The diagnosis and treatment of fetal conditions is one of the most exciting areas of fetal medicine.
U-M Maternal Fetal Medicine (MFM) specialists have continued to expand our scope of advanced fetal diagnostic and therapeutic services, both in terms of number of patients seen as well as range of offerings.
Patients travel from throughout Michigan and beyond to U-M for high quality fetal screening and diagnostic services, including from as far away as Kentucky and Iowa.
Fetal interventions are offered through our Fetal Diagnosis and Treatment Center (FDTC), leveraging the expertise of the MFM team in addition to U-M colleagues in pediatric surgery, neonatology, pediatric cardiology, pediatric radiology, pediatric pathology, pediatric genetics, as well as pediatric urology, pediatric neurosurgery and pediatric neurology.
Together with our pediatric specialist colleagues, the U-M FDTC offers in-utero diagnosis and fetal intervention or newborn treatment for a variety of disorders, including:
- Aortic Stenosis
- Critical pulmonary stenosis
- Intact or restrictive atrial septum with HLHS
- Bladder Outlet Obstruction
- Pleural effusions
- Fetal Hydrops
- Fetal lymphatic malformations (lymphangioma)
- Fetal anemia
- Cervical Teratoma
- Congenital Pulmonary Airway Malformations
- Congenital Diaphragmatic Hernia
- Hypoplastic Left Heart Syndrome
- Giant Neck Mass
- Sacrococcygeal Teratoma
- Twin Reversed Arterial Perfusion (TRAP)
- Twin Twin Transfusion Syndrome (TTTS)
- Complicated monochorionic twin gestations
We currently offer the full range of fetal therapies, ranging from bladder shunt placements in the early second trimester to EXIT procedures required at time of delivery to allow treatment on placental support.. Our team’s in utero cardiac interventions include aortic valvuloplasties to attempt to preserve biventricular function in fetuses with critical aortic stenosis with evolving hypoplastic left heart syndrome and atrial septostomies for fetuses with HLHS and intact atrial septum.
Selective endoscopic laser ablation for twin twin transfusion syndrome is a high volume area, with U-M quickly emerging as a regional referral center for TTTS therapy. These complicated patients frequently require immediate evaluation and treatment and our team maintains the flexibility to accommodate immediate assessment and care for these patients.
Although we would like to see Rhogam reduce the need for intrauterine transfusions, we have continued to see increasing numbers of patients with isoimmunization. Many of these patients require multiple in utero transfusions, which we have performed as early as 16 weeks gestation.
Our Maternal Fetal Medicine team has extensive experience with in utero drainage procedures and placement of shunts. Both thoracic shunts for pleural effusions and vesico-amniotic shunts for megacystis or bladder outlet obstructions can be life saving for the fetus.
In addition to our physicians with a broad range of expertise, the fetal diagnostic team includes certified genetic counselors, highly trained RDMS sonographers, specialized antenatal testing nurses, and dedicated support staff. We conduct weekly case review sessions to regularly bring together all members of the team and to provide a forum for orchestrating detailed discussions regarding management plans on a regular basis.
We offer the full range of counseling and evaluation regarding options for patients presenting with these challenging pregnancies in a supportive environment.