Pioneers in fetal surgery
Surgeons at CHOP's Center for Fetal Diagnosis and Treatment are pioneers in fetal surgery and have the greatest collective experience in the world. Led by N. Scott Adzick, MD, MMM, the Center team pioneered the fetal repair of myelomeningocele technique, first in animal models and later in selected clinical cases. We performed our first fetal MMC repair in 1998.
Experienced multidisciplinary team
Behind the Scenes: Fetal Surgery at CHOP
The Center's large multidisciplinary team, including fetal surgeons, neurosurgeons, maternal and fetal anesthesiologists, fetal cardiologists, maternal-fetal medicine specialists, neonatologists, and advanced practice operating room, labor and delivery and neonatal surgery nurses has worked together since 1995 — a level of ongoing collaboration that is unmatched.
As of April 2019, our team has performed 349 fetal surgeries for myelomeningocele (MMC). More than 2,481 patients with suspected MMC have been referred to our Center since we opened in 1995.
Adherence to fetal surgery standards and guidelines
Fetal surgery is an extremely delicate, complex procedure. Our Center is committed to maintaining optimal patient safety and following high standards for fetal surgery. We adhere to strict criteria when determining which patients qualify for prenatal repair of MMC, and follow the guidelines for fetal MMC repair laid out by the MMC Maternal-Fetal Management Task Force in February 2014, which a member of our team helped develop.
The increasing patient acceptance of fetal surgery for MMC repair and an increase in centers performing it led to the development of these comprehensive guidelines. The guidelines detail the expertise and services required to be considered an established fetal therapy center, including proper surgical management, long-term care, necessary counseling and requirements for outcomes reporting. In August 2014, CHOP reported on our results from 100 recent cases of fetal surgery for spina bifida.
Learn more about our referral guidelines for fetal repair of MMC at Children's Hospital of Philadelphia.
Advancing spina bifida care through dedicated research
In 2011, experts at Children’s Hospital of Philadelphia co-led the landmark Management of Myelomeningocele Study (MOMS). The controlled, clinical trial showed that fetal surgery for spina bifida can provide improved outcomes for families faced with this devastating condition. The study showed that prenatal repair greatly reduces the need to divert fluid from the brain, improves mobility and improves the chances that a child will be able to walk independently.
Today, that study continues, with important follow-up that will allow clinical teams to compare the lasting outcomes of prenatal repair versus standard postnatal repair. The ongoing participation of patient families and institutions involved in the original trial will provide valuable insight into the long-term effects of the latest treatment options for spina bifida, improving the standard of care for patients today and in the future.
In addition to this landmark trial, our team members have been published in a wide variety of recognized scientific journals — thereby helping to advance the field’s knowledge with our basic and clinical spina bifida research findings.
Coordinated care in one location
All of your care will be provided in one comfortable, family-centered location that was designed to produce optimal outcomes for you and your baby. We will work closely with your physician back home to coordinate your care.
Our facilities, which include a centralized area for prenatal diagnostic imaging and dedicated fetal operating rooms, have been designed specifically for fetal surgery patients and babies with prenatally diagnosed birth defects.
- Our Garbose Family Special Delivery Unit is staffed and fully equipped to manage the delicate delivery required after fetal surgery for spina bifida. Having a dedicated birth unit within a pediatric hospital means expert care for both mother and baby before, during and after birth.
- CHOP’s renowned Newborn/Infant Intensive Care Unit, consistently ranked among the best in the nation for newborn care, is experienced in caring for babies born after fetal surgery for spina bifida.
- Our Spina Bifida Program offers comprehensive long-term follow-up care for spina bifida patients as they grow.
Access to top pediatric specialists
CHOP is consistently ranked among the best in the nation by U.S. News & World Report’s Honor Roll of the nation’s Best Children’s Hospitals. These rankings mean your child will receive some of the best care available in the country at CHOP.
For children with spina bifida, this means direct access to the nation’s best across the variety of pediatric subspecialties that may be involved in their care, including orthopedics, urology, physical therapy, radiology and more.
Support services for your family
From the time of diagnosis through fetal surgery and delivery, you can expect a supportive environment and a commitment to making the experience as easy as possible on your entire family.
We offer a full range of support services and support staff that can help you and your family overcome challenges in receiving care, cope with your baby's diagnosis and treatment, and connect you with additional resources closer to your home.
- Before you make your decision about fetal surgery, we will explain every component of the experience and answer all of your questions during a thorough counseling session.
- Our dedicated psychosocial services team, including a clinical psychologist and social workers, provides emotional support, individualized and couple's counseling, supportive therapy, and social work services.
- Our Center’s team is experienced in working with many insurance plans to facilitate care for families who seek our services. We also have resources available to assist families with travel-related and other expenses associated with coming to Children’s Hospital of Philadelphia. We are happy to discuss your individual situation and needs.