4 WEEKLYPRESS.COM • UCREVIEW.COM • JUNE 12, 2013 Fetal diagnosis and therapy team hits milestone continued from page 1


team has treated large numbers of patients with a given diagnosis, whereas many medical profession- als will only see one or two such patients in their entire career.”


The 1,000th Fetal Surgery Like nearly 20 percent of the fetal surgeries at CHOP, the 1,000th case was a complex open surgery on a mother whose fetus was prenatally diagnosed with spina bi- fida.


Jackie Oberio, who lives in the Baltimore area, was 19 weeks pregnant when she and her husband Gideon found out that their unborn daughter had my- elomeningocele, the most severe form of spina bifida, a condition in which part of the developing spine fails to close properly.


After speaking with sev- eral local specialists and conducting lots of online research, the Oberios dis- covered the Center for Fetal Diagnosis and Treatment at CHOP. Led by Dr. Adzick, Center team members had


pioneered a surgical proce- dure to repair spina bifida before birth and had been performing it at CHOP since 1998. The CHOP team had found that addressing spina bifida by operating on the baby in the womb, months before birth, could reduce the need to divert fluid from the brain, im- prove neurologic function and increase the likelihood that a child would be able to walk independently. Those same results were later confirmed in 2011 when the results of a land- mark nationwide clinical trial, co-led by CHOP, were published in the New Eng- land Journal of Medicine and conclusively established the effectiveness of fetal surgery for spina bifida. On February 28th, the Oberios traveled from their home in Maryland to Philadelphia for a compre- hensive two-day evaluation to determine if they were indeed candidates for fetal surgery. During their evalu- ation they met with a mul- tidisciplinary team that in- cluded some of the world’s


most experienced experts in fetal surgery and therapy, including maternal-fetal medicine specialists, re- productive geneticists, surgeons, anesthesiologists, neonatologists, fetal cardi- ologists, genetic counselors, fetal imaging experts, psy- chologists, social workers, and child life specialists, as well as advanced practice, obstetric, neonatal and op- erating room nurses. All are specifically trained to care for mother and infant pairs in which the baby is prena- tally diagnosed with birth defects.


“The doctors at CHOP


went over what would hap- pen if we had the surgery, what would happen if we didn’t do the surgery, what happens if the baby is born preterm, what happens if the baby needs a shunt, what was going to happen to me,” Jackie said. “Every little thing that could hap- pen they went through in detail five times, helped with questions and emo- tionally supported us.” Jackie qualified for the


surgery and returned home


to gather belongings for her temporary relocation to Philadelphia. Only a week after her initial evaluation, CHOP surgeons success- fully closed the opening in her unborn baby’s spine. For the next two and a half months, Jackie’s home was in Philadelphia where she was restricted to modified bed rest, while Gideon traveled back and forth to Baltimore for work. “Leaving Jackie every four days was one of the hard- est things I’ve ever had to do” said Gideon, a cardiac nurse in Baltimore. On May 28th, maternal fetal medicine specialist Nahla Khalek, M.D., and obstetrician May-Ange Ntoso, M.D., and their team performed a cesar- ean delivery in CHOP’s Garbose Family Special Delivery Unit (SDU), the world’s first birth facility designed exclusively for pregnancies complicated by birth defects. Audrey Rose weighed a healthy 5 pounds, 8 ounces and had nothing more than a scar where her myelomeningo-


cele had been. After deliv- ery, she was immediately cared for in the Harriet and Ronald Lassin Newborn/ Infant Intensive Care Unit and is expected to return home in several days. The Center for Fetal Di- agnosis and Treatment at The Children’s Hospital of Philadelphia is an interna- tionally recognized leader in fetal surgery and fetal care. One of the only programs of its kind in the world, it offers a comprehensive breadth of services, including fetal ther- apy, to support patients from prenatal evaluation through delivery, postnatal care, and long-term follow-up. Estab- lished in 1995, the Center has welcomed nearly 15,000 ex- pectant parents and received referrals from all 50 states and more than 50 countries. Its multidisciplinary team brings decades of experience to the care and treatment of the fetus and the expectant mother. The Center has performed over 1,000 fetal surgeries, includ- ing complex open procedures for birth defects such as spina bifida; less invasive fetoscopic or ultrasound-guided surger-


ies for conditions such as twin-twin transfusion syn- drome; and specialized coor- dinated delivery approaches for babies that require surgical intervention while still on maternal-placental life sup- port (EXIT delivery). For more information visit http:// fetalsurgery.chop.edu. The Fetal Heart Program at The Children’s Hospital of Philadelphia specializes in the detection, evaluation and management of fetal heart defects prior to a baby’s birth. The team performs more than 3,300 fetal echocardiography studies annually, making it one of the largest fetal heart programs in the US. The program’s offerings include: state-of-the-art technology, planning for labor and deliv- ery and complete care for the newborn after birth, access to the full Cardiac Center team and the most advanced fetal heart defect treatments avail- able, including fetal heart interventions if necessary. The Cardiac Center performs more than 850 cardiothoracic surgeries per year and the Center’s outcomes are among the best in the world.


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