2020 Colorado Fetal Care Center 2020 - Page 26

Conditions We Treat

Our center has the deep experience and expertise to treat virtually any condition that might affect an unborn baby or newborn — no matter how rare . But even more important than our array of treatments is our rate of success . We value transparency in our outcomes , which is why we track and report the outcomes that matter .
• Abdominal wall defects
• Achondrogenesis
• Achondroplasia
• Agenesis of the corpus callosum
• Ambiguous genitalia
• Amniotic band syndrome
• Anencephaly
• Aortic valve stenosis
• Aqueductal stenosis
• Arachnoid cysts
• Arthrogryposis
• Atrioventricular canal defect
• Bladder exstrophy
• Bladder outlet obstruction
• Body stalk anomaly
• Bronchopulmonary sequestration
• Campomelic dysplasia
• Cardiomyopathy
• Cerebral calcifications
• Cervical teratoma
• Choledochal cyst
• Chondrodysplasia punctata
• Cleft lip and palate
• Clinodactyly
• Cloacal exstrophy
• Clubfoot
• Coarctation of the aorta
• Colonic atresia
• Complete atrioventricular septal defect
• Congenital diaphragmatic hernia
• Congenital high airway obstruction syndrome
• Congenital pulmonary airway malformation
• Conjoined twins
• Craniosynostosis
• Cystic hygroma in early or late pregnancy
• Cystic lesions of the abdomen
• Dandy-Walker malformation and variants
• Diastrophic dysplasia
• Double outlet right ventricle
• Duodenal atresia and stenosis
• Ebstein anomaly
• Echogenic kidneys
• Ectopia cordis
• Ectrodactyly
• Ellis-van Creveld syndrome
• Encephalocelea
• Enteric duplicational atresia
• Epignathus
• Epulis
• Esophageal atresia and tracheoesophageal fistula
• Exencephaly / acrania
• Fetal cardiac conditions
• Gastroschisis
• Goiter
• Hemifacial microsomia
• Hemivertebrae
• Heterotaxy syndrome
• Hirschsprung ’ s disease
• Holoprosencephaly
• Hydranencephaly
• Hydrocephalus
• Hydronephrosis : ectopic ureterocele
• Hydronephrosis : minimal
• Hydronephrosis : ureteropelvic junction obstruction
• Hydrops fetalis
• Hydrothorax
• Hypertelorism
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Research and Clinical Trials Renal Anhydramnios Fetal Therapy Trial Fetoscopic Endoluminal Tracheal Occlusion Trial IRB #19-0806 ClinicalTrials.gov Identifier: NCT03101891 Principal investigator: Michael Zaretsky, MD IRB #18-0461 ClinicalTrials.gov Identifier: NCT03674372 Principal investigator: Kenneth Liechty, MD Early pregnancy renal anhydramnios, or EPRA, is a condition where a pregnant woman does not have amniotic fluid around her fetus because of a problem with the fetus's kidneys, which can be fatal due to inadequate lung growth. The Renal Anhydramnios Fetal Therapy (RAFT) Trial offers eligible pregnant women with a diagnosis of EPRA an experimental therapy of repeated or serial "amnioinfusions" of fluid into the womb. This study will determine whether fetoscopic endoluminal tracheal occlusion (FETO ) surgery works and is safe for babies with severe right or left congenital diaphragmatic hernia (CDH). CDH is a condition in which a hole in the baby's diaphragm allows the abdominal organs to move into the chest and limit lung growth. The goal of the FETO device is to block the airway with a balloon-type device, allowing fluid to build up and help the unborn baby's lungs grow, which may improve the baby's quality of life. Contact: Hilary Hoffman [email protected] Surveillance and Treatment to Prevent Fetal Atrioventricular Block Likely to Occur Quickly Contact: Hilary Hoffman [email protected] Gastroschisis Outcomes of Delivery Trial IRB #20-1310 ClinicalTrials.gov Identifier: NCT04474223 Principal investigator: Bettina Cuneo, MD IRB #19-0970 ClinicalTrials.gov Identifier: NCT02774746 Principal investigator: Nicholas Behrendt, MD Fetal complete atrioventricular block, or AVB, is irreversible; however, there may be a vital transition period of several hours in which incomplete block may be successfully treated. In-home fetal monitoring optimizes the likelihood of timely detection of the transition period, empowering mothers to identifying it using a fetal heart rate monitor at home. This study seeks to confirm the efficacy of this approach. This study investigates the hypothesis that delivery at 35 weeks in stable patients with gastroschisis is superior to observation and expectant management with a goal of delivery at 38 weeks. To test this hypothesis, we will complete a prospective, multi-institutional trial, randomizing patients to delivery at 35 weeks or observation with a goal of 38 weeks. The primary composite outcome will include stillbirth, neonatal death prior to discharge, respiratory morbidity, and need for parenteral nutrition at 30 days. Contact: Bettina Cuneo, MD [email protected] Contact: Hilary Hoffman [email protected] Mayo Clinic Cord Blood Banking Hypoplastic left heart syndrome (HLHS) is a rare heart defect in which the left side of the heart is severely underdeveloped and the right side of the heart must pump blood to both the lungs and the body. This study collects and banks babies’ umbilical cord blood at Mayo Clinic’s Todd and Karen Wanek Family Program for HLHS, making it possible for children to participate in future clinical trials using stems cells from their own body. The goal of the clinical trial is to strengthen the heart using stem cells. Fetal Magnetocardiogram While electrocardiogram, or ECG, is well established for measuring heart rhythm, this technology has never been applied to fetal hearts, due to the difficulty of recording these signals within the womb. A cutting-edge new device known as an optically pumped magnetometer, or OPM, records the magnetic fields given off by the fetal heart and converts them to electrical signals, a technology called fetal magnetocardiogram, or fMCG. Until now, this technology has only been available in a handful of research laboratories in the world. As of 2020, the Colorado Fetal Care Center is the only fetal care center in the world with an OPM and the ability to perform advanced fMCG in-house. This technology, as employed in the labor and delivery unit, has the potential to improve fetal outcomes in ways not yet imagined. 24 | Colorado Fetal Care Center 2020 Overview and Outcomes | 25