Current status of subspecialization in pediatric surgery: A focus on fetal surgery
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Read the article on jpedsurg.org ↗Article · May 2021 · 1 min read
In brief
In brief
Survey of 405 APSA members reveals significant variation in fetal surgery practice patterns, with 77 respondents from fetal centers reporting diverse service models. While 96% of centers include pediatric surgeons on fetal teams, only 29% performed fetal operations in the past year, with most centers focusing on prenatal consultation and care coordination rather than direct fetal intervention.
Written by the GCMD Library team from the article.
Background/Purpose: Fetal surgery is a growing field within pediatric surgery. We sought to understand practice patterns of pediatric surgeons who subspecialize in fetal surgery.
Methods: A survey was sent to all active non-trainee surgeons within the American Pediatric Surgical Association. Respondents were stratified based on self-reported fetal affiliations.
Results: Of 1015 surveys, we received 405 responses (40%). Fetal surgery practices were described by 77 self-designated fetal center members. Centers provide prenatal consultation (99%), diagnostic imaging (84%), care/delivery coordination (83%), and/or fetal surgery/procedures (52%). The majority (56%) of fetal programs are directed by surgery and maternal fetal medicine. Pediatric surgeons are represented on the fetal team in 96% of centers. Prenatal consultations are primarily seen by any pediatric surgeon in the group (53%), with the pediatric surgeon on call operating on/caring for the baby postnatally in the majority (64%), regardless of who performed the prenatal consultation. Only 29% of fetal center members performed a fetal operation in the last year. Yearly fetal case numbers vary widely per procedure, with the most common being complex twin procedures and needle-based sclerotherapy.
Conclusions: Fetal centers vary by services offered, team composition, and interventions performed, with few surgeons performing a wide range of fetal surgery.