Fetal Care Center at Connecticut Children’s

The Fetal Care Center at Connecticut Children’s provides comprehensive prenatal diagnosis and the full spectrum of fetal surgical interventions for the most complex fetal anomalies. 

Call: 860.545.9830 Request an Appointment

Every baby is unique, and every baby with a fetal anomaly requires a comprehensive approach to evaluation and treatment. Many conditions are best treated after delivery in a freestanding children’s hospital, like Connecticut Children’s. Other conditions may benefit from prenatal intervention, either in the form of open fetal surgery, fetoscopic surgery, or ultrasound guided fetal intervention. Other conditions may require a specialized delivery plan to treat the baby just prior to delivery, in order to ensure a safe transition to postnatal life. A comprehensive prenatal evaluation — using integrated imaging by ultrasound, fetal MRI and fetal echocardiography — is necessary to determine which approach may be best for your baby.

Our specialists are experts in diagnosing, treating and caring for moms and babies with a broad range of fetal abnormalities, including:

• Twin-twin transfusion syndrome (TTTS)
• Myelomeningocele (MMC)
• Congenital diaphragmatic hernia (CDH)
• Congenital pulmonary airway malformation (CPAM)
• Bladder outlet obstruction (BOO)
• Fetal renal (kidney) failure
• Hydronephrosis
• Sacrococcygeal teratoma (SCT)
• Twin reversed arterial perfusion (TRAP) sequence
• Amniotic band sequence (ABS)

Meet Dr. Crombleholme

The Fetal Care Center at Connecticut Children’s is led by Timothy M. Crombleholme, MD, one of the world’s most experienced fetal surgeons. Dr. Crombleholme is a pioneer in fetal surgery with over 35 years experience in fetoscopic surgery, open fetal surgery, image-guided fetal intervention, and EXIT procedures. He is a nationally recognized authority in the treatment of congenital diaphragmatic hernia (CDH), myelomeningocele (MMC), twin-twin transfusion syndrome (TTTS), congenital pulmonary airway malformation (CPAM) and sacrococcygeal teratoma, among many others.

Dr. Crombleholme received his medical degree from Tufts University School of Medicine and completed his surgical residency and fetal surgery fellowship at the University of California San Francisco (UCSF). At UCSF, Dr. Cromblehome trained under Michael R. Harrison, MD, known as the father of fetal surgery.

As a testament to his passion and expertise, Dr. Crombleholme has not only helped establish some of the top fetal care centers in the country but has co-authored more than 300 peer-reviewed articles, book chapters and co-authored the textbook Fetology: Diagnosis and Management of the Fetal Patient, which is widely considered the gold standard in the field. He leads an active clinical research program focused on innovative treatments for CDH, MMC, TTTS and fetal growth restriction as well as a research laboratory focused on placental gene therapy to correct fetal growth restriction.

Our Approach to Care

Every baby is unique, and every expectant mother with a high-risk pregnancy needs and deserves comprehensive evaluation and treatment from a nurturing and supportive team of experts.

We take a multidisciplinary approach to caring for moms and their babies. That includes experts in fetal surgery, cardiology, cardiac surgery, fetal imaging, genetics, neonatology, nephrology, neurology, neurosurgery, otolaryngology, surgery, and urology.

Through our Pediatric Care Alliance with Hartford HealthCare, you’ll have access to maternal-fetal medicine specialists and obstetricians — and confidence knowing all your providers are coordinating your care.

The center also has specialized, integrated teams to expertly treat fetal conditions, such as congenital diaphragmatic hernia and fetal renal failure.

What to Expect

During your first visit, you will be scheduled for a single day, comprehensive diagnostic evaluation including ultrasound, fetal echocardiogram and fetal MRI imaging. At the end of your comprehensive single-day evaluation, our team will develop your personalized care plan — identifying your and your baby’s unique needs — and present a detailed management plan for you and your baby for the rest of the pregnancy, delivery management and postnatal care.

We respect the relationship you have with your Obstetrician and Maternal Fetal Medicine Specialist. We keep them fully informed of our findings and proposed plan of care, plus we continually update them as your pregnancy progresses. We will provide you with ongoing support and education regarding your baby’s diagnosis as the pregnancy develops. Our talented group specialists will meet with you as often as needed to discuss your individual care. We are committed to providing all the resources available for you and your baby, and informing you of available research protocols and therapeutic innovations in fetal care to achieve the best possible outcome.

Learn more about our treatments and services »

What is Fetal Surgery?

Fetal surgery is a group of complex interventions and surgical techniques used to treat and repair birth defects while a baby is in utero. Approximately 3 percent of babies in the U.S. are born with a birth defect. Most of these conditions are best treated after birth, but some birth defects can compromise a baby’s chances of survival. Advances in fetal imaging, prenatal testing and surgical techniques have afforded physicians the opportunity to intervene before birth to improve the outcome of many fetal conditions.

There are multiple types of fetal surgery:

• Ultrasound guided fetal intervention: Under ultrasound guidance, needles can be introduced into the fetus to perform procedures, including intrauterine blood transfusion, interstitial laser photocoagulation, radiofrequency ablation and ultrasound guided placement of shunts (small catheters), which can be used to drain fluid collections in the chest or bladder. 
• Fetoscopic Surgery: This surgery is performed through a 4 millimeter incision in the mother’s abdomen and utilizes fetoscopes (small cameras) and surgical instruments to treat abnormalities in the fetus, including twin-twin transfusion syndrome, myelomeningocele, amniotic band sequence and chorioangioma.
• Open Fetal Surgery: Fetal surgeons make an incision in the mother’s abdomen to expose the uterus during the middle of pregnancy and operate on the fetus for conditions such as myelomeningocele and mediastinal and pericardial teratoma.
• Ex-utero Intrapartum Therapy (EXIT) Procedure: A means of delivering the baby in order to operate while on placental support, the surgeons make an incision in the mother’s abdomen and open the uterus to operate on the fetus prior to delivery.

Location

The Fetal Care Center is part of Connecticut Children’s Main Campus in Hartford. We’re located on Floor 2, Suite F of the Medical Center (282 Washington Street, Hartford).

The state-of-the-art facility allows us to complete all appointments, diagnostic testing and medical procedures under one roof.