Oregon Health & Science University expands fetal care program

Pacific Northwest families can now receive advanced prenatal surgical intervention close to home

special editorial submitted by hope steward partner, OHSU Doernbecher Fetal Therapy Program

Oregon Health & Science University (OHSU) has expanded its fetal program to become one of the most comprehensive fetal care centers in the Pacific Northwest. Starting with twin-twin transfusion syndrome (TTTS) laser surgery, the expansion makes OHSU’s Fetal Therapy Program one of only five programs nationally to provide medical and surgical interventions for high-risk pregnancies and neonates all under one roof. With this growth, families from Oregon and neighboring states can soon receive critical care at a dedicated center, close to home.

Integrated care, one location

In collaboration with OHSU’s Center for Women’s Health, the fetal care program provides services through OHSU Doernbecher Children’s Hospital. Doernbecher is nationally recognized by U.S. News and World Report as a top-ranked children’s hospital in five pediatric specialties, including newborn care. It consistently ranks as Oregon’s top children’s hospital year over year, and is home to the region’s largest team specializing in complex fetal conditions.

By providing the full-spectrum of care in one location, patients have access to a complete array of hospital services – such as genetic counseling, imaging, surgery, and neonatal care – without the complications of communicating between providers or traveling to different clinics or hospitals. This integrated model simplifies logistics, eliminates the need for emergency transport, and allows pregnant patients to deliver and recover onsite while babies receive care.

An experienced team

The unmatched team at OHSU includes maternal fetal medicine specialists, pediatric cardiologists, radiologists, neonatologists, pediatric subspecialists, and fetal surgeons, resulting in unparalleled care. Together, these providers have historically seen approximately 400 pregnant women per year, treating conditions such as abdominal wall defects, tumors and other masses, and cleft palates.

Two fetal surgeons bring their own unique specialties to the program, providing expertise to both patients – mother and fetus – simultaneously.

Andrew Chon, M.D., is a maternalfetal medicine specialist. He completed his fellowships in Maternal-Fetal Medicine and Fetal Surgery at the University of Southern California in Los Angeles. Dr. Chon specializes in multiple gestations, prevention of premature births, and minimally invasive procedures.

Raphael Sun, M.D., is a pediatric surgeon and an expert in prenatal anomalies. He completed his pediatric surgery fellowship at Texas Children’s Hospital in Houston and received training in fetal surgery at Texas Children’s Fetal Center.

Dr. Chon and Dr. Sun each serve as assistant professors in their respective disciplines, and have advanced training in fetal procedures such as neural tube defect repairs, congenital diaphragmatic hernia, and twintwin transfusion syndrome. After their fellowship trainings in highvolume centers, both surgeons came to grow the OHSU program and to answer the need for fetal surgery care in the region and beyond.

Their paths are complimentary. While specialists in either maternal-fetal medicine or pediatric surgery can pursue advanced training in fetal surgery, bringing in both perspectives is an asset to the OHSU program.

“We have all the right components, the right team,” says Dr. Sun, “It becomes a more comprehensive and complete treatment plan for the patient.”

Guided, centralized care

There are many moving parts to a fetal diagnosis, surgery, and recovery. Families in the fetal care program at OHSU can rely on a dedicated nurse coordinator to guide them through decisions, expectations, and procedures at each step of the process. Because of the different specialists involved in care, the fetal nurse coordinator is critical to ensuring providers meet patients’ needs in an organized and timely manner. Patients take comfort in knowing they always have someone to turn to with questions.

An initial visit may begin with a thorough review of records, a discussion of recommended diagnostic and genetic testing, and potential imaging studies such as ultrasound, echocardiography, and MRI. All patients meet with a maternal fetal medicine provider at every visit, Dr. Rachel Pilliod or Dr. Stephanie Dukhovny. In general, patients can expect all their initial tests and doctor visits to occur in one day. They also have the option of meeting with a dedicated genetic counselor and social worker. After a review of findings, the team determines an individualized care plan with the patient. The fetal nurse coordinator assists families with all aspects of this process, and provides compassionate care through the fetal therapy journey and beyond.

“The expansion of OHSU’s fetal therapy program means that parents in Oregon and the Pacific Northwest will have access to the broadest, and most advanced, range of maternal and fetal care right in their backyards,” says Stephanie Dukhovny, M.D., associate professor of obstetrics and gynecology in the OHSU School of Medicine, board-certified Maternal Fetal Medicine/ Geneticist, and director of the Fetal Therapy Program.

Filling a void

The long-standing fetal therapy program at OHSU has consistently provided the most comprehensive care from Seattle to San Francisco for families with complex prenatal conditions. Doernbecher’s award-winning Level IV Neonatal Intensive Care Unit (NICU) has served babies since 1968. With the expansion of the team and conditions treated at OHSU, Oregonians and regional families can now get the highest level of fetal surgery interventions at a top-tier academic, research, and health care institution.

“I find the courage and strength of our patients to be inspiring,” says Rose Stockman, fetal nurse coordinator, “I enjoy educating families and preparing them for the next steps of their journey. Care coordination opens pathways of establishing trust, supporting choice and forming strong relationships.”

“The expansion of OHSU’s fetal therapy program means that parents in Oregon and the Pacific Northwest will have access to the broadest, and most advanced, range of maternal and fetal care right in their backyards,” says Stephanie Dukhovny, M.D., associate professor of obstetrics and gynecology in the OHSU School of Medicine, board-certified Maternal Fetal Medicine/Geneticist, and director of the Fetal Therapy Program. “This allows them to stay closer to home, and their local support systems, which are essential to both their physical and emotional well-being.”

The fetal care team at OHSU is here to provide the best genetic testing, imaging, counseling and treatment to families navigating a fetal condition. Learn more about fetal surgery and intervention at OHSU by visiting ohsu. edu/fetal-therapy.

about OHSU

Located in Portland, Oregon, OHSU Doernbecher’s Fetal Therapy Program is the only place in the Pacific Northwest where high-risk pregnant people and babies can stay together for the full spectrum of fetal care -- from diagnosis, to delivery, recovery, and beyond. OHSU Doernbecher Children’s Hospital is home to the state’s only Level IV NICU, and is nationally recognized as a top-ranked children’s hospital in 5 pediatric specialties.

Discover the Fetal Therapy Program at OHSU ohsu.edu/fetal-therapy