Stanford Medicine Newsletter Updates For the Local Community

 

Fetal center helps parents prepare for complications

   

Complex fetal diagnoses bring extraordinary strain to pregnant women and their families. Learning that an eagerly awaited child will be born with a medical problem is often the worst crisis that expectant parents have faced.

To support families through complicated fetal diagnoses, Lucile Packard Children’s Hospital recently opened the Center for Comprehensive Fetal Health & Maternal and Family Care. Its goal is to provide comprehensive, coordinated, family-centered care for mothers and infants with difficult diagnoses, before and after birth.

“The new center is a unique collaborative effort among many disciplines at Packard Children’s and Stanford Hospital & Clinics,” said Susan Hintz, MD, the center’s medical director and an associate professor in neonatal and developmental medicine at Packard Children’s. “Our aim is to provide outstanding care to women carrying fetuses with complex anomalies starting before their infants are born.”

The center works to ensure that each patient receives excellent, cohesive care from all sub-specialties appropriate to her case.

“This new center brings together all of Packard’s very sophisticated medicine, counseling and social care with clear leadership and a streamlined approach to getting a patient through a complex system,” said Yasser El-Sayed, MD, associate chief of maternal-fetal medicine at Packard Children’s. With better prenatal imaging and maternal-fetal medicine dramatically improving survival for high-risk neonates, the demand for advanced fetal care is greater than ever.

Subspecialty collaborations

All families referred to the Center for Fetal Health will receive care from services such as maternal-fetal medicine, perinatal radiology, neonatology, genetic counseling and social work. In addi-tion, patients will be referred to appropriate specialists from such fields as cardiovascular surgery, cardiology, general surgery, neurosurgery, urology and nephrology.

“We can handle a broad range of cases, from early delivery for a fetal emergency to referring a patient back to her community for delivery closer to home,” Hintz said. The entire multidisciplinary team meets twice each month to review active cases, and subspecialists communicate frequently outside of these meetings to facilitate coordinated care plans.

For life-threatening diagnoses such as severe cardiac defects, the Packard Children’s team can provide surgical or other interventional care from the moment of birth. “Some infants go directly from our delivery room to the operating room or to the interventional catheterization lab,” Hintz said.

At the other end of the spectrum, the team will work with families expecting babies with mild to moderate problems to decide where to deliver the infant. In some cases, Hintz said, it is perfectly safe and less stressful for the family to deliver at its home hospital and then receive follow-up care as a Packard Children’s outpatient with appropriate subspecialists.

Enabling research

Enhanced interdisciplinary collaboration at the center will benefit both current patients and physician-scientists studying fetal, neonatal and pediatric medicine and surgery. As infants survive increasingly complex fetal anomalies, physicians need more information about the natural history of congenital defects.

Pediatric surgeon Karl Sylvester, MD, anticipates that the new center will enable Packard Children’s to contribute to research in brain abnormalities, cardiac malformations and clinical genetics. “In the past, our tools have limited us to identifying structural abnormalities via ultra-sound and MRI,” Sylvester said. “But the tools of molecular medicine are quickly becoming applicable to pre- and postnatal care.” These new tools will help the center’s team to counsel families and obtain data to share with the broader medical community, he added.

“Packard Children’s has fantastic resources for families facing complex fetal diagnoses,” Hintz said. “The new center’s coordinated efforts will help families prepare for challenges they’ll face during pregnancy, after delivery and, in some cases, for years to come.”

For information about the Center for Comprehensive Fetal Health & Maternal and Family Care, contact 650-724-2221.

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