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Procedures Offered
Texas Children’s Fetal Center® is one of only a few worldwide centers to offer the full spectrum of fetal therapies.
We are known for leading the development and implementation of innovative fetal procedures and therapies, bringing families new options and new hope for the treatment of fetal anomalies. When fetal intervention is required, patients can come here with confidence knowing we are accustomed to treating the most complex fetal abnormalities and pregnancies.
Procedures are performed in our state-of-the-art operating facilities at Texas Children’s Pavilion for Women, specially designed and equipped for fetal surgery and other interventions. If needed, your baby will have immediate access to Texas Children’s level IV neonatal intensive care unit (NICU) – the highest level of care available for premature and critically-ill newborns.
Conditions treated include:
Open Fetal Surgery for Sacrococcygeal Teratoma and Vascular Tumors
For fetuses with sacrococcygeal teratoma (SCT) or large vascular tumors, the fetal heart may have to work harder to supply blood to the tumors and the rest of the body. Fetal surgery to remove the tumor(s) may be needed to prevent hydrops, or heart failure in the fetus.
Open Fetal Surgery for Lung Masses/CPAM
While most fetuses with lung masses, known as congenital pulmonary airway malformations (CPAM), do not require treatment before birth, in rare cases, open fetal surgery may be required to remove the mass and prevent life-threatening complications.
Open and In-Utero Repair of Spina Bifida
We perform open fetal surgery and fetoscopic repair for select fetuses with severe spina bifida, for improved outcomes compared to after-birth repair. In 2014, Texas Children’s performed the nation’s first experimental fetoscopic closure of an open neural tube defect (NTD). As of December 2020, our Fetal Center has performed more than 85 successful fetoscopic repairs of NTD.
Fetal Cardiac Intervention
Fetal cardiac surgery is performed to repair a serious congenital heart defect before the baby is born, for improved outcomes at birth. These procedures are a coordinated effort involving a large team of specialists including maternal-fetal medicine experts, fetal cardiologists and congenital heart surgeons, among many others.
- Balloon Atrial Septostomy for Hypoplastic Left Heart Syndrome (HLHS)
- Balloon Dilation of Aortic Valve for HLHS
Ex-Utero Intrapartum Treatment (EXIT)
Ex-utero intrapartum treatment, or the “EXIT procedure,” is performed at the time of delivery via a scheduled C-section. The procedure is used to deliver fetuses with conditions expected to cause severe breathing difficulties at birth, such as large lung masses that affect lung function or giant neck masses that block the fetal airway.
Selective Fetoscopic Laser Photocoagulation (SFLP) for Twin-Twin Transfusion Syndrome
This procedure is used for the treatment of select, severe cases of twin-twin transfusion syndrome (TTTS). A small camera, known as a fetoscope, is used to locate abnormal blood vessel connections in the placenta and seal those connections using laser energy, stopping the transfer of blood between fetuses.
Fetal Endoscopic Tracheal Occlusion (FETO) for Congenital Diaphragmatic Hernia
Texas Children’s is one of the few fetal centers in the nation to offer FETO, an experimental procedure used in severe cases of congenital diaphragmatic hernia (CDH) to improve lung growth before birth. The procedure involves inserting a tiny balloon into the fetal trachea to block the flow of fluid out of the fetal lungs, causing the fluid to accumulate and inflate the underdeveloped lungs.
Amniotic Band Resection
Amniotic band resection is a fetal surgery used to treat severe cases of amniotic band syndrome (ABS), where thin bands of tissue are wrapped around parts of the developing fetus, causing deformities and in some cases life-threatening complications. In this procedure, a laser is used to cut the bands that are endangering the fetus, freeing the constricted body part(s) and preventing further damage.
Fetal Shunt Placement
In this procedure, a hollow tube or “shunt” is inserted through the mother’s abdomen and uterus into the fetus to drain excess fluid from an area of the fetal body. It is most commonly used for fetuses with lower urinary tract obstructions (LUTO), with the shunt placed in the fetal bladder to drain blocked urine out into the amniotic cavity.
Intrauterine Transfusion
In severe cases of fetal anemia (low red blood cell count), this intervention is used to transfuse red blood cells from a donor to the fetus to prevent or treat fetal heart failure (hydrops). Guided by ultrasound, a needle is inserted through the mother’s abdomen and into the umbilical cord or the fetal abdomen where the red blood cells are injected.
Radio Frequency Ablation (RFA) or Umbilical Coagulation for Complicated Monochorionic Pregnancies
This is a rare, highly selective fetal intervention that uses radio frequency waves or bipolar energy to interrupt blood flow to a severely abnormal twin (who has no chance of survival) to save the life of a coexisting normal twin. The procedure may be used, for example, in an extremely rare condition known as TRAP sequence, when the normal twin is in imminent danger.
For more information or to schedule an appointment,
call Texas Children’s Fetal Center at 832-822-2229 or 1-877-FetalRx (338-2579) toll-free.
Our phones are answered 24/7. Immediate appointments are often available.