Lifespan, Women
& Infants Collaborate to Expand Fetal Treatment Program
(April 20, 1999)
First-of-its-Kind,
Multidisciplinary Program Advances Care of Women with High-Risk
Pregnancies
Rhode Island Hospitals pediatric
division, Hasbro Childrens Hospital, New England Medical
Center and its Floating Hospital for Children have joined forces
with Women & Infants Hospital to provide revolutionary fetal
treatment options. Lifespan and Women
& Infants Fetal Treatment Program will build on their
firmly established, comprehensive perinatal services to provide
medical treatment of the fetus in utero as well as innovative
laser treatments and fetal endoscopic operations. The program
will be directed by Floating Hospitals Chief of Genetics,
Diana Bianchi, MD, and Sabrina Craigo, MD, a Maternal/Fetal Medicine
specialist at NEMC; Hasbro Childrens Hospital pediatric
surgeon Francois I. Luks, MD, PhD; and Women & Infants Hospital
maternal/fetal medicine specialist Stephen R. Carr, MD.
Treatment options range from medically managing the fetus via
the mother, to procedures that involve surgically entering the
uterus endoscopically. For example, doctors can treat a babys
cardiac arrhythmia in utero by administering medication to the
mother that crosses the placenta to reach the fetus, or control
fetal anemia by injecting blood products directly into the umbilical
cord through a needle in the mothers abdomen. Using ultrasound
guidance, plastic shunts can be placed to treat a congenital
anomaly known as bladder outlet obstruction. This blockage of
the fetal urethra disrupts kidney and lung development and the
shunt works to improve their
function. In more extreme cases, surgical intervention is necessary.
For example, it is now possible to temporarily occlude the fetal
trachea endoscopically to help lungs grow and overcome the complications
associated with severe forms of diaphragmatic
hernia. "The program will take the recognized strengths
of each of the partners and pool them into a truly coordinated
effort," said Carr of Women & Infants. "The Fetal
Treatment Program will offer new capabilities and technologies
to women of New England carrying anomalous fetuses."
"Using endoscopic or minimally
invasive techniques, we can now surgically treat certain fetal
anomalies with less risk," said pediatric surgeon Luks.
"Additionally, there are innovative ways to treat specific
complications of twin pregnancies never before
available."
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