Our long experience with prenatal diagnosis and planning for optimum care allows us to offer the highest quality treatment whether intervention is indicated before or after birth.
Under the direction of Dr. Michael Harrison, the Fetal Treatment Center was the first institution to develop fetal surgery techniques. The first open fetal surgery in the world was performed at UCSF since the early 1980's. We presently have more experience with fetal surgery and endoscopic fetal intervention (FETENDO fetal surgery) than any other institution in the world. We are dedicated to fetal anemia research and treatment innovation.
The fetus uses red blood cells to carry oxygen in its circulation, just the way children and adults do, and as a result, the fetus can also suffer from low blood counts or anemia. This problem may result because the red blood cells are not being produced or because they are being destroyed faster than they can be made.
Fetal thrombocytopenia is a low platelet count in the fetus. Platelets are tiny cell fragments that help in blood clotting. If the number of platelets is very low, then spontaneous bleeding can occur, particularly into the fetal brain, leading to a stroke. Maternal-fetal immune incompatibility, similar to what occurs with red blood cells described previously, is the most common cause for a dangerously low fetal platelet count.
If the anemia or thrombocytopeniais recognized early and treatment is started in a timely manner, then outcomes can be excellent. However, the procedures that are involved in managing these problems do carry some risk and, therefore, are best treated by experienced doctors at centers where they are regularly performed. The UCSF Fetal Treatment Center is one of those experienced centers, and we can also refer you to a qualified center that is in your local area.
The anemia is severe if there are signs of heart failure (hydrops) . If there is a risk of anemia but no signs of hydrops, then ultrasound, amniocentesis and testing of amniotic fluid may help determine the likelihood of a problem. To determine the risk of anemia, we measure the speed of blood flow in one of the fetal brain blood vessels (MCA-PSV).
This complicated fetal condition is best managed by experts, who perform the difficult procedures described above routinely, at a center where such cases are commonly treated. Cases of fetal anemia will require close monitoring of the pregnancy to allow transfusions to be carried out in a timely fashion.
The fetal platelet count must be close to normal to allow a vaginal delivery safely. It is important that babies that have had these problems in their pregnancy are delivered at a hospital that can provide expert neonatal care, as they may have short term complications from their anemia or low platelet counts and may require transfusions or other specialized treatments.
Baby Sarah Elizabeth has a very successful recovery from an SCT which is removed while she is still a fetus.