(PRNewswire) Less than four years after opening the Garbose Family Special Delivery Unit, the world's first birth facility exclusively for mothers carrying babies with known birth defects, The Children's Hospital of Philadelphia (CHOP) has celebrated 1,000 deliveries. All babies delivered in the Special Delivery Unit are prenatally diagnosed with birth defects, such as spina bifida or congenital heart disease, and will either undergo fetal surgery or need immediate specialized care or surgery after birth.
"Approximately one in 33 babies is diagnosed with a birth defect each year," said Julie S. Moldenhauer, M.D., CHOP Maternal Fetal Medicine/Reproductive Genetics Specialist and Medical Director of the Special Delivery Unit. "Traditionally, these mothers will give birth in one hospital, and their newborn will be transferred to a specialized pediatric hospital shortly after delivery. The Garbose Family Special Delivery Unit changed that by allowing for mother and baby to be simultaneously cared for at one institution by a team with great experience and expertise."
The Special Delivery Unit opened in 2008 and is the delivery arm of CHOP's internationally recognized Center for Fetal Diagnosis and Treatment, which has been providing care for women expecting babies diagnosed with fetal conditions for more than 16 years. "When we opened the Garbose Family Special Delivery Unit, we anticipated that this unique, multidisciplinary approach would improve outcomes for mother and baby before, during and after birth," said N. Scott Adzick, M.D., Surgeon-in-Chief at CHOP and Medical Director of the Center for Fetal Diagnosis and Treatment.
Kathy Banks of New Britain, Pennsylvania found out nine weeks into her pregnancy that she and her husband, Andrew, were expecting twins. Their 20-week ultrasound raised some concerns about one of the twin's hearts and their doctor quickly referred the Banks to CHOP's Fetal Heart Program for further evaluation. Once at CHOP, the team found that although the Banks' daughter was developing normally, their son had Tetralogy of Fallot, a serious structural malformation of the heart.
Although the news was difficult to receive, the prenatal diagnosis allowed the Banks to adjust and prepare for their son's arrival. It also provided valuable time for the team at CHOP to formulate a plan for the baby's delivery and post-natal care. Kathy was carefully monitored by CHOP's Center for Fetal Diagnosis and Treatment team and Fetal Heart Program for the duration of her pregnancy. On March 19, during a regular prenatal appointment, she asked about scheduling her upcoming cesarean delivery and was told it was too soon -- she wasn't due for another eight weeks and the goal was to deliver the twins as close to full term as possible. However, no sooner did she and her husband return home that day, than Kathy's water broke. The couple turned right around and drove back to Philadelphia.
Obstetrician Jodi Slepian, M.D., and her team performed a cesarean delivery in the early hours of March 20. Angela Rose and Liam Andrew Banks were born within seconds of each other, both only weighing a little over three pounds. The multi-disciplinary neo-natal team was ready and waiting to care for both newborns.
Liam, the baby with the congenital heart defect, was born pink and active. The team ensured that his condition was stable. After the parents were able to see both babies briefly, they were taken to CHOP's Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit to be treated for prematurity, while Mom recovered just a few floors away in the Special Delivery Unit. "The babies are gaining weight and plumping up," says Kathy, "but they are still peanuts." As she recovers from the cesarean delivery, she is able to visit her twins as often as she feels up to it, for as long as she likes.
Jack Rychik, M.D., Director of the Fetal Heart Program, says, "The babies need to continue to grow and Liam will need surgery to repair his heart in a few weeks time. Babies diagnosed with birth defects in utero and their moms need specialized obstetrical services, including prenatal and delivery care," continued Rychik says, "Without the Special Delivery Unit, and the immediate care offered by experienced specialists in pediatric cardiology and neonatology all under one roof, the Banks' outcome could have been much different."
The Center for Fetal Diagnosis and Treatment and Fetal Heart Program outpatient services are housed adjacent to the inpatient area, and the outpatient area is staffed by a team of maternal-fetal medicine specialists, obstetricians, genetic counselors, nurses, mid-wives, radiologists, ultrasound and echocardiography technicians, sonographers and others, all dedicated to both mom and baby. When an expectant mother comes for an evaluation, she has a series of tests including a highly specialized detailed anatomy ultrasound, and possibly an ultrafast fetal MRI and an echocardiogram.
After the images are evaluated, the team sits down with the family to discuss the diagnosis and treatment options. All of this takes place in one day.