Groundbreaking Facility in Maternal-Fetal Medicine Celebrates First 10 Years, First 3,600 Deliveries

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SDU Group Photo Patient families join CHOP leaders and Lynne and Bill Garbose to celebrate 10 years of the Garbose Family Special Delivery Unit As the world’s first comprehensive obstetrical care unit for healthy mothers carrying fetuses with known birth defects, the Garbose Family Special Delivery Unit welcomes babies who either undergo fetal surgery to treat a condition before birth or need specialized care immediately after birth. Children’s Hospital of Philadelphia (CHOP) celebrated a major milestone in the Unit, marking its 10th anniversary with a special ceremony at the Hospital.

Launched in 2008 as the first special delivery unit in a children’s hospital dedicated to high-risk pregnancies, the Garbose Family Special Delivery Unit addresses an important need in maternal-fetal medicine by allowing mother and baby to be simultaneously cared for in one medical center by a highly specialized, multidisciplinary team.

The Unit, which was made possible by a lead philanthropic gift from Lynne and Bill Garbose, introduced a new paradigm for the care of pregnant women whose fetuses are prenatally diagnosed with a birth defect. The Garboses were motivated by their own heart-rending experience three decades ago in losing a newborn child to a fatal heart defect. At the time, mothers faced with a devastating prenatal diagnosis were unable to deliver a critically ill baby in a pediatric hospital — neither in their hometown nor anywhere in the U.S. That situation changed with the advent of the pioneering Unit.

“It takes a special person to work here. It’s not a standard labor and delivery unit, because nearly all of our newborns must go to one of our intensive care units,” said Julie S. Moldenhauer, MD, CHOP Maternal-Fetal Medicine and Reproductive Genetics Specialist and the Medical Director of the Garbose Family Special Delivery Unit. “At a stressful time for families, our staff, especially our stellar SDU nurses, goes above and beyond their duties; added to our technical expertise, this unit reflects the caring, compassionate side of what we do.”

Improving outcomes for mothers and babies

Only four years after its founding, the Garbose Family Special Delivery Unit completed its 1,000th delivery, in April 2012. The Unit has now performed over 3,600 deliveries, averaging 450 to 500 deliveries a year, with patients from all 50 states and dozens of foreign countries. Eight labor and delivery beds in 2008 have expanded to 13 beds today.

The Unit is the delivery arm of CHOP’s internationally recognized Center for Fetal Diagnosis and Treatment (CFDT), established in 1995 as one of the first comprehensive fetal medicine centers in the world, and still the largest such program. “Our goal for the Garbose Family Special Delivery Unit is to improve outcomes for mothers and babies before, during and after birth — and we are continuing to advance those outcomes,” said N. Scott Adzick, MD, CHOP’s Surgeon-in-Chief and the Medical Director of the CFDT.

The next decade of breakthroughs

Now Lynne and Bill have decided to fund a new Garbose Family Endowed Research Fellowship in Pediatric and Fetal Surgery in a specialized laboratory program within the CFDT: the Center for Fetal Research. That Center, led by fetal surgeon Alan W. Flake, MD, most recently attracted worldwide attention for its creation of an artificial womb. This device, a temperature-controlled, fluid-filled environment currently being tested in fetal lambs, is being investigated to dramatically improve outcomes in extremely premature infants, those born at 23 or 24 weeks of gestation. The new extra-uterine clinical device would offer a crucial bridge for fragile infants. During this time, their immature lungs and other organs could develop as they would in their mother’s uterus, until they reach the 28-week threshold, at which time the complications of prematurity become far less severe.

Lynne and Bill Garbose were inspired by Dr. Emily Partridge, a surgeon and research fellow in Dr. Flake’s laboratory, who played a key role in developing the artificial womb. The new Garbose Family Endowed Fellowship will support highly promising new fetal research fellows in generating new breakthroughs, thereby sustaining a pipeline of physician-researchers to lead the next generation of fetal medicine experts.

“The impact of this recent gift from Lynne and Bill Garbose will go far beyond helping patients and families here at CHOP, as it will transform fetal and pediatric medicine by supporting talented, young surgical scientists who will devise the breakthroughs of the future,” said Adzick. “Training the next generation is a core piece of CHOP’s mission and a pillar of our recently launched For Tomorrow’s Breakthrough’s campaign, the most ambitious fundraising effort in our 163-year history. I could not be more grateful to Lynne and Bill for their generosity and partnership.”

“On the occasion of the Special Delivery Unit’s 10th anniversary, we are so proud to be associated with the dedicated, multidisciplinary team of physicians, nurses and other staff who work there,” said Bill Garbose. “We remember vividly the afternoon many years ago when the CHOP team laid out their thoughts and plans for the world’s first Special Delivery Unit. We — and thousands of parents and their children — are so grateful for the team’s vision, dedication and perseverance.”

Coordinated, expert care

The CFDT and the Garbose Family Special Delivery Unit’s multidisciplinary team encompasses experts in maternal-fetal medicine, reproductive genetics, obstetrics, surgery, anesthesiology, neonatology, fetal cardiology, genetic counseling, midwifery, fetal imaging, social work, psychology, psychiatry, child life, palliative care, lactation consulting, respiratory therapy and research. In addition, there are highly experienced advanced practice, obstetric, neonatal and operating room nurses, along with dedicated fetal therapy coordinators who navigate patients through their entire CFDT experience.

“We never forget that we are caring for two patients — a healthy mom and her sick baby, and for both their physical needs and their emotional needs,” said Lori Howell, DNP, MS, RN, Executive Director of the CFDT and, as of July 1, 2018, the inaugural recipient of CHOP’s new Lynne L. Garbose Endowed Chair in Fetal Family Care. “We rely on a deep pool of experts from many disciplines and a wealth of experience. The high volume of patients we see with incredibly complex, rare conditions makes all the difference in providing the very best care.”

The Unit also draws on the sophisticated technological capabilities of both the CFDT and CHOP’s Fetal Heart Program. The Unit houses two operating rooms equipped for cesarean deliveries and fetal surgery, plus a hybrid OR available to both the fetal surgery and cardiothoracic surgery teams. Adjacent outpatient areas for both the CFDT and the Fetal Heart Program offer multiple subspecialty services, including detailed imaging technologies for evaluation and diagnosis and the full spectrum of prenatal care.

Over the past decade, the Unit has expanded its services to include psychologists, psychiatrists, child life specialists and a chaplain. Moldenhauer is particularly excited about newer services, such as Serenity Sessions, in which a psychologist leads mindfulness exercises and pregnancy yoga for expectant mothers. Midwives run another new program, Mama Care, offering group prenatal care sessions for expectant mothers and their support persons.

Over the next 10 years, adds Moldenhauer, as the Unit’s volume and experience continue to expand, she expects the team to evaluate longer-term outcomes of their specific model of maternal-fetal care, as well as develop care guidelines based on their analyses.

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