Herman planned a crash course in fetal surgery for Arizona
| “ | Everything in-utero happens at hyperspeed... In fetal surgery, every patient you treat will be encased in a mother. A mother whose heightened state of concern is a biological and evolutionary necessity. | ” |
— Nicole Herman describing her specialty
| ||
Fetal surgery (sometimes referred to as prenatal surgery or maternal-fetal surgery) is a surgical sub-specialty of pediatric surgery and maternal-fetal medicine that includes any of a broad range of surgical techniques that are used to treat birth defects in fetuses who are still in the pregnant uterus.
Surgeons trained in fetal surgery are called fetal surgeons or maternal-fetal surgeons. Due to the field of fetal surgery being relatively new, the few fetal surgeons that are practicing are essentially inventing it.
Additionally, fetal surgeons, even those with a background in pediatric surgery, are trained to handle maternal-fetal/obstetrical cases that do not require fetal surgery performed.
Notable Fetal Surgeons[]
- Dr. Addison Montgomery (Director of Medicine and staff, OB/GYN at Seaside Health and Wellness, OB/GYN, neonatal-fetal surgeon at St. Ambrose Hospital, and former Head of OB/GYN and Neonatal Surgery at Seattle Grace Hospital)
- Dr. Vivian Carlsmith (Attending Obstetrician-Gynecologist/Perinatologist at UCLA)
- Dr. Emma Marling (Head of Maternal-Fetal Medicine at Seattle Presbyterian Hospital)
- Dr. Nicole Herman (Co-Head of Fetal Surgery at Robbins-Herman Center for Women's Health, former Head of Fetal Surgery at Grey Sloan Memorial Hospital)
- Dr. Arizona Robbins (Co-Head of Fetal Surgery at Robbins-Herman Center for Women's Health, former Head of Fetal Surgery and Attending Pediatric surgeon at Grey Sloan Memorial Hospital)
- Dr. Lacy (Head of Fetal Surgery at Cleveland Clinic)
Notable Cases[]
- Twin to Twin Transfusion Syndrome (TTTS) (Raindrops Keep Falling On My Head): Addison works to separate fetal blood vessels in twins sharing a placenta using fetoscopic laser ablation (using a laser to sever the fetal blood vessels)
- Mirror Syndrome with a In-Utero Blood Transfusion (Ex-Life): While Addison is at Seattle Grace Hospital tending to her brother, Derek asks Addison to consult on his patient, who is showing signs of Mirror Syndrome, caused by the baby's anemia following a blood transfusion with the mother in surgery and causing congestive heart failure in both mother and child. Addison recommends delivering the baby, while Derek suggests a in-utero blood transfusion, despite the fact he knows nothing of the procedure and Addison is highly against the procedure, and the mother insists on the blood transfusion. Addison does successfully tranfuse blood into the baby, resolving the heart failure and anemia, not while berating Derek for cornering her into this.
- Fetal Hydrocephalus: (The Parent Trap): Addison performed an in-utero intracranial septostomy for fetal hydrocephalus.
Notes and Trivia[]
- Despite being a sub-specialty of pediatric surgery and maternal-fetal medicine, fetal surgery is a separate department at Grey Sloan Memorial Hospital.
- Although pediatric surgeons in the real world are capable of performing fetal surgeries, fetal surgeons are far more skilled.
- The show has not shown pediatric surgeons capable of performing fetal surgeries in the past, as Arizona Robbins prior to season 11 has not done any fetal surgical procedures.
- Fetal surgery is practiced in the fetal surgery department within the OB/GYN wing at Grey Sloan Memorial Hospital.
- There are only 8 people in the world, including Addison, who can perform fetal surgery on a world-class level.
- There are only 5 fetal surgeons on the west of the Mississippi river, Addison, Nicole Herman, and Emma Marling being three of them. After The Distance, Arizona has become the sixth. However, due to Herman going blind after her tumor surgery, the number of practicing fetal surgeons have gone down to five.
- Perinatologists that practice fetal surgery are also fetal surgeons as they perform surgeries in-utero.
- Although Dr. Lucy Fields is a maternal-fetal medicine fellow, she is not considered a fetal surgeon as she was not shown performing any fetal surgeries during her tenure at Seattle Grace Mercy West Hospital.
- Arizona completed Herman's year-long fetal surgery fellowship in less than six months.
- Stephanie referred to fetal surgery as "one of the most exclusive specialties" that Arizona "mastered overnight".
- Grey Sloan Memorial Hospital is considered the go-to hospital for fetal cardiac intervention due to Dr. Nicole Herman and later Dr. Arizona Robbins, who studied under Dr. Herman.