Fetal therapies

Texas Children’s Fetal Center is one of only a few worldwide to offer the full spectrum of fetal therapies

Experts at the Fetal Center are internationally recognized leaders in fetal medicine and fetal and neonatal surgery. Patients from around the world visit the Fetal Center to receive the most advanced care for their unborn child.

We offer comprehensive fetal care in one centralized location

Open fetal surgery for SCT and vascular tumors

Fetuses with SCT or large vascular tumors may have their hearts working very hard to supply the increased blood flow to the tumors. This may result in heart failure (hydrops) in the fetus. To avert hydrops, the fetuses can undergo removal of the tumors during the pregnancy. The mother’s abdomen and uterus are opened, and the tumor is removed from the fetus while still in the womb. The uterus is then closed, and the pregnancy is allowed to continue.

Open fetal surgery for lung masses/CCAM

In rare instances, open fetal surgery may be required to save the life of a fetus with a very large lung mass. Whereas most fetuses with lung masses do not require treatment, in rare cases fetal treatment may be required. Read more

Open fetal surgery for spina bifida

We perform open fetal surgery repair for some fetuses with spina bifida. In this operation, the mother’s abdomen and uterus are opened. The defect in the spine is exposed and pediatric neurosurgeons repair the defect, similar to that which might be performed after birth. Read more

Open fetal cardiac intervention

These are procedures on the fetal heart while still inside the uterus involving a multidisciplinary team of maternal fetal medicine specialists, fetal cardiologists, and interventional pediatric cardiologists.

Balloon Atrial Septostomy for HLHS

Balloon Dilation of Aortic Valve for HLHS

Ex-utero intrapartum treatment (EXIT)

Ex-utero intrapartum treatment, or the “EXIT Procedure,” is a specialized fetal surgery operation that occurs at the time of birth for certain fetuses with rare conditions that may be predicted to have problems immediately after birth. This procedure is performed similar to other fetal surgery operations in that the mother is under general anesthesia. Read more

Fetoscopic laser photocoagulation for TTTS

A surgical procedure using a small camera (fetoscope) to locate the abnormal blood vessel connections and treat the problem by sealing the abnormal connections using laser energy.

Experimental fetal tracheal occlusion for congenital diaphragmatic hernia

In some very severe cases of congenital diaphragmatic hernia, the lungs are very small and in spite of the best management, these neonates do not survive after birth. Some fetuses, when diagnosed early enough, may be eligible for an experimental procedure to occlude the trachea of the fetus with a balloon. The balloon is placed through a small straw sized tube (trocar) and through the mother’s abdomen into the uterus with ultrasound guidance. Through the trocar, a tiny endoscope (tube with a camera at the tip) is placed into the fetus’ mouth and guided into the trachea where the balloon is inflated and deployed. The accumulation of fluid and pressure in the lungs then causes the lungs to grow. After several weeks, the balloon is removed in a similar fashion, and the pregnancy is allowed to progress towards term. The expectation is that these neonates, when born, would now have sufficient lungs to permit survival and better outcomes.

Amniotic band resection

Amniotic bands that are constricting the umbilical cord or the extremities and threaten amputation may be divided. With a combination of ultrasound guidance and fetoscopy (a tube with a camera at the tip inserted into the uterus), the bands can be identified and divided with surgical instruments or laser. The bands are divided to liberate the affected fetal parts from their constrictive effects.

Fetal shunt placement

An ultrasound-guided fetal intervention where a tube (shunt) is placed in the abdomen of the fetus to connect the bladder to the amniotic cavity, leading to drainage of the blocked urine.

Intrauterine transfusion

An ultrasound-guided fetal intervention where a needle is inserted into the umbilical cord or the fetal abdomen and blood is transfused to the baby for treatment of severe anemia.

Radio frequency ablation or umbilical coagulation for complicated monochorionic pregnancies

A rare and highly selective fetal intervention where out of concern for the coexisting twin's health or life, blood flow to the affected twin is interrupted using radiofrequency waves or bipolar energy. A clinical example of this procedure being used is a TRAP sequence, where the life of the pump twin is in imminent danger.