The National Medical Association’s 2010 Convention and Scientific Assembly hit a home run again. From July 31st to August 4th, over 5,000 physicians convened at the Gaylord Palms Resort in Kissimmee, Florida to learn updated information regarding their craft. One of the most innovative topics of discussion in our Ob-Gyn section meeting was given by Dr. Reuben Quintero, a Maternal Fetal Specialists at the University of Miami, Jackson Memorial Hospital.
Dr. Quintero is a maverick who operates on babies-in-the womb BEFORE they are born. These procedures are collectively called fetoscopy and include the repair of conditions such as Twin-twin transfusion, Congenital Diaphramatic Hernia and Bladder Obstruction. Welcome to the 21st century. The most revolutionary procedure that has entered the obstetrical horizon is a procedure called the Amniopatch.
Preterm premature rupture of membranes (PPROM), commonly known as the “water breaking” occurs in 3 percent of all pregnancies and is the cause of 85 percent of newborn death and illness. It is also associated with 30 to 40 percent of premature births and affects approximately 150,000 births per year. PPROM that occurs between 13 to 26 weeks has a poor prognosis. In addition, PPROM occurs in 1.2 percent of patients after genetic amniocentesis and 3-5 percent after fetoscopy. However, these statistics may soon change. The Amniopatch is a procedure that can “plug” up the hole with the use of platelets and cryoprecipitate. The jury is still out regarding how and why it works but the statistics presented by Dr. Quintero are quite impressive. The procedure was developed when a patient with a twin pregnancy experienced rupture of membranes after fetal surgery. She leaked fluid for approximately three weeks until the Amniopatch was performed. Dr. Quintero explained that the membranes resealed and the patient delivered at 37-weeks via a repeat C. Section. How remarkable.
Dr. Quintero concedes that the Amniopatch is still “experimental” and requires several more medical studies before it will approved as mainstream therapy. There was also a discrepancy between the results obtained from the National Institute of Health and Dr. Quintero’s study. Presently there are three main centers that perform the procedure: The Maria Vittorio Hospital in Turin, Italy, University of Miami at Jackson Memorial Hospital and the University of Southern California.
The future treatment and elimination of PPROM is phenomenal. Let’s hope the application of this life-saving innovation will happen sooner rather than later.
For more information on the Amniopatch, please contact The Fetal Therapy Center at Jackson Memorial Hospital http://ob-gyn.med.miami.edu/x250.xml
A healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.