The progression of certain pregnancy complications can be altered through minimally invasive fetal interventions. The Fetal Therapy Program at the Center for Fetal Medicine and Prenatal Genetics provides seamless coordination and treatment that can aid a fetus before birth.
The Program, featuring availability for consultation within 24 hours, includes specialty services and therapies for a growing number of conditions, including congenital cardiac disease such as hypoplastic (underdeveloped) left heart syndrome, twin-twin transfusion syndrome (intrauterine blood transfusion from one twin to the other), complications of identical twins, fetal airway obstruction, fetal masses and birth defects such as congenital diaphragmatic hernia (hole in the diaphragm) and neural tube defects (also known as spina bifida). Continuity care for pregnancies in which an infant with a congenital complication or genetic disease is coordinated with the BWH MFM (high risk pregnancy) physicians and pediatric subspecialists.
The Fetal Cardiac Intervention Program is the cornerstone of our Fetal Therapy Program. In collaboration with Boston Children's Hospital, this nationally recognized program is a leader in the development of minimally invasive approaches to the fetus with a cardiac condition diagnosed prenatally. The Program specializes in evaluating and providing in utero treatment to alter the progression of hypoplastic left heart disease, a condition that leads to the underdevelopment of the left side of the heart.
If this developmental defect in the heart is identified before it reaches its end stage, our specialists can treat the condition by opening up the aortic valve. This dilation allows the left side of the heart to continue to grow. Learn more about fetal cardiac surgery to treat hypoplastic left heart disease, including one family’s story.
Our Fetal Therapy Program also specializes in treating complications occurring in twins, especially those with cases of monochorionic twins. Twin pregnancies may be complicated by a congenital or genetic disease in only one of the twins. Concerns for monochorionic twins (twins that share the same placenta) range from growth disparities to twin-twin transfusion syndrome and twin reversed arterial perfusion sequence.
Coordinated care between the Fetal Therapy Program and ongoing obstetric care in the Maternal Fetal Medicine practice helps optimize the outcomes for these high risk twins.
For other conditions, our specialists use a combination of surgical and medical management to obtain the best outcomes for mother and child. Other in utero treatments such as for pregnancies complicated by fetal anemia caused by viral infection, and red blood cell abnormalities such as Rh disease are also available. For all of our fetal treatment interventions, our goal is the mother's safety and improved newborn outcomes.
Planning for a safe delivery for the infant with an anticipated complication is an important aspect of fetal care. The fetal therapy high risk physicians, in conjunction with MFM physicians, neonatologists, pediatric subspecialists, geneticists, and nursing can coordinate the ongoing pregnancy care, fetal surveillance, delivery planning and postpartum support essential for the best outcome for the neonate, mother and family. Families often relocate to Boston from across the nation for care through the fetal therapy program and we are committed to ensuring a smooth and supportive transition for these high risk pregnancies.