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Fetal surgery continues to advance

Repairing birth defects in the womb. Inserting a tiny laser into the mother's uterus to seal off an abnormal blood flow and save fetal twins. Advancing the science that may allow doctors to deliver cells or DNA to treat sickle cell anemia and other genetic diseases before birth.

These are examples of the still-emerging field of fetal surgery. "Fetal surgery is a unique field in maternal-fetal medicine," said pediatric surgeon N. Scott Adzick, M.D., medical director of the Center for Fetal Diagnosis and Treatment (CFDT) at The Children's Hospital of Philadelphia. "Detecting birth defects prenatally has allowed physicians to provide better perinatal care," said Adzick, "but many of these babies were already too sick for us to treat them successfully after they were born. This dilemma led to the development of fetal surgery."

"Some of the fetal anomalies we treat are so rare that a physician may encounter them only once or twice in a career," continued Adzick, who is surgeon-in-chief at Children's Hospital. "However, as prenatal diagnosis continues to improve, along with surgical techniques and tools of molecular biology, we have an expanded range of conditions for which we may devise ways to intervene before birth with clear benefits."

Internationally prominent as a pioneer in fetal surgery, Adzick edited the February 2010 issue of the journal Seminars in Fetal & Neonatal Medicine. That issue is entirely devoted to advances in fetal surgery. Adzick and other practitioners at The Children's Hospital of Philadelphia describe innovative surgeries, high-tech procedures, and the prospect of prenatal gene therapy and stem cell treatments in a collection of articles reviewing the current state of the science in fetal therapy.

The CFDT, which marks its 15th anniversary this year, is a premier program, one of a handful worldwide to offer a full range of fetal procedures. Since the center opened in 1995, more than 10,000 parents

Contact: Joey McCool Ryan
Children's Hospital of Philadelphia

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