Early Identification Can Shape Outcomes for Complex Pregnancies
For fetuses with known medical or surgical conditions, delivery planning is a critical component of care. Prenatal findings that suggest a need for immediate airway management, cardiopulmonary support, surgical evaluation or multidisciplinary assessment at birth require coordination long before labor begins.
Early identification of these patients allows healthcare providers to align delivery location, subspecialty involvement, postnatal pathways and family counseling before birth. When specialized teams are prepared and present at delivery, evaluation and intervention can begin immediately, avoiding delays that can happen with postnatal transfer and fragmented care.
A Fetal-to-Neonatal Care Pathway Designed for High-Acuity Newborns
The Cincinnati Children's Fetal Care Center Special Delivery Unit (SDU) was developed to support healthy mothers carrying fetuses expected to need specialized neonatal care immediately after delivery. Located within a pediatric hospital, the SDU serves as a bridge between prenatal diagnosis and advanced neonatal management.
The model brings together maternal-fetal medicine specialists, neonatologists, pediatric surgeons, cardiologists, anesthesiologists and other subspecialists before delivery to develop coordinated care plans for complex pregnancies.
Importantly, delivery within the SDU creates a seamless transition to Level IV NICU and CICU services when advanced neonatal, surgical or cardiac care is required. This integrated fetal-to-neonatal pathway supports continuity across the full care continuum.
Expanded SDU Capacity Supports Complex Delivery Planning
A recent expansion of the SDU has increased capacity and strengthened coordination among the different specialty teams.
The expanded unit includes two triage rooms for maternal and fetal assessment; nine labor, delivery, recovery and postpartum suites; three operating rooms equipped for high-complexity deliveries and fetal procedures; a dedicated infant resuscitation room next to delivery suites; and a procedure room for advanced prenatal or peripartum interventions.
These resources support conditions in which immediate subspecialty access and coordinated decision-making are essential to neonatal care.
Early Consultation Creates More Options for Patients and Providers
Prenatal consultation should be considered as soon as imaging or diagnostic evaluation suggests a condition that may require immediate neonatal intervention.
Early engagement allows referring providers and Cincinnati Children's specialists to collaborate on delivery planning, determine anticipated postnatal pathways, and provide families with clearer expectations before birth. Consultation can happen at any point following diagnosis and may help guide decisions regarding delivery location, timing, subspecialty involvement and neonatal management.
Conditions that may warrant consideration of the SDU include congenital diaphragmatic hernia, critical congenital heart disease, myelomeningocele, suspected airway obstruction, and abdominal wall defects.
Refer a Patient
Physicians are encouraged to engage the Cincinnati Children's Fetal Care Center when prenatal findings suggest a need for immediate neonatal or surgical involvement at delivery. Early consultation supports improved care coordination and preparation.
(Published August 2026)
