What it means:
Our fetal imaging technologists, fetal radiologists and maternal fetal medicine doctors see thousands of images a year and focus only on prenatal (before birth) diagnoses. They have a trained eye that only experience can bring, which means you get the most accurate diagnosis.
Our twin-to-twin transfusion syndrome outcomes
Twin-to-twin transfusion syndrome (TTTS) is a serious and rare condition in identical twins who share a placenta. An imbalance in circulation of fluid and blood can create severe complications in twins. We treat the most severe and complex cases of TTTS that other fetal centers might not treat at all.
What we measure:
We track survival rates for one and both twins in TTTS pregnancies. A number of factors impact survival, including severity of the condition, when it was diagnosed, risk of prematurity and the presence of selective fetal growth restriction.
The following table shows our survival rates compared to the Solomon Group, an industry benchmark that we compare ourselves to. The Solomon Group was part of a clinical trial to establish expected outcomes for TTTS pregnancies that require selective fetoscopic laser photocoagulation, and advanced surgical treatment.
Twin-to-twin transfusion survival rates (Jan. 2012 to June 2020)
|
Solomon Group – 137 women, 274 fetuses Higher is better |
Colorado Fetal Care Center – 284 women, 568 fetuses Higher is better |
Overall survival |
74% |
79.9% |
At least one surviving neonate |
85% |
91.9% |
Double survival |
64% |
68% |
Neonatal survival |
91.6% |
94.5% |
What it means:
When compared to the Solomon Group, the Colorado Fetal Care Center has higher survival rates for one or both twins. We achieve these survival rates even though we treat the most severe cases of TTTS.
Our myelomeningocele outcomes
Myelomeningocele (MMC) is a serious form of spina bifida, a birth defect of the spine and spinal cord. MMC occurs when the baby’s spine, spinal cord and spinal canal don’t close properly. We often treat MMC with open fetal surgery, which can reduce the need for a shunt and improve movement for your baby.
What we measure:
We measure the shunt rate, which is how often a baby with MMC will need a shunt at some point to help drain excess spinal fluid from the brain. A shunt increases the chances for further complications in the future, so the lower the rate the better. We compare our shunt rate to a national study (MOMS).
We track the percentage of patients who have complete reversal or improvement of hindbrain herniation, which occurs when the brain stem is squeezed into the spine and causes injury. Our team also reports the percentage of patients who deliver in their home hospital and the total number of fetal surgeries.
Shunt rate (Jan. 2012 to June 2020)
Ventricle size |
MOMS shunt rate Lower is better |
Colorado Fetal Care Center shunt rate Lower is better |
<10mm |
20% |
15.4% |
10-15mm |
45% |
34.1% |
>15mm |
79% |
90% |
74%
Of patients saw reversal or improvement in hindbrain herniation
77%
Of patients with MMC delivered at their home hospital
What it means:
When compared to the outcomes of a national study on surgical repair of MMC, we had lower shunt rates for babies with ventricles smaller than 15 mm. This reduces the risk for future complications and means the baby doesn’t need a shunt placement operation.
A primary goal of prenatal surgery for MMC is to reverse hindbrain herniation, which can injure the spine. Two weeks after surgery, 74% of our patients saw complete reversal or improvement of hindbrain herniation, which is an outstanding rate of reversal and above the rate for other patients in the MOMS study.
Another goal of prenatal surgery for MMC is to get the unborn baby healthy enough so that mom can deliver at her home hospital. This cuts down on travel and stress and allows them to stay close to family during this special time. Finally, our total number of MMC surgeries shows our team’s experience in caring for MMC. Research shows that more experience leads to better outcomes for babies.
Our congenital diaphragmatic hernia outcomes
Congenital diaphragmatic hernia (CDH) is a birth defect that occurs when a baby’s diaphragm doesn’t form correctly creating an opening between the chest and abdominal cavities. This allows abdominal organs to enter the chest cavity and prevent lung development.
We treat CDH both before and after birth depending on what is best for each baby.
What we measure:
We measure overall volume of patients with CDH, survival rate and percentage of patients who deliver their babies at Children’s Colorado when clinically necessary.