Children's Hospital Colorado
Colorado Fetal Care Center
Colorado Fetal Care Center

Fetal Interventions and Procedures

Dr. Crombleholme operates with a team of surgeons.

For expectant mothers whose babies have been diagnosed with a fetal condition, the Colorado Fetal Care Center offers a variety of fetal interventions and procedures. Comprehensive and state-of-the-art interventions are performed in our dedicated fetal clinic to ensure expert care for mom and baby.

Over the last decade, our team has worked diligently to improve detection and treatment for fetal conditions and, as a result, the Colorado Fetal Care Center has grown exponentially. Now, our world-renowned physicians have even more support and resources that help them provide nationally recognized fetal care.

Fetal interventions offered at the Colorado Fetal Care Center

An Ex Utero Intrapartum Treatment (or EXIT procedure) is an operative intervention requiring general anesthesia for the mother. The anesthesia relaxes the uterus and passes through the placenta to the fetus. This intervention is utilized for operative procedures on the fetus. The baby will be delivered at the end of the EXIT procedure. The placental bypass during the fetal procedure allows for fetal stability during the operative phase for the fetal diagnosis. A neonatal resuscitation team is available for the delivery.

Fetoscopic tracheal occlusion is used to accelerate lung growth in babies with conditions like severe left congenital diaphragmatic hernia (CDH). Because the greatest risk to a baby with CDH is pulmonary hypoplasia or underdevelopment of the lungs, intervention before birth is necessary to accelerate both lung growth and pulmonary vascular development.

Tracheal occlusion with a detachable balloon is performed using a small fetoscope with attached camera. A fetal surgeon will maneuver the balloon into the fetus's mouth and down the trachea. After inserting the tracheal balloon fetoscopically, the lungs will be encouraged to grow and open fetal surgery will hopefully be avoided.

For more information

For questions about this procedure, call the Colorado Fetal Care Center at 855-412-3825.

A close-up of a doctor holding a scope used for fetoscopy.

A fetoscopy is a minimally invasive procedure where a scope is placed in a pregnant woman's uterus under ultrasound guidance. The scope allows specialists to gain visual access to the fetus, uterus, amniotic sac, etc. to determine conditions or rule out concerns. This procedure is conducted in the Fetal Intervention Room and is used for many different fetal conditions, including congenital diaphragmatic hernia (CDH), twin-to-twin transfusion syndrome (TTTS) and amniotic band syndrome.

An interstitial laser is a minimally invasive procedure performed under ultrasound guidance. This intervention is conducted in the Fetal Intervention Room and requires a maternal epidural and sedation. The scope provides visual access to the uterus and helps identify vessels to be ablated (closed). An overnight stay is expected to monitor the mother for contractions. Consistent follow up and ultrasounds are also employed after this procedure to ensure quick recovery.

Radio frequency ablation, or RFA, is a minimally invasive procedure where a needle is placed into the pregnant women's uterus under ultrasound guidance. The needle is used to coagulate vessels present in twin reversed arterial perfusion (TRAP sequence). During this procedure, the mother receives an epidural and IV sedation. An overnight stay in the hospital is expected to assess for contractions.

Shunt placement is a minimally invasive procedure using ultrasound guidance where a drainage shunt is placed into a fetal body cavity, such as the chest or bladder. After it is placed, a shunt will facilitate the removal of fluid so that normal fetal growth can occur. Shunts are often used to treat fetal conditions. Shunt placement may require local or epidural anesthesia, as well as an overnight stay to assess for contractions.