The University Hospital Leuven is Belgium’s largest hospital (>1800 beds). Its Division of Prenatal Diagnosis & Fetal Medicine is Belgium’s largest multidisciplinary referral centre for fetal diagnosis and therapy. Therefore many congenital birth defects are already referred before birth so that delivery can take place at the optimal location, where postnatal care will take place. It is also a major referral center for postnatal referrals, either via the department of neonatology and pediatrics, or via the department of surgery (for surgical correction). What also made the center unique, is that it is a center fetal surgery for the conditions that may benefit from prenatal repair, of which one condition is part of the focus of the ERNICA network (Congenital Diaphragmatic Hernia).
Prenatally diagnosed cases: The center offers all services, from genetic assessment, fetal imaging, invasive diagnosis, and the entire portfolio of fetal therapy, as defined by the International Fetal Medicine and Surgery Society. Postnatal specialists join the prenatal specialists both in weekly expert meetings as well as individualized counseling of patients attending the clinic. For some of the conditions within this program there is also in utero therapy (surgery) possible. The group does over 150 invasive fetal interventions per year.
For the bulk of the conditions -when diagnosed in utero - treatment can await until after birth. These are managed by the neonatologists and surgical disciplins of the organ of interest. Follow up in the first year of life is overseen by the neonatologist, whereafter the pediatrician will manage the children up to 16 years. For CDH pediatric pulmonologists are in charge, for the bowel problems a pediatric gastro-enterologists takes the lead. The multidisciplinary teams include social workers, dieticians and logopedist or whatever paramedical disciplin of relevance.
The centre has experience of either coordination or being a member of European network. Team members and P.I. have a substantial track record in coordinating or participating to European collaborative projects. Of relevance to fetal therapy are: (1) the creation of the Eurofoetus network, which was Biomed 2 project dedicated to the development of instruments for fetoscopic surgery used to treat orphan diseases in utero; (2)EuroTwin2twin: a project dedicated to the study of mononchorionic twins, and the design, execution and finishing of the first successful randomized control in fetoscopic surgey ever, showing superiority of fetoscopic laser coagulation of placental anastomoses over amniodrainage for twin-transfusion syndrome. Of relevance to congenital anomalies focus of the ERNICA network are that this center was a member of EuroSTEC: project dedicated to novel solutions for congenital birth defects. In that project the center did set-up of a RCT on percutaneous fetal endotracheal occlusion (FETO), on the treatment of congenital diaphragmatic hernia.