Volumes and Outcomes: Fetal Anomalies

Experience Matters: Fetal Diagnosis Volumes and Outcomes

By the Numbers More than 23,176patients referred to the Center for Fetal Diagnosis and Treatment More than 15,107patients evaluated at the Center 1,716fetal surgeries performed at the Center (before birth) 3,833deliveries in the Garbose Family Special Delivery Unit since opening in June 2008. All numbers except deliveries reflect data from 1995-September 2018 at 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 23,176 expectant parents from all 50 states and more than 70 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: 23,716

 
Complicated Multiples: 3,394
 
Miscellaneous: 3,180
 
Neurologic Abnormality: 2,908
 
Congenital Heart Disease: 2,624
 
Myelomeningocele (Spina Bifida): 2,404
 
Lung Lesion: 2,259
 
Genitourinary Defects: 2,266
 
Gastrointestinal Anomalies: 1,811
 
Congenital Diaphragmatic Hernia:
1,492
 
Neck Mass: 446
 
Sacrococcygeal Teratoma: 336
 
Hematologic/Immune: 56

 

 

Types of birth defects, by percentage and number, referred to the Center for Fetal Diagnosis and Treatment (CFDT) at CHOP (1995 - September 2018). Congenital heart disease is evaluated by the Fetal Heart Program, in collaboration with the CFDT.

 

Fetal surgery procedures

Our team has performed more than 1,716 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 Children's Hospital of Philadelphia's Center for Fetal Diagnosis and Treatment between 1995 and September 2018.

Total cases: 1,716

 
Fetoscopic procedures involving
multiples: 935
 
Open procedures for MMC,
SCT, CCAM: 390
 
Shunts - TA/VA/cystoscopy: 227
 
EXIT procedures: 97
 
Other: 47
 
EXIT procedures following open
fetal surgery: 13
 
Fetal cardiac procedures: 7

 

 

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 3,394 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: 3,394

 
TTTS (2,223 cases)
 
Other (858 cases)
 
TRAP (203 cases)
 
Conjoined (110 cases)

 

 

Based on data from the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia - 1995 through September 2018.

 

Complicated Twin Pregnancies: Interventions

Total Interventions: 935

 
Selective Laser Photocoagulation (545 cases)
 
Radiofrequency Ablation (278 cases)
 
Bipolar Cord Coagulation (107 cases)
 
Other (5 cases)

 

 

Based on data from the Center for Fetal Diagnosis and Treatment at Children's Hospital of Philadelphia - 1995 through September 2018.

 

Twin-twin Transfusion Syndrome (TTTS) Experience

Since 1995, the Center for Fetal Diagnosis and Treatment has treated 518 pregnancies complicated by twin-twin transfusion syndrome (TTTS) with the procedures shown here:

 
Selective Laser Photocoagulation (SLPC): 445
 
Radiofrequency Ablation (RFA): 41
 
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 2016.

 

Selective Laser Photocoagulation for TTTS - Outcomes

This graph highlights outcomes of 240 twins/triplets, Stage 2 or greater, <26 weeks, treated at CHOP with selective laser photocoagulation (SLPC). Based on unpublished data from January 2010-December 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 2016 at the Center for Fetal Diagnosis and Treatment at The Children’s Hospital of Philadelphia.

 
Radiofrequency Ablation (RFA): 102
 
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, 182 pregnancies have been referred to the Center for Fetal Diagnosis and Treatment with suspected twin reversed arterial perfusion (TRAP) sequence. 80 pregnancies were treated for TRAP sequence using the procedures shown here:

 
Radiofrequency Ablation (RFA): 43
 
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 2016.

 


Next Steps
Pregnant Mom and Child

Choosing a Fetal Treatment Center

Know what questions to ask when considering fetal surgery so you can make an informed decision that is right for you and your baby.

Pregnant Mom and Child

What to Expect

From the moment of referral through delivery and postnatal care, your family can expect a supportive experience when you come to us with a diagnosis of a birth defect.