In the Department of Obstetrics and Gynecology at the Brigham and Women’s Hospital a top priority is the development of new medical procedures that will advance the practice of medicine and improve the health of our community. Many members of the Department are constantly developing new medical procedures that will transform the practice of both obstetrics and
gynecology. Innovative
ob/gyn procedures that were in active development during the past year include the intrauterine treatment of congenital anomalies and the use of high intensity focused ultrasound to treat uterine fibroids.
In a stellar inter-disciplinary team effort, specialists from both the Brigham and Women’s Hospital and Boston’s Children’s Hospital performed the world’s first successful in utero repair of a congenital heart valve disorder on "Baby Jack." At 20 weeks gestation, ultrasound testing revealed that Baby Jack had a severely narrowed aortic valve and that his left ventricle was not working. These signs indicated that Baby Jack would have hypoplastic left heart syndrome at birth and would die soon thereafter. Baby Jack’s parents consulted the Brigham and Women’s Hospital Fetal Therapy Program and Children’s Hospital Advanced Fetal Care Center. The two collaborating teams developed a plan to repair the heart valve defect while Baby Jack was still in his mother’s womb. Louise Wilkins-Haug, MD, PhD, the Director of the Division of Reproductive Genetics at the Brigham and Women’s Hospital, inserted a needle through the mother’s abdominal wall and uterus and into the baby’s heart under ultrasound guidance provided by Dr. Carol Benson. Children’s Hospital physicians then threaded a wire through the needle and used a small balloon to unblock the aortic valve. Six months after birth, Baby Jack is doing well and has not needed any additional surgery. After the birth of Baby Jack, his mother noted "We were handed a miracle". Great medicine in the making is about dedicated teams of physicians, nurses and staff working together to develop the innovative treatments that will save lives.
Uterine fibroids are the most common tumor of women. Approximately 30% of women will develop uterine fibroids. Uterine fibroids are usually treated surgically, either with a hysterectomy or myomectomy procedure. Recent discoveries make it likely that other treatment modalities will one day replace the surgical approach to the treatment of uterine fibroids. Dr Cynthia Morton, the William Lambert Richardson Professor of Obstetrics and Gynecology at the Brigham and Women’s Hospital, discovered a gene that causes uterine fibroids. Hopefully, the discovery that fibroids are caused by a genetic abnormality will allow the development of medicines to prevent fibroids by targeting the abnormal gene. Medicines to correct the genetic disorder that causes fibroids is probably a decade away, but available right now is an exceptionally novel, non-invasive approach to destroying uterine fibroids. Elizabeth A. Stewart, MD, and collaborators in the Department of Radiology, led by Ferenc Jolesz, MD, have developed a non-invasive technique for treatment of fibroids that involves destruction of the tumor using high intensity focused ultrasound treatment. In this novel procedure, the fibroid is localized by magnetic resonance imaging, and then the tumor is destroyed by ultrasound energy directed to the center of the tumor. Magnetic resonance imaging is utilized to ensure that adjacent organs are not damaged by the treatment. Early testing in women indicates that this treatment is both successful and associated with minimal side effects. If additional testing confirms these initial results it is likely that millions of women who would once have had a hysterectomy will now be treated by this non-invasive approach. This will dramatically improve the quality of life of women affected by fibroids and save billions in health care costs.
Advances such as the in utero treatment of fetal heart disease and the non-invasive treatment of uterine fibroids can only be made at institutions dedicated to both the highest quality health care and to the expansion of the boundaries of medicine through research and teaching. The Brigham and Women’s Hospital and its member physicians, nurses and staff are dedicated to working every day to advance the practice of medicine by discovering and deploying innovative treatments. Innovation is at the core of great medicine and the clinicians and scientists who lead this innovation are our greatest
Robert L. Barbieri, Chairman
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