Creation of the UC Davis fetal care team began with the arrival of Diana Farmer, a member of the Institute of Medicine of the National Academies – one of the highest honors in medicine – and a fellow of the prestigious Royal College of Surgeons of England. In the late 1990s Farmer was the first woman in the world to perform open fetal surgery.
Farmer is known for skilled surgical treatment of congenital anomalies and cancer, airway and intestinal surgeries in newborns, as well as for a body of research that includes more than 200 peer-reviewed articles and a landmark study to evaluate the safety and efficacy of fetal spina bifida surgery. She is currently researching a novel stem cell therapy for repairing damaged neural tissue in patients with the condition.
Farmer recruited Shinjiro Hirose in 2015 to serve as chief of the newly established UC Davis Division of Pediatric General, Thoracic and Fetal Surgery, with a joint appointment as director of pediatric surgery at Shriners Hospitals for Children – Northern California.
In addition to his background in fetal surgery, Hirose is a nationally recognized children’s cancer surgeon and an expert in the development and use of minimally invasive surgery in children.
David Schrimmer joined UC Davis from UC San Diego, where he founded the fetal therapy and multiples program. He serves as chief of the new UC Davis Division of Maternal-Fetal Medicine in the Department of Obstetrics and Gynecology, offering fetal intervention for complications of multiple pregnancies as well as highly regarded nonsurgical care of mothers carrying fetuses with complex anomalies such as congenital diaphragmatic hernia.
Hirose and Schrimmer are among the creators and founding members of the University of California Fetal Therapy Consortium, a collaboration of the five fetal treatment programs at UC campuses in Davis, Irvine, Los Angeles, San Diego and San Francisco.
Known for experience, compassion and skill
Farmer, Hirose and Schrimmer have performed hundreds of surgeries and interventions between them and offer or are planning a wide range of on-site interventional capabilities and methods unique to inland Northern California, such as:
- Open fetal surgery, which involves treating the fetus directly within the uterus via a Caesarian-like abdominal incision. The method is used for conditions such as spina bifida and for specific tumors before birth.
- Less invasive procedures such as fetoscopic or fetal image-guided surgery, which can avoid the large incision by using an endoscope and or sonogram to view the fetus during surgery and then a small incision to insert and manipulate instruments. For example, the team can employ an endoscope with a laser to treat twin-to-twin transfusion syndrome.
- Ex-utero intrapartum treatment procedure or EXIT, a surgical intervention at the time of birth that is most often used to relieve respiratory conditions such as airway compression or abnormal lung masses. The fetus is partially removed from the mother and undergoes surgery while still attached to the umbilical cord, which is then cut for completion of delivery.
“In many cases with these procedures you’re not just saving a life, you’re ‘saving a lifetime,’” Farmer said. “Often these infants would face ongoing health challenges and limitations throughout their entire lives that many of us might only experience in advanced age.”