When Megan and Mark Postak recently discovered their first child would be born with spina bifida, the Wadsworth couple had plenty of questions.
Does the size of the hole in their baby’s spine indicate the severity of problems he could face?
How will doctors decide when to schedule his delivery?
Should they bank their baby’s umbilical cord blood after birth?
They got many answers — and some much-needed peace of mind — by spending a recent day at Akron Children’s Hospital’s new Fetal Treatment Clinic.
Rather than scheduling separate appointments with a high-risk obstetrician, geneticist, pediatric radiologist, neurologist, neurosurgeon, neonatologist and the spina bifida clinic coordinator, the Postaks sat in a conference room and talked with the specialists all at the same time.
Together, they discussed plans for the baby’s delivery by cesarean section and the subsequent surgery he will need shortly after birth to close the hole near the bottom of his spine to prevent infection and damage to his spinal cord.
Over several hours, the couple also toured the neonatal intensive-care unit where their son, Miles, will spend his first weeks of life after he’s born in the next month or two.
“The team approach makes it easier for us so we don’t have to schedule different appointments,” Megan Postak said. “It keeps everyone on the same page. It makes us feel a little more at ease.”
The clinic is a new service recently launched by the hospital’s D. Gary Benfield MD Fetal Treatment Center.
The center started in 2002 to offer coordinated care when a potential or confirmed genetic condition or birth defect is detected in a fetus.
The center’s team includes Children’s high-risk obstetricians, geneticists, newborn specialists, genetic counselors and nurse case managers. Depending on the detected problem, cardiologists, pediatric surgeons, neurologists, neurosurgeons, urologists, nephrologists and other specialists also are available.
The program also works with other high-risk obstetricians in the region who aren’t employed by Children’s.
Since it started, the Fetal Treatment Center has provided services to more than 2,000 families throughout the region.
Although the pediatric specialists have been offering care to expectant families through the center for more than a decade, the appointments often were spread across several days or weeks.
“The patient was part of it before, but it was fragmented,” said Dr. Melissa Mancuso, a high-risk obstetrician and co-director of the Fetal Treatment Center. “They would meet with each team member and they’d get little pieces. This has actually streamlined the process, to get it all in one [meeting] and have all the answers.”
Mancuso recently helped launch the multi-disciplinary clinic days after participating in a similar service at her previous job in University of Alabama at Birmingham.
The hospital offers one or two Fetal Treatment Clinic days per month, with two or three families being seen during each clinic day. The appointments typically are covered as consultations by health insurers, Mancuso said.
The clinics are designed for patients with complex problems that will require surgery within the first several days after birth, such as spina bifida, hydrocephalus, congenital heart defects and abdominal wall defects.
By bringing all the specialists together to talk with expectant parents, “the patient is hearing it all at once,” said Melonie Michelson, a genetic counselor and coordinator of the Fetal Treatment Center. “We don’t give multiple messages.”
During their recent visit, the Postaks were told what to expect after their son is born.
“The staff has been wonderful as far as easing fears,” Mark Postak said.
Julie Wright, a registered nurse and clinical case manager, showed the couple around the hospital and gave them tips about where to meet visiting family members and where to go if the new mom needs to rest.
She explained that even though Miles will be taken to Children's shortly after his birth at Akron General, his mother will be able to get a pass from her doctor to visit before she's discharged.
“You’ll be able to come over and see your little guy,” she assured them.
The coordination among the specialists through the clinic meetings also has resulted in reduced time to surgery for babies born with serious problems, Mancuso said.
“It helps with planning,” she said.
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.