Advanced Fetal Care Center (AFCC)
Surgery and interventions
Surgery or other intervention becomes an option when doctors predict that the fetus will not live long enough to make it to delivery or live long after birth. New treatments and supportive care through the AFCC are improving the quality of life for this special group of newborns through their first years and throughout childhood.
If there is a need for a fetal intervention, the AFCC team will discuss options with you, including risks and long-term outcomes based on our experience and the most current data. All necessary services are centrally coordinated by the AFCC team.
Interventions performed by the AFCC include:
Fetoscopic surgery, which uses minimally invasive techniques to correct congenital malformations without the need to remove the fetus from the womb.
Fetal cardiac interventional procedures, using a needle or catheter to treat certain fetal cardiac abnormalities. Tiny balloon catheters can be inflated to open abnormal heart valves or other obstructions. Boston Children's Hospital is the only hospital to date successfully performing these procedures. Read more about fetal cardiac interventions.
EXIT (Ex utero intrapartum treatment) conducted at the time of the delivery, often for a congenital defect that blocks the airway. The baby is partially delivered through Cesarean section and remains on placental support (still attached to the umbilical cord), giving surgeons time to treat the obstruction and secure the baby's airway so that by the time the cord is cut, the baby can breathe independently.
EXIT to ECMO (extra corporeal membranous oxygenation), where, following an EXIT procedure, a baby is temporarily placed on a heart/lung bypass machine that circulates oxygenated blood through the body. Surgeons are then able to complete the delivery and repair the abnormality while giving the baby's lungs and heart time to develop and heal.
- Additional surgery, performed as needed once the newborn is stabilized.