image: Drs. Katharine Wenstrom and Stephen Carr have published a Clinical Expert Series on fetal surgery in Obstetrics & Gynecology. view more
Credit: Al Weems
Since the first human fetal surgery was reported in 1965, several different fetal surgical procedures have been developed and perfected, resulting in significantly improved outcomes for many fetuses. However, the significant investments associated with this highly specialized service and quality metrics must be considered as more fetal treatment programs are developed.
Katharine D. Wenstrom, MD, director of the Division of Maternal-Fetal Medicine at Women & Infants Hospital of Rhode Island, co-director of the hospital's Integrated Program for High-Risk Pregnancy, and a professor of obstetrics and gynecology at The Warren Alpert Medical School of Brown University, and Stephen R. Carr, MD, director of Women & Infants' Prenatal Diagnosis Center and Maternal-Fetal Medicine Diagnostic Imaging, co-director of the Fetal Treatment Program of New England, and a professor of obstetrics and gynecology at the Alpert Medical School, have published an article as part of a Clinical Expert Series in the October 2014 edition of Obstetrics & Gynecology, now available online. The article is entitled "Fetal Surgery: Principles, Indications, and Evidence."
According to the authors, there have been tremendous advances in fetal treatment in the past few years, made by centers like the Fetal Treatment Program of New England (a combined service of Women & Infants and Hasbro Children's hospitals).
"This means that in some cases when we identify a fetal problem prenatally, we can offer a treatment," said Dr. Carr. "This article presents the scientific justification for available in utero interventions, evaluates data on their benefits and risks, and offers a framework for future development and refinement of new and more focused interventions that address fetal problems while minimizing maternal risk."
Drs. Carr and Wenstrom concluded that the tremendous resources that are required to perform fetal surgery, including considerable investment in training that is required of a fetal surgeon, together with the relative rarity of most of the conditions for which fetal surgery is attempted, necessitate that the number of fetal surgery centers be limited so that each can care for enough patients to justify their cost and maintain the skills of the fetal interventionist.
Obstetrics & Gynecology is the official publication of the American College of Obstetricians and Gynecologists (the College). Popularly known as "The Green Journal," Obstetrics & Gynecology has been published since 1953. The goal of the journal is to promote excellence in the clinical practice of obstetrics and gynecology and closely related fields.
About Women & Infants Hospital
Women & Infants Hospital of Rhode Island, a Care New England hospital, is one of the nation's leading specialty hospitals for women and newborns. A major teaching affiliate of The Warren Alpert Medical School of Brown University for obstetrics, gynecology and newborn pediatrics, as well as a number of specialized programs in women's medicine, Women & Infants is the eighth largest stand-alone obstetrical service in the country with nearly 8,400 deliveries per year. A U.S.News 2014-15 Best Children's Hospital in Neonatology, in 2009, Women & Infants opened the country's largest, single-family room neonatal intensive care unit.
New England's premier hospital for women and newborns, Women & Infants and Brown offer fellowship programs in gynecologic oncology, maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, neonatal-perinatal medicine, pediatric and perinatal pathology, gynecologic pathology and cytopathology, and reproductive endocrinology and infertility. It is home to the nation's only mother-baby perinatal psychiatric partial hospital, as well as the nation's only fellowship program in obstetric medicine.
Women & Infants has been designated as a Breast Center of Excellence from the American College of Radiography; a Center of Excellence in Minimally Invasive Gynecology; a Center for In Vitro Maturation Excellence by SAGE In Vitro Fertilization; a Center of Biomedical Research Excellence by the National Institutes of Health; and a Neonatal Resource Services Center of Excellence. It is one of the largest and most prestigious research facilities in high risk and normal obstetrics, gynecology and newborn pediatrics in the nation, and is a member of the National Cancer Institute's Gynecologic Oncology Group and the National Institutes of Health's Pelvic Floor Disorders Network.
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Obstetrics and Gynecology