins
  • Cystic chest lesions
  • Cystic abdominal lesions
  • Duodenal atresia and stenosis
  • Ectopia cordis
  • Esophageal atresia (EA)
  • Fetal neck conditions
  • Hepatic calcifications
  • Hirschsprung’s disease
  • Hypophosphatasia
  • Immune hydrops
  • Imperforate anus
  • Intra-abdominal calcifications
  • Intrauterine death in one twin
  • Intrauterine growth restriction
  • Jejunoileal atresia and stenosis
  • Kidney issues
  • Liver tumors
  • Malformation in twins
  • Monoamniotic twins
  • Musculoskeletal issues
  • Neuroblastoma
  • Nonimmune hydrops fetalis
  • Oligohydramnios
  • Ovarian cysts
  • Pentalogy of Cantrell
  • Pleural effusion
  • Polyhydramnios
  • Pyloric atresia and stenosis
  • Respiratory disorders
  • Retinoblastoma
  • Sacrococcygeal teratoma
  • Single umbilical artery
  • Tracheoesophageal fistula (TEF)
  • Umbilical cord abnormalities

Treatment for fetal development disorders

To help your family feel as assured as possible in our approach, we collaborate with you to establish the best care plan for you and your child.

Abdominal wall abnormalities

With this type of condition, the abdominal wall doesn't close properly, which can impair your newborn’s ability to digest food. Common abdominal wall abnormalities we treat include:

  • Gastroschisis
  • Omphalocele
  • Overgrowth syndromes

We typically diagnose these conditions by ultrasound during the second trimester of pregnancy. However, they may still not be discovered until delivery.

In some situations, a phased surgical approach after birth is required to gradually secure the organs or provide enough time for underdeveloped lungs to grow and expand. For severe circumstances, we will likely wait to perform surgery until your child is between one and two years old.

ABS care

ABS happens when fibrous, string-like bands develop from the inner lining of the sac that surrounds the baby in the womb. Your baby can become entangled in these bands, which may attach to body parts and restrict their blood flow and development.

To detect these bands, we use advanced ultrasound technology. Although some situations may not require treatment, our doctors will need to closely monitor your baby as they grow. As needed, we may perform a fetoscopy while your baby is still in the womb, which will use a small camera to examine the fetus and guide any necessary subsequent procedures.

Anomalies of monochorionic twins

Monochorionic twins are identical twins who share one placenta. This increases their chances of experiencing developmental challenges, such as amniotic fluid complications, low birth weight, umbilical cord entanglement, twin-to-twin transfusion syndrome (TTTS) and twin reversed arterial perfusion (TRAP) sequence.

TTTS is a rare pregnancy complication that causes an imbalanced blood flow between identical twins. Alternately, TRAP sequence occurs when one identical twin doesn't have a functioning heart and must rely on the other for blood flow. For severe TTTS, we use a laser-based surgical technique to disconnect part of the blood supply between the twins. With TRAP sequence, we may recommend delivering your healthy twin.

Bladder issues

During pregnancy, your baby may develop bladder problems, such as:

  • Bladder exstrophy
  • Bladder outlet obstruction (BOO)
  • Cloacal exstrophy
  • Ectopic ureterocele
  • Persistent cloaca
  • Ureteropelvic junction obstruction

BOO care

BOO is a rare condition affecting the urethra, which carries urine from the bladder out of the body. With BOO, the urethra becomes too narrow or obstructed, causing urine to back up in the bladder, exposing your unborn baby to potential kidney and lung problems.

On an ultrasound, an enlarged bladder, low amniotic fluid level or abnormal kidney appearance can alert us to the presence of BOO. If amniotic fluid levels are regular, no treatment may be needed before delivery. Extremely low amniotic fluid levels may require fetoscopic laser treatment or placement of a shunt or amnioport. Surgery may be necessary if your baby is at risk of kidney damage or lung impairment, but hasn't yet experienced reversible kidney damage.

Congenital chest malformations

Congenital chest malformations are unusual and can include small, asymptomatic entities, as well as large masses that require immediate surgery.

Malformations of a developing chest cavity can often present as hybrid conditions at once. We typically diagnose these conditions through fetal sonography. When a related condition is detected, our team performs a magnetic resonance imaging (MRI) scan to capture precise images and determine the best possible treatment plan.

Fetal neck conditions

Fetal neck issues are caused by various factors, and are often linked to other genetic disorders. Their treatment outcome ultimately depends on the stage of gestation when the diagnosis is made, as well as the severity of the condition.

Fetal neck conditions might include:

  • Cervical teratoma
  • Congenital high airway obstruction syndrome (CHAOS)
  • Cystic hygroma
  • Fetal thyroid disorders
  • Goiter

CHAOS care

CHAOS occurs when a fetus’s trachea or larynx experiences a blockage, trapping lung fluid and potentially affecting the heart’s function. We diagnose CHAOS by ultrasound, and care may include an ex utero intrapartum treatment (EXIT) or open fetal procedure at the time of birth.

Cystic hygroma

Cystic hygromas are one or more fetal neck cysts that form and continue to grow over time. They can be caused by malformations in the lymphatic system, and occur at any point in the pregnancy. To diagnose them, our doctors typically perform a prenatal ultrasound.

Fetal goiter

Although uncommon, a fetal goiter is usually associated with fetal hyperthyroidism or hypothyroidism. After birth, we diagnose fetal goiters by ultrasound, which will present as a mass. Once a cause has been determined for the mass, our team will develop a care plan that's unique to you.

Fetal thyroid disorders

Thyroid hormones are essential for brain development. When a fetus is deprived of them, it can have serious effects. Most instances of fetal hypothyroidism are caused when a pregnant mother takes antithyroid drugs. Less commonly, it can also occur when the mother has uncontrolled hyperthyroidism, which is then passed on to the baby. This can then lead to preterm birth and a low birth weight for the baby.

Kidney issues

With experienced nephrologists, we are able to provide exceptional care for a range of kidney issues, such as:

  • Echogenic kidneys
  • Hydronephrosis
  • Mesoblastic nephroma
  • Multicystic dysplastic kidney
  • Polycystic kidney disease
  • Renal agenesis
  • Wilms’ tumor

Musculoskeletal issues

Our orthopedic doctors and surgeons address discomfort and injuries that affect your baby's bones, joints, ligaments, muscles and tendons. The musculoskeletal conditions we treat include:

  • Achondrogenesis
  • Achondroplasia
  • Arthrogryposis
  • Body-stalk anomaly
  • Chondrodysplasia punctata
  • Clinodactyly
  • Clubfoot
  • Diastrophic dysplasia
  • Ectrodactyly
  • Ellis-van Creveld syndrome
  • Hemivertebrae
  • Jarcho-Levin syndrome
  • Osteogenesis imperfecta
  • Polydactyly
  • Radial aplasia
  • Short rib polydactyly syndrome (SRPS)
  • Sirenomelia
  • Syndactyly
  • Thanatophoric dysplasia

Respiratory disorders

Pulmonary-related conditions can prevent your baby from properly breathing on their own. We treat a variety of these conditions, such as:

  • Bronchopulmonary sequestration (BPS)
  • Congenital airway malformations
  • Congenital airway obstructions
  • Congenital diaphragmatic hernia (CDH)
  • Cystic chest lesions
  • Pleural effusion
  • Pulmonary agenesis

BPS care

BPS is an uncommon congenital abnormality of the lower respiratory tract. In an unborn baby, it can lead to an abnormal mass of lung tissue that lacks a connection to the body’s regular airways.

If a mass is found, we will perform an ultrasound and an amniocentesis to test for genetic and chromosomal abnormalities. In certain situations, the mass may may not cause any problems, and can be removed after birth. The mass may even shrink on its own. Alternatively, however, it can cause extra fluid to build up inside the chest and abdomen. Under these serious circumstances, treatment before birth is necessary to promote sufficient lung growth.

CDH care

CDH occurs when the diaphragm fails to close during fetal development, sending contents from the abdominal organs into the chest through the opening. This can result in underdeveloped lungs, high blood pressure, asthma, feeding disorders and developmental delays.

If your baby is diagnosed with CDH, we may recommend fetoscopic endoluminal tracheal occlusion (FETO) surgery before birth. This procedure provides an artificial way to block the trachea and promote development of your baby’s lungs. After delivery, treatment may include extracorporeal membrane oxygenation (ECMO), which oxygenates the blood and enables the lungs to properly rest and grow. In the most severe situations, your baby may need an EXIT-to-ECMO procedure before advanced therapies can be applied.

CPAM

CPAM, a cystic mass of noncancerous lung tissue, typically appears in only one lung. If your baby has CPAM at birth, and isn't able to breathe on their own, we will place a tube into their airway. If the mass is large, we will perform surgery in their first week of life.

If your baby can breathe without assistance, they will go home with you from the newborn nursery to give them time to grow. Surgery will then need to be performed when they're between two and six months of age. The main type of treatment for CPAM is a lobectomy, which enables our surgeons to completely remove the lobe in the lung that may contain any cysts.

Pleural effusion

Pleural effusion, also known as hydrothorax, occurs when an abnormal amount of fluid accumulates between the lungs and underneath the chest wall. This development can be a sign of heart failure, an infection or a tumor. Pleural effusion can be detected using diagnostic imaging, and treatment may include thoracentesis, which is used to remove extra fluid around the lungs.

Sacrococcygeal teratoma

A sacrococcygeal teratoma is a tumor that develops before birth and grows at the base of a baby's tailbone. In most situations, they are small, noncancerous masses that don't cause complications during pregnancy. However, they can grow significantly and make the fetal heart work harder than it should. This can then lead to heart failure.

For the mother, there is risk for maternal mirror syndrome, a condition that causes similar symptoms to what the baby is experiencing. We can detect problems for the mother through a routine blood test or ultrasound prior to the baby's birth. If the tumor becomes sizeable, or if your unborn baby shows signs of heart failure, fetal surgery or a cesarean-section (C-section) delivery may be necessary. Additionally, surgery to remove the tumor can usually happen after your baby is born.