2020 Michigan Medicine Fetal Diagnosis and Treatment Center brochure

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Fetal Diagnosis and Treatment Center

At the Michigan Medicine Fetal Diagnosis and Treatment Center, we are committed to providing comprehensive, coordinated and compassionate care for both women and infants.

Why Choose Us? One Home • M ichigan Medicine is one of just a few medical centers nationwide where Labor and Delivery is nestled within a comprehensive children’s hospital.

Comprehensive Care Through the Years • W e offer seamless care from fetal life through adulthood, focused on optimizing long-term outcomes and quality of life.

• O ur Fetal Diagnosis and Treatment Center offers comprehensive prenatal diagnosis and cutting-edge treatment.

• A fter delivery, families are connected with our multidisciplinary longitudinal follow-up clinics.

Optimal Setting

Experience Matters

• B eing under one roof provides the optimal environment for fetal therapy and surgery. • C are for high-risk pregnant women is integrated, cohesive, caring and supportive. Once babies are born, family members remain together, allowing for continued family-focused care.

• O ur cohesive, well-established, experienced team is comprised of members who are recognized as international leaders in prenatal diagnosis and fetal therapy. • O ur team has worked together since 2006. New team members continue to bring innovation, cutting-edge research, and patient-focused care.

Discover the Michigan Difference Full Spectrum of Fetal Care

Top in the Nation

• I n a caring environment, the Fetal Diagnosis and Treatment Center offers the full spectrum of care, including comprehensive diagnostic screening and testing, prenatal care and pregnancy management, extensive counseling, and all available fetal interventions and surgeries.

• O ur maternal fetal medicine physicians, pediatric surgeons, and neonatologists are ranked among the best in the nation and are available around the clock for consultations, referrals, and complex deliveries.

• O ur top priorities are outstanding care, multidisciplinary collaboration and innovation. During pregnancy, families meet with all of the necessary specialists to help understand the conditions and available management options. • P roviding care in an integrated women’s and children’s hospital optimizes care for women and infants. In particular, high-risk deliveries are performed in an operating room with an adjacent state-of-the-art, fully operational newborn evaluation, stabilization and treatment (NEST) room. Every room is single patient, fully equipped and built around family-centered care, with immediate access to operating rooms, catheterization labs and advanced imaging modalities.

• O ur Congenital Heart Center, consistently ranked as one of the best in the nation, is co-located within the building for easy access to cardiology services. • A s the birthplace of Extracorporeal Membrane Oxygenation (ECMO) in 1980, we remain leaders and innovators in extracorporeal support. • W e are leaders in clinical, basic science, and translational research to optimize outcomes for women and infants.

Comprehensive Fetal Care At Michigan Medicine, our interprofessional team works together to provide an individualized treatment plan that includes high-risk pregnancy management, fetal intervention when indicated, delivery planning, and postnatal care and treatment.

Specialized Obstetric, Operating Room, ICU Nursing

Social Work

Financial Counseling

Nurse Coordination

Child and Family Life

Palliative Care


Genetic Counseling

Adult and Pediatric Genetics

Maternal Fetal Medicine

Fetal Diagnosis and Treatment Center

Pediatric Otolaryngology (ENT)

Oral Maxillofacial Reconstructive Surgery

Pediatric Surgery


Pediatric Neurosurgery

Pediatric and Fetal Radiology

Pediatric Cardiology

Pediatric Urology

Plastic Surgery

Pediatric Neurology

Pediatric Cardiothoracic Surgery

Maternal and Pediatric Anesthesiology

Full Range of Fetal Procedures and Surgeries Our expert team offers the full range of fetal procedures and surgeries to diagnose and treat conditions prior to birth. From initial fetal screening to highly complex fetal interventions and delivery management, our experienced team uses minimally invasive techniques as well as open fetal surgery.

Our commitment to excellence includes rigorous simulation and training, thoughtful care coordination, ongoing quality assurance, and data monitoring.

Minimally Invasive Procedures

Open Fetal Procedures

• F etoscopic laser for twin-twin transfusion syndrome

• E x Utero Intrapartum Treatment (EXIT) for airway obstruction, mass/tumor resection, or to ECMO

• F etoscopic treatment of amniotic bands • F etal blood sampling (cordocentesis) and intrauterine blood transfusion • U ltrasound-guided umbilical cord administration of medications • Fetal cardiac aortic valvuloplasty • Fetal cardiac atrial septostomy • Fetal skin or muscle biopsy • U ltrasound-guided percutaneous shunt placement: vesicoamniotic and thoracoamniotic shunts • R adiofrequency ablation (twin reversed arterial perfusion (TRAP) and complicated monochorionic twins) • F etal endoscopic tracheal occlusion (FETO) for severe congenital diaphragmatic hernia (CDH)

• O pen fetal surgery for myelomeningocele repair • O pen fetal surgery for tumor resection (e.g., sacrococcygeal teratoma)

Patient and Family Centered Care At Michigan Medicine, we strive for a patient-centered culture where patients and families are empowered to have a voice.

Family Support and Services

Our Patient and Family Centered Care program supports care that recognizes and respects the uniqueness of each family and encourages families to partner with health care providers. Designed by families and health care providers, our Family Center is a place where patients and families can learn, relax and become advocates for their health care. Overall, the four concepts of Patient and Family Centered Care are:

• Social work

• Dignity and respect

• C omprehensive care plans and communication with referring providers when patients return to their primary care provider and/or institution

• Information sharing • Collaboration • Participation

• Detailed care coordination for patients while at Michigan Medicine • Breastfeeding and lactation support • Spiritual care • Travel and lodging coordination and support for families • On-site and off-site Ronald McDonald House locations

Cutting-Edge Research and Innovative Treatments Our team aims to drive improvements in maternal and fetal outcomes and to develop therapies for generations to come. We have a deep passion for exploring diverse and complex conditions that have lifelong implications for both maternal and fetal health.

Placental Pharmacogenetics and Substance Use Disorders in Pregnancy • O ur team aims to understand the role of placental efflux transporters in fetal opioid exposure.

Working to Improve Obstetric Safety • A longside national and state partners, and using innovative technologies, we are leading efforts to improve maternal safety, build perinatal collaboratives, and reduce healthcare disparities.

Consequences of Long-Term Hospitalization for Complex Antepartum Patients • W e are studying obstetric and neonatal outcomes as well as patient satisfaction in the population of women admitted for extended antepartum stays. • O ur team is focused on creating novel strategies to enhance support offered to this population.

Fetal Hemoglobin Project • P ioneering strategies to support healthy oxygen delivery in newborns of extremely low gestational age or newborns requiring postnatal surgery.

Artificial Placenta • N IH-funded researchers are working to improve survival rates in the tiniest, most premature babies in a groundbreaking way. Our innovative artificial placenta mimics the intrauterine environment, providing gas exchange without mechanical ventilation. • R ecreating the intrauterine environment will allow critical organ development outside of the uterus. Next steps will be to determine if milestones justify preliminary clinical trials in extremely premature babies.

Novel Alternatives to Stapled Hysterotomy in Open Fetal Surgery • F or the past few years, our team has been investigating novel techniques to enter the uterus for open fetal surgery. • O ur animal studies are showing that use of the Harmonic ACE+7 to create a hemostatic hysterotomy is safe. Additionally, healing is similar to traditional stapling.

Fetal Endoscopic Tracheal Occlusion (FETO) for Congenital Diaphragmatic Hernia (CDH) • F etal Endoscopic Tracheal Occlusion (FETO) is offered at Michigan Medicine. • T his experimental therapy is offered for fetuses with severe pulmonary hypoplasia with liver in the thoracic cavity due to congenital diaphragmatic hernia (CDH), including right- or left-sided defects.

Connecting with Networks Across North America to Enable More Discovery and Improve Patient Care • W e are active members and participants in the North American Fetal Therapy Network (NAFTNet), a multicenter network of 36 medical centers in the United States and Canada that perform advanced in-utero fetal therapeutic procedures. • W e are actively involved in collaborative research projects, registries, and publications with NAFTNet, including complicated monochorionic twin gestations, open myelomeningocele repair registry, mode of delivery for fetuses with myelomeningoceles, and sleep-disordered breathing in neonates with myelomeningocele.

Our leaders in maternal fetal care are committed to providing comprehensive, collaborative and compassionate care for women and infants … all under one roof. Fetal Diagnosis and Treatment Center

1540 East Hospital Drive Ann Arbor, MI 48104-4204

734-763-6295 uofmhealth.org/fetalcenter @UmichMedicine Thank you to our incredible patients who have shared their photographs for this publication.

Regents of the University of Michigan Jordan B. Acker, Michael J. Behm, Mark J. Bernstein, Paul W. Brown, Sarah Hubbard, Denise Ilitch, Ron Weiser, Katherine E. White, Mary Sue Coleman (ex officio) University of Michigan Health Executive Officers Marschall S. Runge, M.D., Ph.D., Executive Vice President for Medical Affairs, Dean; Steven L. Kunkel, Ph.D., Executive Vice Dean for Research; David C. Miller, M.D., M.P.H, Executive Vice Dean for Clinical Affairs; Debra F. Weinstein, M.D., Executive Vice Dean for Academic Affairs A Non-discriminatory, Affirmative Action Employer ©2022 Regents of the University of Michigan