Children's National Health System

THROUGH ENHANCED FETAL imaging techniques, the Fetal Medicine Institute's team of specialists provides timely, accurate information about brain and heart abnormalities, including structural and functional problems, as well as developmental abnormalities, and partners with community physicians to ensure the safest possible start for every infant. FOCUSING ON THE FETAL BRAIN Using MRI (magnetic resonance imaging) and advanced techniques developed by the Fetal Medicine Institute's Advanced Pediatric Brain Imaging Research Laboratory—one of very few research facilities in the United States devoted to fetal brain research—the team identifies fetuses with an increased risk of brain injury. "Our team of engineers, physicians, and computer specialists has developed quantitative techniques that provide measurements of brain volume," says Adré J. du Plessis, MBChB, Chief of the Fetal Medicine Institute at Children's National. "In addition to MRI, we use MR spectroscopy to tell us more about the chemical constituents of the brain, and we combine what is derived from these studies with information about blood flow in the fetal brain and in the umbilical cord. This allows determination as to whether the brain is maturing appropriately." DIAGNOSING AND MANAGING CONGENITAL HEART DISEASE A fetal echocardiogram is indicated in situations when an expectant mother has an increased risk of carrying a baby with congenital heart disease. The most common risk factors include: + A family history of congenital heart disease + Specific maternal medical problems, such as diabetes or lupus + Fetal problems, such as an increased nuchal translucency in the first trimester + Concern for a genetic or chromosomal abnormality + Findings on an obstetric ultrasound suggesting a heart problem or other abnormality The Fetal Heart Program's Early Cardiac Imaging Program enables expecting parents to receive an overall diagnosis of congenital heart disease two months sooner than most programs. This early imaging is followed up with a comprehensive fetal heart scan to ensure diagnostic accuracy. "Having to wait until 20 weeks gestation for answers about whether there is a fetal heart defect causes a great deal of stress in pregnancy," says Mary T. Donofrio, MD, Director of the Fetal Heart Program, Medical Director of the Critical Care Delivery Service, Director of the Advanced The Fetal and Medicine Institute at Children's National Health System is one of the only programs in the nation that focuses on identifying abnormalities in both the fetal heart and brain. R E D E F I N I N G Fetal Care 10 FETAL MEDICINE BY TIFFANY PARNELL

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