Current status of subspecialization in pediatric surgery: Fetal surgery | Anonymous survey | 1015 surveys | 405 responses received (40%) | distributed to APSA membership, October 2020 | 79% practicing at an academic hospital | 58% practicing in a major metro location | 99% completed formal fellowship training in pediatric surgery (n=399) | Pediatric surgeons were on the fetal team in 96% of centers. | Fetal centers provide | prenatal consultation - 99% | diagnostic imaging - 84% | care/delivery coordination - 83% | fetal surgery/procedures - 52% | Prenatal consultations primarily seen by any pediatric surgeons in the group (53%) | Pediatric surgeon on call operated/cared for the baby postnatally regardless of prenatal consultation (64%) | Conclusion: Fetal centers offer different services, team composition, and interventions, with few surgeons performing a wide range of fetal surgery. | https://pubmed.ncbi.nlm.nih.gov/34134857/ | @EmTombash | @StayCurrentMD | Source: Lopyan NM et al. Division of Pediatric Surgery, Department of Surgery, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA | Journal of Pediatric Surgery | Cincinnati Children's
Current status of subspecialization in pediatric surgery: A focus on fetal surgery
Infographic · Jun 2022 · 1 min read
In brief
In brief
Survey of 405 pediatric surgeons reveals wide variation in fetal surgery center structure and scope. While 96% 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 operative intervention.
- Only 29% of fetal center pediatric surgeons performed a fetal operation in the past year, indicating concentration of operative experience.
- Most fetal programs (56%) use co-directorship between pediatric surgery and maternal-fetal medicine for multidisciplinary leadership.
- Prenatal consultation is often performed by any group surgeon (53%), but the on-call surgeon typically manages postnatal care (64%).
- Complex twin procedures and needle-based sclerotherapy are the most commonly performed fetal interventions across centers.
- Fetal centers show wide variation in services offered—52% perform fetal procedures while nearly all provide prenatal consultation (99%).
Written by the GCMD Library team from the infographic.
Infographic with teal and yellow color blocks presenting survey data through text, percentages, and simple illustrations of medical professionals. Layout flows from top to bottom with key statistics highlighted in larger text and supporting details in smaller sections. Icons of surgeons and patients appear in corners.
Natalie M Lopyan, Erin E Perrone, Samir K Gadepalli, Mehul V Raval, Kuojen Tsao, Barrie S Rich, American Academy of Pediatrics Section on Surgery Delivery of Surgical Care Committee
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.