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In every thirty three babies is born with a birth defect January is birth defects awareness month I think a lot of people aren't maybe perhaps aware of that somebody who definitely is is doctor Scott ads like he's a surgeon in chief at the children's hospital of Philadelphia a quite a resume that doctor ads like has he's he's absolutely dedicated his life to this is an innovator in fetal medicine since the fields inception release of doc thanks so much for coming on with us my pleasure the babies each year are born with birth defects to put it in perspective also this is brick effects awareness month I'll get give you some key points first of all wanted thirty three babies is born with a birth defects other amazingly common the effects are costly billions of dollars required for medical treatment X. are merciless no parent should is immune the mysterious most because the birth defects are unknown they're over logged in my view the research is under funded and their birth defects are deadly the leading cause of infant mortality so in terms of stats each year in the US nearly a hundred and fifty thousand babies are born with birth defects many with conditions so rare most parents and even some clinicians have never heard of them and so too often these families are made aware of the treatments available in a place like our center for Peter diagnosis and treatment to show those hospital of Philadelphia and are left feeling overwhelmed with few options so it's great that works out talking so that your listeners can hear about this relatively new enterprise a fetal surgery yes so talk about that what can be helped by having the surgery while the baby is still in the womb I'll give you a couple of examples the two most frequent operations we do before birth are describing a laser therapy for twin twin transfusion syndrome and the other is open fetal surgery for the for the so Clinton transfusions syndrome the set up is identical twins each in their own amniotic sack and as opposed to east twenty having its own post that the password this that connects the fetus to the mother they have a shared placenta and there are abnormal blood vessels I go from one side to the other side but want to be identical twins gets too much blood and goes in the heart failure and develops and an excess of amniotic fluid and the other twin doesn't get enough blood goes make kidney failure and doesn't produce any I'm not close the comes a stock plan the way to treat that and the state both twins or otherwise doomed is to put a scope into the to the uterus that the mothers of down a wall in your wall Mitchell was the person and use a laser fiber to photo quagga later include those culprit blood vessels with very good outcomes the second example is feel surgery responded Bethlen Ospina method is birth defect in which the coverings of the spinal cord don't form and so the and the higher this is a misspelling core the more nervous are affected and and we learned that there's ongoing damage to those mirrors through the entry or environment particularly amniotic fluid exposure because that's mostly people here so we've developed techniques about twenty years ago back in nineteen ninety eight to do this repeats but about the repair before birth and amp shown actually do a randomized prospective trial for the by the national institutes of health that fetal surgery respond above the photo has much better outcomes than surgery after birth in terms of better motor function for the babies in terms of dollars to walk in terms of decrease incidence of hydrocephalus and brain damage in terms of decreased need for a shunt to drain fluid from the brain so that Snow White they applied actually worldwide stew so saying that is widely applied and wondering how rare still is fetal surgery given some of what you've already told us well cracks old older information is maybe a four thousand people searches done worldwide we we've got about a quarter of them but we've also throughs consortia like a north American people therapy network which is a network of now thirty six feet of treatment centers in North.

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