From The Orange County Register, June 14, 2021
By Theresa Walker
The Fetal Care Center of Southern California, based at CHOC Children’s Hospital in Orange, is set to open its doors on Wednesday, June 16, offering expectant moms whose babies will be born with birth defects the kind of comprehensive care in one place, and during a single visit, that is hard to find in the region.
The outpatient center is a partnership between UCI Health and CHOC, located in calming office space on the sixth floor of CHOC’s Commerce Tower building on Main Street in Orange, across from the hospital. There, a coordinated team of specialists working in tandem with a patient’s obstetrician, can oversee care from diagnosis in the womb to treatment after birth.
Such services are available at other hospitals in varying degrees or through individual providers. The CHOC/UCI center is designed to ease the strain and stress on parents who learn that their unborn child is facing a congenital condition. By having all-in-one care, all in one place from any specialists they’ll need to see, the need for an expectant mom to make multiple appointments on different days is eliminated.
“Many providers individually try to tackle these problems,” said Dr. Peter Yu, a CHOC pediatric surgeon who is the medical director for the Fetal Care Center of Southern California. “But we come to the patient, accommodate their schedule, give them all the imaging they need and the counseling they need.
The types of birth anomalies the specialists at the center can help treat include congenital heart defects, diaphragmatic hernias, bladders that develop outside the fetus, gastroesophageal reflux, hydrocephalus and spina bifida. And those specialists, on staff at CHOC and UCI Health, are experts in cardiology, genetics, neonatology, neurology, orthopaedic surgery, plastic surgery, urology and other fields.
Whatever is needed, the center’s administrators say.
The services will include consultation, education and counseling, fetal diagnostics, pre-natal interventions and treatment planning, and, for some babies, immediate post-natal surgery or an operation at some point later in their first year of life.
According to Yu and other specialists at the center, the only other maternal-fetal medicine outpatient center with that kind of reach is at UC San Francisco, one of the longest operating fetal centers in the nation.
Preparation and planning
There are roughly 50,000 births a year in Orange County, Yu said. From 1% to 3% of all babies will be affected by a serious birth defect.
While most of its patients are expected to be from Orange County, the center anticipates it also will serve expectant moms from the surrounding area. The office suite includes rooms for imaging, a consultation room large enough for the patient and the entire care team, areas for the patients to relax and workstations for the doctors.
CHOC’s neonatal intensive care unit is nearby, a place where Yu estimates half of the newborns under the care of specialists at the center will end up. There’s also the NICU a couple miles away in Orange at UCI Medical Center. CHOC and UCI operate the county’s only Level III neonatal intensive care units.
And perhaps 80% of the babies undergoing pre-natal care at the center will need some kind of surgery as newborns or in infancy, Yu said.
A full slate of patients – a half-dozen expectant moms – is expected when the doors open on Wednesday. Because they will be seeing multiple providers and perhaps need additional radiology, each patient visit will likely take a good part of their day to complete. Time is also built in to give the parents a break in what can be an emotionally intensive day.
“To get a potentially devastating diagnosis turns these families’ lives upside down,” said Dr. Kushal Bhakta, a neonatologist who is medical director of CHOC’s Small Baby Unit. Bhakta was in the Fetal Care Center of Southern California office on a recent day, along with Yu and pediatric cardiologist Dr. Nita Doshi, during one of multiple media tours prior to the opening.
Ultrasound imaging technology is so advanced these days, birth defects can be detected as early as 16 weeks into the pregnancy.
It is essential for parents to have an informed grasp of what is happening with the fetus and be prepared for the treatment needed before and after birth, Doshi said: “That’s really what drives the best outcome for that baby’s life.”
One call for all
The task of scheduling all the appointments and pulling together the team of specialists for each patient falls to Amy Cuevas, a registered nurse who is the maternal-fetal program coordinator for the center.
“The Bat Phone goes directly to her,” Bhakta said. “She’s the one that makes the magic happen.”
Cuevas was hired away about a year ago from a similar job at the University of Chicago. She has been working virtually until now, with about 70 patients under her management, doing many of the same care-coordinating tasks that will continue when the center physically opens.
Cuevas and a recently hired second nurse will handle all calls with patients, their obstetricians and the center’s specialists in arranging appointments and scheduling radiology if needed. Cuevas said that single point of contact has surprised some physicians.
“I’ve had so many providers say, ‘So I just have to call you?’”