Hailee Nail learned that her baby had spina bifida on August 13, 2020, when she saw her obstetrician in Tulsa, Oklahoma, for her 20-week anatomy scan.
She arrived at The Fetal Center* at Children’s Memorial Hermann Hospital two weeks later, just as a clinical trial of fetoscopic repair using the NEOX Cord 1K patch opened at McGovern Medical School at UTHealth Houston.
Nail became the first mother enrolled in the first trial in the world of fetoscopic repair using cryopreserved human umbilical cord as a meningeal patch in an FDA-approved study. In December 2020, she delivered a healthy baby girl with good leg movement and a back that looked normal.
Nail is also one of more than 5,300 patients from 39 states that have been evaluated over the past 10 years at The Fetal Center, a national referral center established in 2011 and an international leader in fetal diagnosis, fetal intervention, and comprehensive fetal care for infants with congenital anomalies or genetic abnormalities.
The affiliated UTHealth Houston physician team collaborates with 65 centers worldwide to improve care through patient education and research. Resources at Children’s Memorial Hermann Hospital include a Level IV Neonatal Intensive Care Unit and Level IV Maternal Designation, a Level I Children’s Surgery Program verified by the American College of Surgeons, and the only hospital in Greater Houston providing neonatal and maternal critical care in the same facility, including obstetrical trauma care.
Physicians affiliated with The Fetal Center were the first in Texas and among the first in the nation to perform open fetal surgery for the repair of myelomeningocele, the most severe form of spina bifida, following the results of a landmark clinical trial, Management of Myelomeningocele Study (MOMS), published in 2011.
"Overall, our outcomes data are better than or mirror those reported in the MOMS trial, and the percentage of patients who delivered past 37 weeks is almost double the number reported in the trial," says KuoJen Tsao, MD, The Children’s Fund, Inc. Distinguished Professor in Pediatric Surgery, professor and chief of the Division of Pediatric General and Thoracic Surgery at McGovern Medical School, and co-director of The Fetal Center. "Our program is comprehensive, from prenatal care through delivery and postnatal care, and we are one of a very few centers that can care for critically ill moms and babies under the same roof."
The Fetal Center is also home to the International Congenital Diaphragmatic Hernia (CDH) Registry and Long-Term Follow-Up Program. Through its affiliation with UTHealth Houston, the Center offers fetoscopic endoluminal tracheal occlusion (FETO) for the prenatal treatment of CDH through participation in the Tracheal Occlusion To Accelerate Lung Growth (TOTAL) trial, the results of which were recently published in the New England Journal of Medicine.
"As one of only 10 U.S. fetal centers granted FDA and institutional approval to offer FETO intervention, and as the only fetal center in the U.S. to participate in both arms of the TOTAL trial, our multidisciplinary team is actively engaged and dedicated to improving outcomes for all patients with CDH — mild, moderate, or severe," says Anthony Johnson, DO, professor of obstetrics, gynecology, and reproductive sciences at McGovern Medical School and co-director of The Fetal Center. "We don’t stop with the fetal side. As a children’s hospital inside an adult acute care hospital — a new model for delivering care — we’re able to serve our patients from before birth to old age."
McGovern Medical School at UTHealth Houston is one of nine U.S. participants in the Renal Anhydramnios Fetal Therapy (RAFT) Trial, funded by the National Institutes of Health. Renal anomalies are a major interest of Rodrigo Ruano, MD, PhD, professor of obstetrics, gynecology, and reproductive sciences at McGovern Medical School and co-director of The Fetal Center.
Dr. Ruano envisions an increasingly bright future for moms and babies.
"We can expect advancements in minimally invasive procedures for severe congenital anomalies, with reduced risk of rupture of membranes, a complication of fetal surgery and preterm deliveries," Dr. Ruano says. "We’ll also see more accurate prenatal diagnosis with new technologies. One great benefit for patients is our access to pediatric subspecialty physicians who are faculty at McGovern Medical School. It’s amazing to be part of such a great multidisciplinary team."
To learn more about The Fetal Center as it celebrates its 10th anniversary, visit memorialhermann.org/fetal.
*Located within the Texas Medical Center, The Fetal Center is affiliated with McGovern Medical School at UTHealth Houston, UT Physicians, and Children’s Memorial Hermann Hospital.