University of California, San Francisco Fetal Treatment Center

The Fetal Treatment Center at the University of California, San Francisco (UCSF) is a multidisciplinary care center focused on diagnosing, treating, and providing long-term follow-up for fetal birth defects. It brings together specialists in pediatric surgery, genetics, obstetrics/perinatology, radiology, nursing, and neonatal medicine.

History

In 1980, Dr. Michael R. Harrison and his research colleagues at UCSF pioneered open fetal surgery techniques using animal models. In 1981, Harrison performed the first open fetal surgery on a fetus to correct a severe urinary tract obstruction.

Under Harrison's leadership, the Fetal Treatment Center continued to develop and refine fetal intervention techniques for various birth defects. The center also aimed to develop less invasive treatment methods, such as fetendo and fetal image-guided surgery.

Dr. Hanmin Lee M.D. currently serves as the director of the UCSF Fetal Treatment Center, succeeding Harrison, who is now the director emeritus.

Clinical Services

The Fetal Treatment Center specializes in diagnosing and treating the following fetal birth defects:

• Agenesis of the corpus callosum
• Amniotic band syndrome
• Bowel obstructions
• Congenital cystic adenomatoid malformation
• Congenital diaphragmatic hernia (CDH)
• Congenital heart disease
• Fetal anemia and thrombocytopenia
• Gastroschisis
• Genetic diseases treatable with stem cells
• Spina bifida (myelomeningocele)
• Omphalocele
• Pulmonary sequestration
• Sacrococcygeal teratoma
• Twin pregnancy complications, including twin-to-twin transfusion syndrome (TTTS), TRAP sequence (acardiac twin), and unequal placenta sharing
• Urinary tract obstruction
• Ventriculomegaly

Research

UCSF performed the world's first open fetal surgery in the 1990s.

The Fetal Treatment Center conducts clinical research, including a randomized clinical trial comparing prenatal surgical repair of myelomeningocele to standard postnatal care. This trial, known as the Management of Myelomeningocele Study (MOMS) trial, involves three centers: UCSF, Children's Hospital of Philadelphia, and Vanderbilt University Medical Center. It is supported by the National Institutes of Health. The center is also investigating the potential effectiveness of steroids in treating fetuses with large microcystic congenital cystic adenomatoid malformation (CCAM).

Experimental research continues in the laboratory, focusing on various potentially curable fetal diseases and the development of smaller and better minimally invasive techniques.

Resources

• UCSF Fetal Treatment Center