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advances in prenatal diagnosis and management combined with advances in
neonatal intensive care have led to improved survival in conditions with
previously high mortality. Because of this, we are now recognize the coexisting
morbidities associated with these congenital disorders as well as determine the
long term effects of interventions and prolong hospitalization. The purpose of
this endeavor is to follow our patients long term to identify developmental issues
associated with care, determine previously unknown risks to mothers for future
pregnancies, and institute changes in the perinatal period that might improve
these outcomes. This is further facilitated by our partnerships with various
divisions to provide long term follow-up in areas such as neurodevelopment.
A great deal
of prenatal and perinatal management is based on diagnosis and evaluation of
disorders by imaging. While this is indeed helpful, this type of diagnosis does
little to describe the pathophysiology of the disease process. In this project,
we are investigating the biomarkers within the serum, cord blood, and amniotic
fluid that can be used to provide insight into underlying mechanisms that may
be used to enhance diagnosis, monitoring, and treatment options in the future.
several conditions with historically high mortality that now have improved
survival due in part to the use of fetal interventions. Minimally invasive
procedures have the benefit of intervention with fewer risks. Through our large
collective experience, we are continually developing innovation and improving
current techniques leading to an increase in the indications for use. Future national
and international multicenter collaborations and trials hope to bring minimally
invasive fetoscopy to the treatment of myelomeningocele and congenital
prospective database collects data on evaluated patients that allow us to
analyze continuously to create parameters and indices that are used to counsel
and manage patients. Correlations to perinatal outcomes can be made using the
data collected and thereby, improve how accurately we are able to inform
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