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ABOUT YOUR VISIT
Patients come to Texas Children’s Fetal Center from across the
nation and around the world for evaluation, diagnosis and treatment
of fetal abnormalities.
Being far from home and family can make
receiving medical treatment even more challenging. That's why every family that comes to the center
for specialty treatment is paired with a nurse coordinator – a
registered nurse highly trained in the needs of patients with fetal
anomalies. The coordinator is available to patients and their
families from the time of arrival until treatment is complete. This
service not only helps to guarantee patients and families a direct
link to a source of medical information, insight and explanation,
but also provides the family with a familiar face and a source of
support during treatment visits.
If your
physician finds a fetal abnormality, he or she can contact
the Fetal Center at
832-822-BABY (2229)
or toll-free 1-877-FetalRX (338-2579)
to begin the process. Once we obtain your ultrasound, prenatal records
and any additional medical information, we will determine if
you meet the criteria for evaluation and or fetal
intervention. Once you arrive at the Fetal Center, you will be evaluated
to determine if you are a candidate for fetal therapy.
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No.
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Most insurance companies cover second-opinion evaluations. Our staff
will help you obtain necessary authorizations. If the doctor
recommends fetal therapy, our staff will contact your insurance
provider regarding coverage.
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It
is difficult to fully evaluate a patient without being seen directly in clinic, we will however make
every effort for the best outcome for both you
and your pregnancy.
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Yes. Most
candidates for fetal therapy require an amniocentesis,
fetal
echocardiogram and
fetal MRI to rule out other structural or chromosomal abnormalities.
If an additional defect is found during your evaluation, you may not
be a candidate for intervention.
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Drs. Johnson & Moise
14th Floor
Baylor Clinic
6620
Main St.
Houston, Texas 77030 |
Drs. Cass and Olutoye
8th
floor,
Clinical Care Center
6621 Fannin Street
Houston, Texas 77030 |
Other helpful information:
Texas Children's Hospital map
St. Luke's Episcopal Hospital map
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Texas Children's Guest Services can help. Simply call Yvonne
Mills at 832-824-1733 from 7 a.m. to 3 p.m. Monday-Friday,
or Diana Vasquez at 832-824-6471 from noon to 8 p.m.
Monday-Friday for information.
You can also download the following information:
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Before surgery, you will not be allowed to eat or drink for a
defined amount of time (usually six to eight hours). This is to prevent the
risk of vomiting during surgery. In medical terms, this is known as
"NPO" (nothing by mouth). We will give you a time to arrive to St.
Luke’s’ Episcopal Hospital, Labor & Delivery, located on the third
floor. Your family may come with you and wait for you in one of our
labor rooms or recovery room while you are being prepped for
surgery. An intravenous line (IV) will be inserted by needle stick
to give fluids and medications during surgery. In most cases, this
will be the only needle stick that is needed.
Preparation for surgery usually takes between 30 to 90 minutes.
After you are prepared for surgery, your spouse or significant
other may join you until you are taken to the operating room. An
ultrasound will be done before going to the operating room to
confirm the baby’s heartbeat. One of the specially trained nurses
that will be assisting in surgery and the nurse anesthetist will
accompany you to surgery.
We recommend that you only bring one or two close family members
or support people with you. Those you bring are here to support you
through the process, and should not add to your concerns. You may
want to arrange for care of other family member such as small
children at home in order to allow you to focus on yourself and your
baby.
Remember, this is your time. You are also welcome to call any
spiritual advisors or clergy members to be with you during this
process. You may wish to have a support network at home ready to
assist you when you leave the hospital.
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When you arrive in the operating room you will be moved to the
operating table. You will be covered with a warm blanket and a
pillow will be placed under your knees to keep you comfortable
during surgery. Medication will be given through your IV tubing to
relax you. Surgery is performed under local anesthesia, meaning you
are awake but relaxed and your abdomen is numbed where the
instrument is inserted. An anesthetist stays with you throughout the
procedure. You will be given additional medication as needed.
Occasionally, general anesthesia, meaning you are put to sleep, may
be used. During surgery, one or two small incisions, approximately
1/10 inch long, are made on the abdomen. The incision(s) are small
and will generally only require steri-stips for closure. In most
cases, surgery lasts one to two hours, but this can vary depending
on a number of factors
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All surgery comes with risk. For pregnant women, there are risks for
both the mother and the fetus. We hope that you will talk about
these risks with your physician carefully. The specialists at Texas
Children’s and St Luke’s Episcopal Hospitals will review these risks
with you before your surgery, but talking with your home doctor
first is important.
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Inability to perform the procedure due to intra-amniotic
bleeding or technical complications. For example, it is possible
that the amniotic fluid could be blood tinged from previous
procedures and not allow an adequate visualization. This means
that we may be unable to treat your baby.
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Cerebral palsy or other forms of brain damage to the fetus. This
complication may be present before surgery, after surgery or
develop after birth.
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Pre-term
labor, amniotic fluid leakage, gross premature rupture of
membranes, or detached membranes (the membranes are detached
from the uterus.) If any of these complications occur, you may
need to remain in the hospital.
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Infection of the amniotic cavity may also occur in this setting
and lead to these complications. If infection is diagnosed, you
need to be delivered to prevent you from having further
complications.
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A
significant drop in the heart beat of the baby. If this should
occur, and the fetus is viable (of an adequate age and condition
to live outside the uterus), an emergency cesarean section could
be performed.
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Physical injury to you or the fetus.
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Bleeding from the uterine wall may occur. If it does, it may
prevent the doctors from completing the surgery. There can be
bleeding after removal of the trocar. This is usually controlled
by placing external pressure on the surgical site. Occasionally,
however, it may be necessary to perform a skin incision and
place a suture on the wall of the uterus.
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Placental abruption (separation of the
placenta from the uterus). This is a rare but serious
complication. If an abruption does occur, the babies would have
to be delivered by an incision into your uterus.
Need for blood transfusion.
Bleeding of significant magnitude may require a blood
transfusion (giving you blood). Bleeding may be of such
magnitude that it may be necessary to remove the uterus
(hysterectomy). This would not allow you to have any further
children. Severe bleeding may result in damage to many of your
organs, brain damage or even death.
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Following surgery, you will be taken to the recovery room in Labor &
Delivery or a labor room where you will be closely monitored. Your
abdomen will be a little tender or sore. Medication may be given
after surgery to relax the uterus and stop any contractions. Pain or
discomfort after surgery is usually minimal. If needed, pain relief
medicine is available. Your husband or other support person may
remain with you in your room. There is a sleeper sofa for his/her
comfort. Following surgery, you may have food as tolerated. That
night, activity is restricted to bathroom privileges only, but this
depends upon your specific condition. You will undergo an ultrasound
the day after surgery to determine how the baby is doing.
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You will then be discharged home to the care of your primary or
referring obstetrician. Your instructions will include bed rest with
bathroom privileges for seven days after the surgery, with gradual
increase in activity. We also ask that you get a thermometer and
take you temperature three times per day and to notify your primary
obstetrician for any increase above 100.2 F. After four weeks you can
resume normal activity based on your pregnancy condition and the
comfort level of your primary/referring obstetrician. Weekly
ultrasounds are recommended for the next month. After that time, if
all is going well, ultrasounds are performed as directed by your
doctor.Although you are returning home, we
will continue to follow your pregnancy closely. Please make arrangements
with your doctor to forward all of your ultrasound reports and any
other pertinent information to us. We will also give you information
to give to your obstetrician and labor nurse. This will request that
they send your placenta sent back to us after you deliver. The
specialists here would like to examine the placenta to gain further
knowledge that will help in the future treatment of patients with
the same condition.
Social services and pastoral care are
available for all our patients and their families. If you would like
to see them at any time, you need only to request it and they can be
contacted. We are sensitive to the psychological, social and
spiritual needs of the family. We will provide any support that is
necessary. Please contact us if you have any questions, concerns or
special requests. For our out of town patients, we realize that
traveling may be difficult or stressful and want you to know that we
will do everything we can to accommodate your special needs and
schedule.
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