Maternal and Fetal Medicine Research at the Colorado Fetal Care Center

Maternal and fetal medicine advancements

We're known around the world for groundbreaking innovations in fetal care research that are revolutionizing the care and treatment of both mother and child in high-risk pregnancies. Some of our team's most significant advancements include:

Revolutionizing myelomeningocele (MMC) treatment and repair

Our fetal surgeons are advancing and innovating prenatal treatment and repair for fetuses with myelomeningocele. In our efforts to improve MMC patients' quality of life, reduce complications and obtain better outcomes, our researchers have made several significant contributions, innovating the way fetal surgeons approach MMC. These efforts include:

• Evaluated long-term flow patterns in the ductus arteriosus before, during and after fetal MMC repair to potentially reduce the incidence and/or severity of ductus arteriosus (DA) constriction and fetal cardiac dysfunction during open fetal surgery.
• In an effort to reduce the need for shunting, our fetal surgeons became the first in the world to use 3D printing to prefabricate MMC patches before surgery.
• Rony Marwan, MD, and his collaborator Daewon Park, PhD, bioengineered a minimally invasive alternative to open fetal surgery for spina bifida patients.

Improving outcomes for fetuses twin-to-twin (TTTS) transfusion syndrome

We are one of the country's highest volume fetal centers treating twin-twin transfusion syndrome. Our multidisciplinary team of maternal fetal medicine specialists, specialized physicians, fetal cardiologists and pediatric fetal surgeons collaborate to improve outcomes for laser photocoagulation, increase survival and decrease prematurity for babies with TTTS.

In an effort to guide future improvements in patient care, Michael Zaretsky, MD, collaborates with the North American Fetal Therapy Network (NAFTN) in managing a national registry of the complications and outcomes of monochorionic twin pregnancies.

Optimizing the health and delivery of babies with congenital heart disease (CHD)

Our work places us at the forefront of fetal cardiology and makes us leaders in caring for new lives. The Colorado Fetal Care Center team completed the first-ever Ex Utero Intrapartum Treatment (EXIT) to ventricular pacing procedure and continues to lead in innovative ways:

• We are pioneering new techniques in regenerative medicine, including engineering a heart patch made of an infant's own tissue to improve outcomes for babies with hypoplastic left heart syndrome (HLHS). Using amniotic fluid collected at delivery, our team aims to create beating heart cells that can be used for future surgical repairs.
• In the Heart Sounds at Home clinical trial, our researchers were the first to initiate fetal home doppler monitoring in the detection of fetal heart block for positive anti-SSA mothers.
• Lisa Howley, MD, and Bettina Cuneo, MD, participated in a multicenter study aiming to increase parental education and improve transparency between clinical teams and parents. Using a series of questions developed by the Pediatric Congenital Heart Association (PCHA), we provide institution-specific answers for families regarding pediatric cardiac intervention outcomes, as well as short- and long-term expectations for neonates and infants with CHD.

Pioneering new technologies and treatments for babies with congenital diaphragmatic hernia (CDH)

Our Colorado Fetal Care Center is a national referral site for CDH, as the neonates with CDH who are discharged from our NICU have some of the best outcomes in the nation.

• Our fetal surgeons conducted a clinical trial to improve lung growth for fetuses with CDH using fetoscopic tracheal balloon occlusion (FETO). We consistently see improved outcomes for patients with severe left-sided CDH.
• In a multi-center study, our researchers standardized prenatal assessment of risk-stratification for fetuses with CDH.