Banner's Fetal Care Center performs surgery in the womb

Published: 04/01/2024
Updated: 06/05/2024

Delicate spina bifida repair is the state's first fetal surgery


Banner – University Medicine’s Fetal Care Center performed the state’s first spina bifida in-utero procedure in February 2024. This intricate level of care is only available at the Fetal Care Center from an interdisciplinary team combining the expertise of Banner – University Medical Center Tucson and Banner Children’s at Diamond Children’s. The successful repair was completed February 19, and the unborn baby will continue to develop within its mother’s womb while receiving highly specialized care until the time of delivery.

Also known as fetal myelomeningocele, spina bifida is an opening in the spinal column that occurs in early pregnancy, typically developing in the fetus during the first four weeks of pregnancy. The complicated procedure involves opening the uterus and closing the opening in the unborn baby's spine while it is still in the womb. The delicate surgery is done to improve outcomes for infants with spina bifida, improving their ability to walk and preventing further damage to the spinal cord.

The center is the first full-service fetal care center in the Southwest that provides the full range of fetal surgery in a compassionate, highly specialized, and timely fashion for unborn babies. The program also offers parents pre-, peri-, and post-natal management strategies.

Priscila Carranza Olea and her husband, Ramon Alberto Contreras Armenta, were 22 weeks pregnant when they learned of the spina bifida diagnosis. Priscila had not noticed anything different about this pregnancy compared to her other two pregnancies until the time of diagnosis. She had no idea this type of surgery existed and could be done before her expected delivery date in May.

“We are committed to our baby and willing to do anything we could do to give our baby a chance at a healthier life. The Banner team met with us several times to ensure we were prepared and answered all our questions about the risks and benefits. We are impressed with the time they took, their thoroughness and ability to provide all the specialists we may need now and post-delivery. It’s been marvelous,” said Carranza Olea.

She was referred to the Banner – University Medicine Fetal Care Center by Christopher Sullivan, a high-risk pregnancy obstetrician-gynecologist in the community, who sees one to two patients a month who previously had to be referred out of state for care. "The diagnosis of spina bifida or other high-risk pregnancy conditions in Arizona used to mean that patients would have to be referred to other states, such as Colorado or California, with fetal care centers that can repair these defects while the baby is in the womb. Now that families have access locally, with experts in our state, the disruption that typically upended families who had to leave the state, is minimal. The establishment of such a center is a huge step forward in the care of high-risk pregnancies in Arizona," said Sullivan.

“Our Tucson-based leadership team has ensured this monumental clinical and research-based advancement in fetal surgery is available statewide and an example of the capabilities of our academic partnership with the University of Arizona Colleges of Medicine in Tucson and Phoenix. This unique partnership helps us to readily incorporate research innovations that result in enhanced care and wellness for our patients,” said Michael E. Kupferman, MD, MBA, Banner Health’s senior vice president of physician enterprise and president of the Banner – University Medicine Division.

The program is led by Kenneth Liechty, MD, a fetal and pediatric surgeon and director of fetal medicine at Banner – University Medicine and surgeon-in-chief at Banner Children’s at Diamond Children’s Medical Center. Dr. Liechty has been providing fetal care across the country for over 15 years and has led the development of the fetal surgery program at Banner – University Medicine.

“Learning that your unborn child needs a fetal intervention is one of the most stressful situations a family can experience and our ability to keep families close to their social support network within our state and community is a great advantage for the baby’s outcome, as this type of surgery requires a comprehensive, multidisciplinary treatment plan. With our fetal surgery center, we can provide close consultation and continuous support for the family pre- and post-delivery and keep focused on the development of better treatment options through research,” said Dr. Liechty.

The fetal surgery multidisciplinary team includes a pediatric fetal surgeon, maternal-fetal medicine specialist, neonatologist, fetal nurse practitioner, geneticist, social worker, and specific pediatric/fetal subspecialists in neurosurgery, neurology, nephrology, cardiology, radiology, anesthesiology, and more.

“Banner’s fetal care center provides our patients access to an array of fetal medicine expertise found at Banner – University Medicine. With the establishment of the program in Tucson, our community and state now have access to the best of fetal surgery care,” said Anthony M. Avellino, MD, MBA, co-surgeon of the fetal spina bifida repair surgery with Dr. Liechty, and director of pediatric neurosurgery at Banner - University Medicine Tucson, interim chief physician executive for Banner - University Medical Group - Tucson and professor at the University of Arizona College of Medicine – Tucson.

“The ability to successfully perform the first-ever fetal surgery in Arizona is the result of bringing decades of scientific discovery and research into our academic partnership with Banner Health, ensuring that our state and the surrounding communities we serve have access to safe, proven, state-of-the science multi-disciplinary patient care. Our academic medical center is home to innovative and multi-disciplinary teams of physicians and scientists, in this case, maternal and fetal medicine, neonatal care, fetal surgery and pediatric neurosurgery, and anesthesia all brought together to deliver this highly specialized care. At the same time, researchers in the college of medicine continue to investigate novel ways to promote tissue regeneration and post-surgical healing, as well as the application of technologies like 3-D fetal imaging and 3-D printing that allow for the careful planning and virtual performance of these delicate surgical procedures, prior to and in anticipation of the actual surgeries,” said Michael M.I. Abecassis, MD, MBA, the Iovanna C. Lopez Endowed Dean of the University of Arizona College of Medicine – Tucson.

Carranza Olea will continue to be monitored, have her regular pregnancy checkups and is hoping, with the help of the fetal care center, she can deliver her baby on the full-term delivery date of May 28.

To learn more about the Banner – University Medicine Fetal Care Center, please visit here.

Watch the segment featured on KVOA News 4 Tucson.

Updated: 06/05/2024


Our Fetal Care Center performed recently the state’s first spina bifida repair surgery in utero on a fetus on Ramon Alberto Contreras was born at Banner – University Medical Center Tucson. Delivered at 35 weeks of pregnancy, baby Ramon weighed 5 lbs., 6 ounces and is bottle feeding and responding normally, thanks to the highly specialized care received from the multidisciplinary team at Banner and Diamond Children’s Medical Center.

Watch the segment featured on KOLD News 13.