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Columbia Missourian

St. Louis hospital launches fetal care center

By BETSY TAYLOR/The Associated Press
July 7, 2009 | 4:52 p.m. CDT

ST. LOUIS — A St. Louis medical center has started a new program to treat babies with life-threatening conditions while they're still in the womb.

SSM Cardinal Glennon Children's Medical Center announced Tuesday that it has opened its new Fetal Care Institute, which is to provide comprehensive evaluations and fetal intervention. Those are practices that allow doctors to reach inside the uterus to treat an unborn child with a medical problem.

The center is expected to be able to assist pregnant women in the Midwest who previously needed to go to Cincinnati or Houston for certain treatments and surgeries.

"Regionally, we are offering a lot that's new," said Ed Yang, a fetal surgeon who will co-direct the center with Mike Vlastos, a specialist in maternal and fetal medicine.

SSM Cardinal Glennon will join a handful of facilities in the nation that perform open fetal surgery, in which the mother's uterus is opened, surgery is performed on the fetus and the womb is closed so the pregnancy can continue.

Open fetal surgery is already conducted at centers in San Francisco, Philadelphia, Cincinnati, Boston and Houston, fetal surgeons said.

These surgeries remain rare, with "fewer than 500 open fetal surgeries ever in the United States," said Diana Farmer, surgeon in chief at the University of California, San Francisco's Children's Hospital.

Fetal surgery began about 30 years ago at the San Fransisco university, and it was the only place that performed them for about 15 years until Children's Hospital of Philadelphia started, she said.

In open fetal surgeries, "over half of the fetuses are able to be saved, whereas if nothing were done, they'd be expected not to survive," Farmer said.

Much of the focus in the field is on less invasive methods, such as fetoscopic intervention and image-guided needle-based interventions, in which the fetus can be viewed through small scopes or other imaging techniques and is treated through tiny openings in the abdomen.

On June 18, doctors at SSM Cardinal Glennon used a fetoscopic procedure with a laser to remove an amniotic band, or a strand of the amniotic sac, that was wrapped around the leg of an unborn boy at 24 weeks gestation.

Amniotic bands restrict blood flow, which can lead to amputation or severe limb deformity. Adequate blood flow was restored when the band was removed. Ultrasounds have shown the surgery was successful, a hospital representative said.

The Fetal Care Institute is a collaboration among SSM Cardinal Glennon, the Saint Louis University School of Medicine and high-risk pregnancy specialists at SSM St. Mary's Health Center in suburban St. Louis.