Midwest Fetal Care Center

ANW Innovation SummitSeptember 26, 2014

Presented by David Lynch-Salamon, MD

Our vision: More healthy babies

Our vision is to give more babies the best possible opportunity to achieve full health and life potential.

• Fetal Center aligns with Mother Baby’s vision−Destination of choice−Clinical excellence

• Strategic imperative−Solidifies Mother Baby’s position as regional leader−Keeps patients local while creating regional draw−Protects neonatal surgical market share

• Halo effect and downstream revenue−Increased referrals for non-surgical congenital

defects −Future care for neonates introduced here

Guiding principles

Midwest Fetal Care Center team

• Pediatric ENT• Pediatric surgeons• Pediatric

neurosurgeons• Pediatric urologists• Perinatal social

workers• Perinatologists• Radiologists• Sonographers

• Care coordinators• Ethicists• Geneticists• Neonatologists• Nurse specialists• Pediatric

cardiologists

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Treating the most rare and devastating complex conditions

Chest AbnormalitiesCongenital Diaphragmatic Hernia (CDH), Congenital Cystic Adenmatoid Malformation (CCAM), Bronchopulmonary Sequestrations, Pleural Effusions, Pulmonary Agenesis

Twin ProblemsTwin-to-Twin Transfusion Syndrome (TTTS), Twin-Reversed Arterial Perfusion Sequence (TRAP), Anomalies in Monochorionic Twins, Conjoined Twins

Fetal TumorsCervical Teratoma, Mediastinal Teratoma, Sacrococcygeal Teratoma, Lymphangioma, Neuroblastoma

Genitourinary ProblemsBladder Outlet Obstruction, Bladder Exstrophy, Bilateral Ureteral Obstruction, Cloaca, Cloaca Exstrophy

Neurologic Problems Myelomeningocele, Encephalocele

Congenital Heart DiseaseAortic Stenosis, Complete Heart Block, Hypoplastic Left Heart Syndrome (HLHS), Pulmonary Atresia with Intact Ventricular Septum

Amniotic Disorders Amniotic Band Syndrome

CONDITIONS TREATED AT FETAL CENTERS

Moving to the top nationally

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Expanding our reach:Higher volume, better outcomes

MMC = Myelomeningocele TTTS = Twin-Twin Transfusion Syndrome CCAM = Congenital Cystic Adenmatoid Malformation CDH = Congenital Diaphragmatic Hernia

Twin-to twin transfusion syndrome

• Smaller twin (donor) hypovolemic/oligo-hydramnios

• Larger twin (recipient) hypervolemic/poly-hydramnios

• Growth discrepancy may not be present in acute setting

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Video will play

Open fetal surgery: Current indications

• Myelomeningocele

• Chest masses (CCAM)

• Neck masses or possible airway compromise (EXIT)

• Sacrococcygeal teratoma

Ex-utero intrapartum treatment (EXIT)

Stapled hysterotomy

Partial delivery

Intubated while on placental bypass

Massive Cystic Hygroma:Prenatal diagnosis

• In 2013, the Midwest Fetal Care Center was accepted as a member of the North American Fetal Therapy Network (NAFTNet).*

• Stage is set for advanced center capabilities

National designation

*NAFTNet is an association of fetal centers with established expertise in fetal surgery and other forms of care for complex disorders of the fetus.

• 45 laser ablation cases to date• 416 new patients to Fetal Anomalies clinic

and Cardiology clinic• 149 perinatal social work consults this year• Referrals from WI, ND, SD, NE • Increased conference presence and

presentations

Highlights and momentum

Thank youQuestions and discussion