The Fetal Treatment Center at the
University of California, San Francisco
The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It con ...
is a multidisciplinary care center dedicated to the diagnosis, treatment, and long-term follow-up of fetal birth defects. It combines the talents of specialists in
pediatric surgery
Pediatric surgery is a subspecialty of surgery involving the surgery of fetuses, infants, children, adolescents, and young adults.
History
Pediatric surgery arose in the middle of the 1879 century as the surgical care of birth defects requ ...
, genetics,
obstetrics/
perinatology,
radiology
Radiology ( ) is the medical discipline that uses medical imaging to diagnose diseases and guide their treatment, within the bodies of humans and other animals. It began with radiography (which is why its name has a root referring to radiat ...
,
nursing
Nursing is a profession within the health care sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other health ...
, and neonatal medicine.
History
In 1980,
Dr. Michael R. Harrison and research colleagues at UCSF developed the techniques for open fetal surgery using animal models. Then in 1981, Harrison conducted the first open fetal surgery on a fetus to correct a dangerously advanced urinary tract obstruction.
Under the direction of Harrison, the newly created Fetal Treatment Center continued to develop and further refine fetal intervention techniques to treat a range of birth defects. It has also striven to develop less invasive means of treatment such as fetendo and fetal image-guided surgery.
Dr. Hanmin Lee M.D. is the current director for the UCSF Fetal Treatment Center, replacing Harrison, who is now director emeritus.
Clinical services
The Fetal Treatment Center specializes in the diagnosis and treatment of fetal birth defects:
*
Agenesis of the corpus callosum
*
Amniotic band syndrome
Constriction ring syndrome (CRS) is a congenital disorder with unknown cause. Because of the unknown cause there are many different, and sometimes incorrect names. It is a malformation due to intrauterine bands or rings that give deep grooves in, ...
*
Bowel obstructions
*
Congenital cystic adenomatoid malformation
Congenital pulmonary airway malformation (CPAM), formerly known as congenital cystic adenomatoid malformation (CCAM), is a congenital disorder of the lung similar to bronchopulmonary sequestration. In CPAM, usually an entire lobe of lung is replace ...
*
Congenital diaphragmatic hernia
Congenital diaphragmatic hernia (CDH) is a birth defect of the diaphragm. The most common type of CDH is a Bochdalek hernia; other types include Morgagni hernia, diaphragm eventration and central tendon defects of the diaphragm. Malformation of ...
(CDH)
*
Congenital heart disease
A congenital heart defect (CHD), also known as a congenital heart anomaly and congenital heart disease, is a defect in the structure of the heart or great vessels that is present at birth. A congenital heart defect is classed as a cardiovascular ...
* Fetal
anemia
Anemia or anaemia (British English) is a blood disorder in which the blood has a reduced ability to carry oxygen due to a lower than normal number of red blood cells, or a reduction in the amount of hemoglobin. When anemia comes on slowly, t ...
&
thrombocytopenia
Thrombocytopenia is a condition characterized by abnormally low levels of platelets, also known as thrombocytes, in the blood. It is the most common coagulation disorder among intensive care patients and is seen in a fifth of medical patients a ...
*
Gastroschisis
Gastroschisis is a birth defect in which the baby's intestines extend outside of the abdomen through a hole next to the belly button. The size of the hole is variable, and other organs including the stomach and liver may also occur outside the ba ...
* Inherited
Genetic disease
A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders ...
s treatable with
Stem Cells
*
Spina bifida
Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, men ...
(myelomeningocele)
*
Omphalocele
Omphalocele or omphalocoele also called exomphalos, is a rare abdominal wall defect. Beginning at the 6th week of development, rapid elongation of the gut and increased liver size reduces intra abdominal space, which pushes intestinal loops out of ...
*
Pulmonary sequestration
A pulmonary sequestration is a medical condition wherein a piece of tissue that ultimately develops into lung tissue is not attached to the pulmonary arterial blood supply, as is the case in normally developing lung. This sequestered tissue is th ...
*
Sacrococcygeal teratoma
Sacrococcygeal teratoma (SCT) is a type of tumor known as a teratoma that develops at the base of the coccyx (tailbone) and is thought to be primarily derived from remnants of the primitive streak. Sacrococcygeal teratomas are benign 75% of the ...
* Twin pregnancy complications
**
Twin-to-twin transfusion syndrome
Twin-to-twin transfusion syndrome (TTTS), also known as feto-fetal transfusion syndrome (FFTS), twin oligohydramnios-polyhydramnios sequence (TOPS) and stuck twin syndrome, is a complication of monochorionic multiple pregnancies (the most comm ...
(TTTS)
**
TRAP sequence
Twin reversed arterial perfusion sequence, also called TRAP sequence, TRAPS, or acardiac twinning, is a rare complication of monochorionic twin pregnancies. It is a severe variant of twin-to-twin transfusion syndrome (TTTS). In addition to the tw ...
(acardiac twin)
**
Unequal placenta sharing
Inequality may refer to:
Economics
* Attention inequality, unequal distribution of attention across users, groups of people, issues in etc. in attention economy
* Economic inequality, difference in economic well-being between population groups
* ...
*
Urinary tract obstruction
Urinary tract obstruction is a urologic disease consisting of a decrease in the free passage of urine through one or both ureters and/or the urethra. It is a cause of urinary retention. Complete obstruction of the urinary tract requires prompt tre ...
*
Ventriculomegaly
Ventriculomegaly is a brain condition that mainly occurs in the fetus when the lateral ventricles become dilated. The most common definition uses a width of the atrium of the lateral ventricle of greater than 10 mm. This occurs in around 1 ...
Research
The first open fetal surgery in the world was performed at UCSF in the 1990s.
Clinical research includes a randomized clinical trial comparing prenatal surgical repair of
myelomeningocele
Spina bifida (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, men ...
to standard postnatal care. This trial,
Management of Myelomeningocele Study (MOMS) trial, is a three-center study (
UCSF
The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It con ...
,
Children's Hospital of Philadelphia
The Children's Hospital of Philadelphia (CHOP) is a children's hospital in Philadelphia, Pennsylvania, with its primary campus located in the University City neighborhood of West Philadelphia in the campus of the University of Pennsylvania. The ...
,
Vanderbilt University Medical Center
The Vanderbilt University Medical Center (VUMC) is a medical provider with multiple hospitals in Nashville, Tennessee, as well as clinics and facilities throughout Middle Tennessee. VUMC is an independent non-profit organization, but maintains acad ...
) supported by the
National Institutes of Health
The National Institutes of Health, commonly referred to as NIH (with each letter pronounced individually), is the primary agency of the United States government responsible for biomedical and public health research. It was founded in the late ...
. The Fetal Treatment Center is also currently investigating determine whether steroids might be effective in helping fetuses with large microcystic
Congenital cystic adenomatoid malformation
Congenital pulmonary airway malformation (CPAM), formerly known as congenital cystic adenomatoid malformation (CCAM), is a congenital disorder of the lung similar to bronchopulmonary sequestration. In CPAM, usually an entire lobe of lung is replace ...
(CCAM).
Experimental research continues in the laboratory on a variety of potentially curable fetal diseases and the development of new smaller and better minimally invasive techniques.
Resources
UCSF Fetal Treatment Center
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Hospitals in San Francisco
University of California, San Francisco
Teaching hospitals in California
Fetal surgery