Significant 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.

There are 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 diaphragmatic hernia.

Our ongoing 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 families.