Pregnancies with congenital defects cause a grief reaction in future parents, that in many cases can get complicated and to progress to pathological emotional conditions. Due to this grief process psychological evaluation and intervention is important during prenatal diagnose, pregnancy course, and pregnancy end. This article reviews emotional manifestations in couples who undergo a pregnancy diagnosed with congenital malformation, and shows that perinatal and neonatal losses produces an emotional response with all characteristics and symptoms of grief. However, personal factors (both internal and external) can facilitate or complicate it, and evolve to a pathological grief. This pathological grief requires a psychotherapeutic process to avoid clinically meaningful psychological health impacts. The proposal to parents' cope with grief consists in psychological work since prenatal diagnosis until pregnancy end.