Volumes and Outcomes: Fetal Anomalies

  • Experience Matters: Fetal Diagnosis Volumes and Outcomes

    By the Numbers More than 17,790patients referred to the Center for Fetal Diagnosis and Treatment More than 11,200patients evaluated at the Center 1,293fetal surgeries performed at the Center (before birth) 2,341deliveries in the Garbose Family Special Delivery Unit since opening in June 2008. All numbers except deliveries reflect data from 1995-June 2015 at The Children's Hospital of Philadelphia. Since opening in 1995, the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia has cared for more than 17,790 expectant parents from all 50 states and more than 50 countries.

    Our multidisciplinary team has the world's greatest collective experience treating fetuses and infants with congenital anomalies.

    Many of the fetal anomalies we treat at The Center for Fetal Diagnosis and Treatment are quite rare; a physician may encounter only one or two cases in an entire career, while our team sees and treats these complex anomalies every day. This experience helps us to provide the best possible care for your baby.

    Conditions treated

    As part of one of the top-ranked and largest children’s hospitals in the U.S., we have a high volume of patients and treat the full range of fetal anomalies

    Our large patient volume and the diversity of cases we see every day give us a depth and breadth of experience that helps us provide the best care possible.

    Conditions We Treat at the Center for Fetal Diagnosis and Treatment

    Total cases: 17,790

     
    Complicated Multiples: 2,750
     
    Neurologic Abnormality: 2,213
     
    Miscellaneous: 2,223
     
    Lung Lesion: 1,850
     
    Myelomeningocele (Spina Bifida):
    1,877
     
    Genitourinary Defects: 1,789
     
    Congenital Heart Disease: 1,797
     
    Gastrointestinal Anomalies: 1,382
     
    Congenital Diaphragmatic Hernia:
    1,220
     
    Neck Mass: 343
     
    Sacrococcygeal Teratoma: 291
     
    Hematologic/Immune: 55

     

     

    Types of birth defects, by percentage and number, referred to the Center for Fetal Diagnosis and Treatment (CFDT) at CHOP (1995-June 2015). Congenital heart disease is evaluated by the Fetal Heart Program, in collaboration with the CFDT.

     

  • Fetal surgery procedures

    Our team has performed more than 1,293 fetal surgeries, more than any other hospital in the world.

    The following chart breaks down our team's fetal surgery experience performing many highly complex surgical interventions.

    Fetal Surgeries for Congenital Anomalies

    This chart showcases the number and types of fetal surgery procedures performed at The Children's Hospital of Philadelphia's Center for Fetal Diagnosis and Treatment between 1995 and June 2015.

    Total cases: 1,293

     
    Fetoscopic procedures involving
    multiples: 687
     
    Open procedures for MMC,
    SCT, CCAM: 287
     
    Shunts - TA/VA/cystoscopy: 187
     
    EXIT procedures: 89
     
    Other: 22
     
    EXIT procedures following open
    fetal surgery: 13
     
    Fetal cardiac procedures: 8

     

     

    Prenatal surgery is not indicated in all cases. Many other patients with fetal anomalies are treated surgically after birth by CHOP's multidisciplinary team of experts.

     

  • Fetal myelomeningocele repair outcomes

    The Children's Hospital of Philadelphia was one of three clinical centers to participate in the seven-year Management of Myelomeningocele Study (MOMS). This information compares our experience with fetal myelomeningocele (MMC) repair since the MOMS results were announced in December 2010.

    See CHOP's fetal MMC repair outcomes »

  • Complicated monochorionic twin pregnancies

    Our team at the Center for Fetal Diagnosis and Treatment cares for a high volume of monochorionic twin pregnancies each year. Since 1995, more than 2,690 complicated multiple gestation pregnancies have been referred to the Center for Fetal Diagnosis and Treatment. This experience helps to continuously expand our understanding of these complex pregnancies and our ability to differentiate between conditions such as twin-twin transfusion syndrome (TTTS), selective intrauterine growth restriction (sIUGR), and twin reversed arterial perfusion (TRAP) sequence.

    A quick look at our patient volumes and outcomes prove the Center is a nationally recognized resource for evaluation and treatment of complicated twin pregnancies — specifically those affected by twin-twin transfusion syndrome.

    Complicated Twin Pregnancies: Referrals

    Total Referrals: 2,750

     
    TTTS (1,852 cases)
     
    Other (643 cases)
     
    TRAP (168 cases)
     
    Conjoined (87 cases)

     

     

    Based on data from the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia - 1995 through June 2015.

     

    Complicated Twin Pregnancies: Interventions

    Total Interventions: 686

     
    Selective Laser Photocoagulation (404 cases)
     
    Radiofrequency Ablation (173 cases)
     
    Bipolar Cord Coagulation (104 cases)
     
    Other (5 cases)

     

     

    Based on data from the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia - 1995 through June 2015.

     

    Twin-twin Transfusion Syndrome (TTTS) Experience

    Since 1995, the Center for Fetal Diagnosis and Treatment has treated 464 pregnancies complicated by twin-twin transfusion syndrome (TTTS) with the procedures shown here:

     
    Selective Laser Photocoagulation (SLPC): 398
     
    Radiofrequency Ablation (RFA): 34
     
    Bipolar Cord Coagulation (BCC): 32

    Average gestational age for delivery, regardless of type of procedure, is 32 3/7 weeks.

     

    Based on data from the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia, 1995 through June 2015.

     

    Selective Laser Photocoagulation for TTTS - Outcomes

    This graph highlights outcomes of 201 twins/triplets, Stage 2 or greater, <26 weeks, treated at CHOP with selective laser photocoagulation (SLPC). Based on unpublished data from January 2010-February 2015. ©CHOP

     

     
    Survival Rate

    Selective Intrauterine Growth Restriction (sIUGR) Experience

    This chart shows the procedures used in the treatment of pregnancies complicated by selective intrauterine growth restriction (sIUGR) from 1995 through June 2015 at the Center for Fetal Diagnosis and Treatment at The Children’s Hospital of Philadelphia.

     
    Radiofrequency Ablation (RFA): 82
     
    Bipolar Cord Coagulation (BCC): 10

    Average gestational age for delivery, regardless of type of procedure, is 34 6/7 weeks.

     
     

     

    Twin Reversed Arterial Perfusion (TRAP) Sequence Experience

    Since 1995, 168 pregnancies have been referred to the Center for Fetal Diagnosis and Treatment with suspected twin reversed arterial perfusion (TRAP) sequence. 75 pregnancies were treated for TRAP sequence using the procedures shown here:

     
    Radiofrequency Ablation (RFA): 38
     
    Bipolar Cord Coagulation (BCC): 37

    Average gestation age for delivery, regardless of type of procedure, is 35 weeks.

     

    Based on data from the Center for Fetal Diagnosis and Treatment at The Children's Hospital of Philadelphia, 1995 through June 2015.