If you choose fetal surgery at the Center for Fetal Diagnosis and Treatment at CHOP, it's likely you will be a patient in the Garbose Family Special Delivery Unit (SDU) twice — for your fetal surgery and then for delivery of your child.
Fetal surgery is a complex and challenging procedure, requiring the most expert, comprehensive care for both mother and unborn baby. Our Center has been providing that care to patients since 1995.
The opening of the Center's Special Delivery Unit in 2008 completed the circle of care. Today, you and your baby can be treated before, during and after birth in one location by one team of dedicated clinicians. For more information about the history of fetal surgery and what our Center has to offer, see fetal surgery: history of innovation.
This page provides an overview of what you can expect if you choose fetal surgery at our Center. You and your baby will require a high level of care before, during and after birth. Your care team from the Center for Fetal Diagnosis and Treatment, the Special Delivery Unit and the Newborn/Infant Intensive Care Unit will include many different members who are all specially trained to care for you and your baby.
We share an unwavering dedication to the best outcomes for your family and will support you in any way we can. Please share your concerns and ask questions. We want to help you make the best decisions for your unique situation.
Learn more about our Center team and the roles they will play in caring for you and your baby.
You will need to remain close to the Hospital before and after surgery, up to delivery.
It is extremely important to have at least one person stay with you for the entire time you are in the Philadelphia area. After the prenatal surgery, you will be unable to fully care for yourself and will need others to help you. It’s important to establish who your support person is in advance of surgery so you can make the necessary preparations.
Our Center staff is experienced working with families to identify area resources that can help with relocation issues such as housing, financial matters and emotional support. We work with many insurance plans to facilitate care for families who seek our services, and have resources available to assist families with travel-related and other expenses associated with coming to CHOP.
The Center has dedicated social workers who will support your care before fetal surgery, through delivery and your baby’s hospital stay. They will assist you with finding the best housing arrangements for your situation, including local Ronald McDonald Houses and Hosts for Hospitals.
A cornerstone of our care is the thorough counseling families receive before fetal surgery.
Throughout your pregnancy, Center staff will educate you about your baby's condition and treatment options, and review the risks and benefits of fetal surgery for your unique situation. We'll also discuss our clinical research, what we've learned about treating your baby's condition prenatally and what results we've seen at our Hospital.
Once you and your clinical team decide fetal surgery is the right decision for your family, we will schedule your surgery.
The day before fetal surgery at the Center, a perinatal nurse practitioner/certified nurse midwife will again obtain a patient history and perform a physical exam. Tests done on this day include: urinalysis, electrocardiogram (EKG), chest X-ray, vaginal ultrasound and blood test. You’ll also meet with a social worker and anesthesiologist.
At the end of the day, you will meet the entire team who will be taking care of you and your family during and after surgery. This meeting includes team members you met during your evaluation and consultation, as well as others, including operating room nurses, obstetric nurses and anesthesiologists.
Patient and family education is a large part of this meeting. We’ll discuss details of surgery, what to expect during and after the procedure, pregnancy outcomes, C-section delivery, potential effects of the surgery, and more. There will be plenty of time to answer any questions you have.
The morning of fetal surgery, you will arrive at the Special Delivery Unit for admission. An obstetric nurse will greet you, take you to your room and prepare you for the operation. You will be given medication to decrease uterine contractions and reduce acid reflux. You’ll meet operating room nurses who can answer any additional questions you have about the procedure.
The anesthesiologist and the obstetric nurse will go with you to the operating room. During surgery, you and your unborn baby will be continually monitored.
You will remain in the Hospital under intensive monitoring for three to four days, depending on your condition. During this time, the perinatologist will perform daily ultrasounds to monitor your unborn baby’s condition, and the fetal cardiologist will perform echocardiography the first two days following surgery to evaluate cardiac function.
Preterm labor is the most common complication of fetal surgery. While you are in the Hospital, you will be closely monitored for any signs or symptoms of preterm labor.
You will remain on bed rest during your hospital stay, except to use the bathroom and shower. Our staff will monitor you for any signs of infection and other possible complications from fetal surgery.
After you are discharged from the Hospital, the perinatal nurse practitioner/certified nurse midwife will coordinate your ongoing prenatal care.
For the remainder of your pregnancy, follow-up includes:
As your due date nears, you will meet with more members of the Special Delivery Unit team, including a lactation specialist who can help you learn about pumping, providing milk to your child and transitioning to breastfeeding.
If you had open fetal surgery, this pregnancy and all future pregnancies will need to be delivered by planned C-section due to the uterine wound made during prenatal surgery. The C-section prevents wound separation or rupture. If you had a minimally-invasive fetal therapy, you may still be able to deliver vaginally. Your clinical team will discuss with you what is the best delivery option for you and your baby.
Delivery will take place in the Special Delivery Unit, which offers the highest level of immediate care for your newborn, as well as expert obstetric services for you.