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Lifespan, Women & Infants Collaborate to Expand Fetal Treatment Program
(April 20, 1999)

First-of-its-Kind, Multidisciplinary Program Advances Care of Women with High-Risk Pregnancies

Rhode Island Hospital’s pediatric division, Hasbro Children’s Hospital, New England Medical Center and its Floating Hospital for Children have joined forces with Women & Infants Hospital to provide revolutionary fetal treatment options. Lifespan and Women
& Infants’ Fetal Treatment Program will build on their firmly established, comprehensive perinatal services to provide medical treatment of the fetus in utero as well as innovative laser treatments and fetal endoscopic operations. The program will be directed by Floating Hospital’s Chief of Genetics, Diana Bianchi, MD, and Sabrina Craigo, MD, a Maternal/Fetal Medicine specialist at NEMC; Hasbro Children’s Hospital pediatric surgeon Francois I. Luks, MD, PhD; and Women & Infants Hospital maternal/fetal medicine specialist Stephen R. Carr, MD.

Treatment options range from medically managing the fetus via the mother, to procedures that involve surgically entering the uterus endoscopically. For example, doctors can treat a baby’s cardiac arrhythmia in utero by administering medication to the mother that crosses the placenta to reach the fetus, or control fetal anemia by injecting blood products directly into the umbilical cord through a needle in the mother’s abdomen. Using ultrasound guidance, plastic shunts can be placed to treat a congenital anomaly known as bladder outlet obstruction. This blockage of the fetal urethra disrupts kidney and lung development and the shunt works to improve their
function. In more extreme cases, surgical intervention is necessary. For example, it is now possible to temporarily occlude the fetal trachea endoscopically to help lungs grow and overcome the complications associated with severe forms of diaphragmatic
hernia. "The program will take the recognized strengths of each of the partners and pool them into a truly coordinated effort," said Carr of Women & Infants. "The Fetal Treatment Program will offer new capabilities and technologies to women of New England carrying anomalous fetuses."

"Using endoscopic or minimally invasive techniques, we can now surgically treat certain fetal anomalies with less risk," said pediatric surgeon Luks. "Additionally, there are innovative ways to treat specific complications of twin pregnancies never before