The Children’s Hospital of Philadelphia recently celebrated the birth of the 2,000th fetal surgery patient, which is a milestone in more than 25 years.

Since the Richard D. Wood Jr. Fetal Diagnosis and Treatment Center was established in 1995, CHOP has been a leader in fetal surgery, which repairs birth defects in babies who are still in the womb. Through this center, CHOP has taken care of more than 27,000 expectant parents from more than 70 countries in 50 states.

“Forty years ago, fetal surgery was considered experimental, but now it has become the standard of care, providing a better quality of life for many children and families,” said Dr. N. Scott Adzick, the center’s chief surgeon. Founder and director.

“A quarter of fetal surgery is done at CHOP, and we will continue to improve our technology so that we can improve the lives of more patients.”

Every week, the CHOP surgical team will perform fetal surgery, which can not only repair spina bifida and other congenital defects, but also remove fetal tumors and treat twin complications.

Celebrating the birth of Carter

Carter’s world journey was an important milestone for her family and the CHOP doctor who treated her.

Yasmin Southerland was told during the 20-week ultrasound that Carter had Myelomeningocele, The most serious form of spina bifida, a birth defect that affects the neural tube along the spinal column.

When these tubes are not completely closed, the spine cannot fully protect the spinal cord and nerves from damage.This can lead to physical and intellectual disability, including paralysis and loss of bladder and bowel control, according to US Centers for Disease Control and Prevention.

Yasmin and Carter’s father Malcolm lives in Kernersville, North Carolina, but through the help of local experts and their own research, they learned about CHOP’s work in this area. They decided to travel 450 miles for surgery.

“I didn’t even know that the operation could be performed while she was still in the womb,” Yasmin said.

When the CHOP surgeon successfully closed the opening of her daughter’s spine, Yasmin was 25 weeks pregnant. Two weeks later, Carter gave birth prematurely. She stayed in CHOP’s neonatal/infant intensive care unit for three months and then was transferred to a hospital closer to home. But she has been at home since June 2.

“Even though we are far from home, we are very happy to come to CHOP because we had a wonderful experience,” Yasmin said. “I was very nervous before the operation, but in the end I wanted to do my best to improve Carter’s prognosis. Now that her surgery has been successful, I feel better able to deal with any future challenges, especially knowing that I have CHOP in my back pocket. “

Modern Fetal Medicine

Since the establishment of modern fetal medicine, the head of the CHOP Fetal Diagnosis and Treatment Center has been collaborating with other scientists to develop experimental techniques for use in the body.

first of all Open fetal surgery used to be In 1980, it was performed by pediatric surgeon Dr. Michael Harrison, who founded the Fetal Treatment Center at the University of California, San Francisco. In the beginning, this was a controversial area because it was a potential risk for the mother and her fetus.

Initially, only simple structural defects, such as congenital diaphragmatic hernia, could be treated in the uterus.In the end, the International society of fetal medicine and surgery Developed specific standards for fetal surgery. These criteria include low maternal risk.

Since open fetal surgery brings high risks to the expectant mother and her child, the invention of minimally invasive surgery technology has opened the door for more types of fetal surgery to be successfully performed.

CHOP leads pioneering Mother study It was first demonstrated in 2011 that fetal repair of spina bifida provides more benefits than postpartum repair, including increased children’s ability to walk independently and reduced gross and fine motor defects.

The study also found that fetal surgery reduces the need for shunting to divert fluid from the brain.

Ten years later, CHOP researchers participated in a follow-up study that confirmed that the benefits of prenatal restoration on physical function lasted into the child’s school year.Their research results were published in February American Medical Association Pediatrics.

Fetal surgery experts emphasize that even with today’s sophisticated surgical techniques, surgeons and prospective parents need to weigh all the benefits and risks.

One possible complication is premature rupture of membranes, which can lead to premature delivery. Other risks Including uterine rupture after surgery, fetal death, surgical complications, and premature delivery.

The future of fetal surgery lies in stem cells and gene therapy, Some researchers sayAccording to animal studies, stem cell transplantation before the fetal immune system is fully developed is believed to promote the natural repair of defects.