• Texas Children’s Fetal Center first in southwestern United States to perform experimental in-utero procedure to treat congenital diaphragmatic hernia

    HOUSTON – (May 22, 2012) – As one of the country’s leading medical centers for diagnosing and treating fetal anomalies, and one of the first centers to provide a full range of prenatal surgical options, Texas Children’s Fetal Center at the Pavilion for Women is proud to announce the team’s first two successful in-utero fetal interventions to treat Congenital Diaphragmatic Hernia (CDH). These are the only documented cases in the Southwestern United States where endoscopic tracheal occlusion has been used to care for fetuses with severe CDH in-utero. To watch a video about this procedure, please see: http://www.youtube.com/watch?v=lwZEuGPinVU.

    CDH, a developmental anomaly that occurs when the diaphragm fails to form properly, allows contents of the fetal abdomen to travel up into the chest. Normal lung development is also impaired. CDH occurs in as many as 1 in 2,500 births and in the most severe cases can result in significant morbidity and mortality at birth.

    “Our work with CDH patients is extensive, and in the past, a prenatal diagnosis has been daunting for families,” explains Dr. Oluyinka O. Olutoye, co-director of Texas Children’s Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology at Baylor College of Medicine (BCM). “While still in the experimental stages, this in-utero tracheal occlusion procedure is reserved for babies with severe diaphragmatic hernia. It is an exciting advancement and provides new hope for future CDH patients.”

    The minimally invasive and reversible fetoscopic tracheal occlusion procedure involves placing a small balloon into the fetus to plug the trachea. The intervention improves fetal lung growth as a result of successful 'plugging/unplugging' of the trachea, and can considerably alter the outcome of patients diagnosed with CDH. The balloon is left in place to inflate the lungs over the next several weeks and later removed by a similar procedure weeks before the anticipated delivery.

    “It is important to understand that this fetal procedure remains experimental and that the use of some of these devices requires special permission from the FDA. Texas Children’s Hospital is one of the few centers in the United States that have been given permission by the FDA to do this,” added Olutoye.

    “The prognosis for both of these babies prior to this experimental procedure was very poor,” said Dr. Darrell Cass, co-director of Texas Children’s Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology at Baylor College of Medicine. “I am happy to report that our first patient delivered in early April. Presently, the baby is doing well and his course thus far suggests that there was a good effect from performing this procedure in-utero. The balloon was recently removed from our second patient and we’re awaiting delivery in the next few weeks.”

    The recent surgeries were led by a multi-disciplinary team from Texas Children’s Fetal Center at Texas Children’s Hospital including:

    • Dr. Michael Belfort, obstetrician and gynecologist-in-chief at Texas Children's Hospital and chairman of the department of obstetrics and gynecology at BCM
    • Dr. Nancy Ayres, director of non-invasive cardiac imaging at Texas Children’s Hospital and assistant professor of pediatrics at BCM
    • Dr. Oluyinka O. Olutoye, co-director of Texas Children's Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology, at BCM
    • Dr. Darrell Cass, co-director of Texas Children's Fetal Center and associate professor, departments of surgery, pediatrics and obstetrics and gynecology, at BCM

    “With the arrival of Dr. Rodrigo Ruano who has performed more than 60 tracheal occlusions in Brazil and published a landmark study on this procedure, we now have the most experienced team in the prenatal and postnatal management of CDH in the USA,” said Michael Belfort, M.D., Ph.D, obstetrician and gynecologist-in-chief at Texas Children’s Hospital and chairman of the Department of Obstetrics and Gynecology at Baylor College of Medicine.

    Texas Children’s Maternal and Fetal Center is located on the Pavilion’s fourth floor and is one of only a handful of facilities in the world to offer a full spectrum of maternal and fetal care. Comprehensive services include management of any complex pregnancy, genetic counseling and the full range of fetal diagnostic procedures. The Fetal Center also provides highly specialized fetal surgeries for a number of congenital malformations. Texas Children’s is among the nation's leaders in providing high-risk maternal care and the diagnosis and treatment of abnormalities in unborn and newborn infants.

    For more information, please visit http://women.texaschildrens.org/fetalcenter/

    About Texas Children's Hospital
    Texas Children’s Hospital, a not-for-profit organization, is committed to creating a community of healthy children through excellence in patient care, education and research. Consistently ranked among the top children’s hospitals in the nation, Texas Children’s has recognized Centers of Excellence in multiple pediatric subspecialties including the Cancer and Heart Centers, and operates the largest primary pediatric care network in the country. Texas Children's has completed a $1.5 billion expansion, which includes the Jan and Dan Duncan Neurological Research Institute; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; and Texas Children’s Hospital West Campus, a community hospital in suburban West Houston.  For more information on Texas Children's, go to www.texaschildrens.org. Get the latest news from Texas Children’s by visiting the online newsroom and on Twitter at twitter.com/texaschildrens.

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