A dvAnced F etAl c Are c enter 617-355-3896 | www.childrenshospital.org/afcc f_afcc_1107 At a Glance Only comprehensive fetal care center in New England and one of only three in the United States to offer a full
spectrum of fetal diagnosis, treatment and counseling.
Multidisciplinary team of 40 clinicians representing all pediatric subspecialities provide consultation at every step of pregnancy.
Since the center opened in 2000: 2,400 pregnant women have been seen. 1,800 babies have received medical and surgical treatments after delivery.
130 highly advanced fetal interventions have been performed, including EXIT and EXIT to ECMO procedures.
Worlds first and most experienced center in performing successful fetal cardiac interventions treating abnormalities in utero.
First successful cardiac stent placement in utero. First successful laser separation in Massachusetts for twin-twin transfusion syndrome.
Unrivaled results in treating congenital diaphragmatic hernia.
Consultation and collaboration with maternal fetal medicine specialists from Brigham & Womens Hospital, Beth Israel Deaconess Medical Center and Caritas St. Elizabeths Medical Center. About Us The Advanced Fetal Care Center (AFCC) at Childrens Hospital Boston offers
comprehensive, specialized care to women carrying a baby with complex birth defects
that may require treatment before or after birth. Our center supports the needs of families
and referring physicians at every step of carefrom diagnosis and counseling, through
treatment and follow-up. Our staff of specialists represents all pediatric subspecialty
areas and works with a wide range of babies with congenital anomalies. Together, we
have developed ground-breaking procedures in fetal medicine and surgery and have
made a commitment to provide the very best in fetal and pediatric care. Initial Referral Patients are referred to the AFCC from all over the world for diagnostic imaging and
specialist consultation. Appointments are coordinated by our staff to ensure the most
timely and appropriate scheduling. Diagnostics Members of the AFCC team are experienced in caring for babies with medical challenges
that others may see only occasionally, if at all. Our teams expertise, coupled with
state-of-the-art technologies, enables us to provide an accurate and targeted diagnosis
of complex fetal anomalies. This helps families and referring physicians determine the
most appropriate course of care. Diagnostic tests may include a fetal ultrasound, fetal
magnetic resonance (MR) imaging or fetal echocardiogram (fetal echo). Pediatric Specialist Consultation After patients undergo diagnostic imaging, the family will meet with the
multidisciplinary clinical team to review findings, confirm the diagnosis and discuss
the impact this may have on the pregnancy and the babys life. AFCC Conference Each week, the AFCC holds a conference attended by more than 80 health care
professionals from the Harvard consortium of hospitals representing more than 20
disciplines, including obstetrics, neonatology, radiology, pediatric sub-specialties,
nursing and genetic counseling. Cases are presented to discuss their management,
treatment options and outcomes. Support Compassion is a guiding principle throughout the care process. We believe in honest
and open discussions about test findings and treatment options. Our clinical staff
includes nurse practitioners, a nurse and a genetic counselor that provide ongoing
education, support and communication to parents and referring providers through
pregnancy and after delivery. Our clinical social worker is available for confidential
supportive counseling and resource assistance, including providing information about
travel accommodations, arranging tours of the hospital and connecting parents to the
hospitals family-to-family network and Center for Families, a much-used resource at
Childrens. Contact Us For more information or to schedule an appointment,
visit www.childrenshospital.org/afcc and click on Request an
Appointment or call 617-355-3896. Advanced Fetal Care Center
Childrens Hospital Boston 300 Longwood Ave., Pavilion 2
Boston, MA 02115
1-866-FETALCARE
Fax: 617-730-0302 A dvAnced F etAl c Are c enter 617-355-3896 | www.childrenshospital.org/afcc f_afcc_1107 Surgery and Interventions Fetal intervention may be recommended prior to delivery when a specialist believes
that it is in the best interest of a fetuss survival or it may improve long term outcomes.
If there is a need for a fetal intervention, the AFCC team will discuss options with the
parents, including risks and long-term outcomes based on our experience and the most
current data. All necessary services are centrally coordinated by our team. New
treatments and supportive care through the AFCC are improving the quality of life for
this special group of newborns through their first years and throughout childhood. Interventions performed by the AFCC include:
Laser separation for twin-twin transfusion syndrome Fetal cardiac intervention procedures EXIT (Ex utero intrapartum treatment) delivery for airway obstruction or complex congenital diaphragmatic hernia (CDH) Vesico-amniotic shunts for bladder outlet obstruction After Delivery Many of our patients at the AFCC deliver their babies at two of Americas top ranked
hospitals, Brigham and Womens Hospital or Beth Israel Deaconess Medical Center.
Both are located contiguously to Childrens Hospital Boston and are teaching affiliates
of Harvard Medical School. Many patients deliver and continue care in their local
community hospital with follow up from an AFCC specialist after birth. Research and Publications In addition to the study of advances in clinical care, our staff members are conducting
basic research to examine and understand the cellular origins of fetal anomalies. The
goal is to continue to find ways to detect and treat fetal disorders as early as possible,
often through minimally invasive surgical techniques. Researchers are also studying
the disease processes of various fetal anomalies in utero and developing intervention
strategies with cellular, biological and/or genetic solutions. AFCC-affiliated staff have published numerous textbook chapters and articles in
peer-reviewed medical journals. Our specialists are regularly invited to give lectures
and presentations nationally and internationally about advances in research and
clinical care at the AFCC. Our team is recognized for their leadership in general fetal
surgery, anesthesiology and diagnosis of fetal abnormalities. Conditions Treated Our team treats a wide range of conditions, including: Airway obstruction Bladder exstrophy Cervical teratoma Cleft lip and palate Cloacal anomalies Congenital brain anomalies Congenital cystic adenomatoid malformation (CCAM) Congenital diaphragmatic hernia (CDH) Congenital heart defects Congenital high airway obstruction (CHAOS) Congenital orthopedic anomalies Conjoined twins Fetal tumors/masses Gastroschisis Hydrocephalus/ventriculomegaly Hydronephrosis Intestinal obstruction/atresia Kidney, bladder and genital abnormalities Limb deficiencies Lymphatic malformations (cystic hygroma) Myelomeningocele (spina bifida) Obstructive uropathies (hydronephrosis) Omphalocele Pleural effusion (hydrothorax) Posterior urethral valves Pulmonary sequestration Sacrococcygeal teratoma Skeletal dysplasias Twin reversed arterial perfusion (TRAP) Twin-twin transfusion syndrome (TTTS) Vascular malformations and hemangiomas AFCC Clinical Leadership Alan B. Retik, MD, FAAP, FACS Executive Director of the AFCC, Surgeon-in-Chief, Urologist-in-Chief Russell W. Jennings, MD Program Director of the AFCC, Fetal and Pediatric Surgeon For a complete list of our multidisciplinary clinical staff, visit www.childrenshospital.org/afcc and click on Meet the Team.