As many as 3 percent of all pregnancies result in the birth of a baby with chromosomal anomalies like Down syndrome or structural anomalies such as congenital heart disease.
Expectant mothers whose sonogram or other screening test turns up an abnormality are often referred for specialized prenatal assessment and care. The Center for Prenatal Pediatrics at Morgan Stanley Children's Hospital of NewYork-Presbyterian is the only comprehensive program in the New York metropolitan area, providing a seamless progression of specialized care for complex, high-risk pregnancies from diagnosis to birth and beyond.
"Our comprehensive prenatal program offers expectant mothers one of the nation's largest teams of physicians specialized in detecting and treating the most complex, highest-risk conditions. This gives parents the peace of mind that everything possible will be done to optimize the health of their baby," says Dr. Lynn L. Simpson, medical director of The Center for Prenatal Pediatrics at Morgan Stanley Children's Hospital of NewYork-Presbyterian and director of ultrasound at NewYork-Presbyterian Hospital/Columbia University Medical Center. She is associate professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons.
"We offer mothers the latest screening and diagnostic tests - including some that were developed and validated at our Hospital - to determine the baby's specific condition and initiate appropriate monitoring and treatment, before, during, and after birth," continues Dr. Simpson.
NewYork-Presbyterian/Columbia led the 15-center FASTER trial (First and Second Trimester Evaluation of Risk), which, in 2005, demonstrated the high accuracy of non-invasive maternal serum and ultrasound screening for Down syndrome in the first trimester of pregnancy. This approach is now being implemented nationally as an alternative to traditional second-trimester screening.
Other diagnostic procedures offered at The Center for Prenatal Pediatrics include amniocentesis; chorionic villus sampling (CVS); testing for inborn errors of metabolism and rare genetic diseases; and percutaneous umbilical cord sampling (PUBS). In addition, specialized therapeutic interventions such as the placement of in utero shunts, intrauterine fetal transfusions and radiofrequency ablation can be done at the Center.
The Center's family-oriented and coordinated approach helps prepare parents for the birth of an affected child. A plan of care is developed for the remainder of the pregnancy and for the delivery, including monitoring any necessary or anticipated medical and surgical care for the unborn baby. Management in the immediate newborn period is also coordinated between the maternal fetal medicine specialists, neonatologists, pediatric subspecialists and pediatric surgeons, making the transition to life outside the womb occur as smoothly as possible. Genetic counseling and psychological counseling are available to women and their families as needed.
"We offer established routine and complex pediatric surgical procedures - both in utero and neonatal," says Dr. Charles Stolar, chief of pediatric surgery at Morgan Stanley Children's Hospital of NewYork-Presbyterian and the Rudolph N. Schullinger Professor of Surgery and Pediatrics at Columbia University College of Physicians and Surgeons. Dr. Stolar serves on the board of directors of The Center for Prenatal Pediatrics.