Lisa Zuckerwise, MD, associate professor in the Department of Obstetrics and Gynecology and director of the Maternal-Fetal Medicine Program created the UVA Fetal Care Center Case Conference, a multidisciplinary forum to review complex pregnancies.
A prenatal diagnosis of a fetal or placental abnormality can turn a pregnancy upside down. Prenatal care, especially the weeks leading to delivery, can quickly become overwhelming. Multiple specialists, complex imaging, uncertain prognoses, and difficult decisions about timing and type of delivery often unfold over a short period. And that is just the beginning of what may become a prolonged NICU stay and longer-term follow-up care.
Families facing the truly unexpected find a gentle landing place in the UVA Health Fetal Care Center, where maternal-fetal medicine specialists work with pediatric subspecialists to build a plan together before the baby is even born. Although not a freestanding multidisciplinary fetal clinic, UVA’s Fetal Care Center functions as one in practice. The people who care for mom and for baby are often just an elevator ride – or even a few doors down – from one another. Because of this, multidisciplinary collaboration occurs naturally, and families can often meet multiple specialists on a single visit, while clinicians communicate in real time before, during, and after appointments. This not only streamlines care but also reduces the burden on families traveling from across Virginia and beyond.
Structured Forum for Collaboration
To further strengthen multidisciplinary collaboration, Lisa Zuckerwise, MD, associate professor in the UVA Department of Obstetrics and Gynecology and director of Maternal-Fetal Medicine at UVA Heath, established the UVA Fetal Care Center Case Conference in February 2026. The conference provides a structured forum where specialists review pregnancies complicated by fetal and placental abnormalities every other week.
“We used to piece these plans together over the phone, one specialist at a time,” Zuckerwise says. “Now, our goal is to bring everyone together after diagnosis, so that patients receive one coordinated, evidence-based plan from a unified team.”
The conference, held in person and with a teleconference option, brings together specialists from Maternal-Fetal Medicine, Neonatology, Pediatric Surgery, Pediatric Otolaryngology, Pediatric Radiology, Pediatric Anesthesiology, Endocrinology, Genetics, Social Work, Nursing, and other disciplines as needed. Together, they review imaging, discuss current evidence, anticipate challenges, and develop comprehensive plans. Although patients do not attend the conference itself, every discussion culminates in a coordinated care plan that guides counseling, delivery planning, and newborn care.
Advances in prenatal imaging, fetal therapy, and neonatal care, have transformed what is possible for many conditions. As treatment options continue to expand, multidisciplinary planning is increasingly important.
“A lot of these conditions are rare, and no pregnancy is the same,” Zuckerwise says. “Getting the right people in a room together means we’re thinking through all aspects of a unique patient’s and family’s situation in order to provide personalized, expert care.”
Multidisciplinary Planning in Action
A collaborative approach recently proved invaluable for a patient referred to UVA for evaluation of maternal thyroid disease.
During what began as a routine fetal growth ultrasound, the team identified an unexpected finding beneath the fetus’s chin—a neck mass that looked like a fetal goiter or enlarged thyroid gland. The fetus was otherwise growing appropriately, but a mass like that raises an immediate concern: could this baby swallow – or even breathe – once born?
After multidisciplinary counseling and shared decision-making with the family, the team developed an innovative treatment strategy consisting of weekly intra-amniotic thyroid hormone injections performed over four weeks. As the goiter gradually decreased in size, attention shifted from fetal therapy to careful delivery planning.
Although the goiter size had decreased, concern that it could still block the airway remained, so the team chose to deliver using an operation on placental support (OOPS) — a scaled-down version of the EXIT procedure that keeps the baby on placental oxygen while the airway is secured, without the larger uterine incision a full EXIT procedure requires.
Ariana Greenwell, MD, is an assistant professor in the Department of Otolaryngology.
When delivery day arrived, every member of the multidisciplinary team knew their role. Zuckerwise led the delivery, while pediatric otolaryngologist Ariana Greenwell, MD, led the evaluation and securing of the airway. Neonatologist David Kaufman, MD, and pediatric anesthesiologist Christopher Stemland, MD, managed neonatal stabilization, while pediatric surgeon-in-chief Ankush Gosain, MD, stood by in case of escalation to extracorporeal support.
The team successfully secured the baby’s airway while on placental support, after which the cord was clamped and the baby was handed off to the pediatric team for continued care.
What could have been a high-risk emergency instead became a carefully orchestrated success. The infant was extubated within 24 hours and discharged home with her mother on postoperative day three, with coordinated follow-up across pediatric endocrinology, otolaryngology, and maternal-fetal medicine.
For Zuckerwise, cases like this underscore the value of multidisciplinary collaboration and planning.
“Every specialty brings a different perspective, but everyone shares the same goal—providing the safest, most thoughtful care possible for both mother and baby,” she says. “When we come together before delivery, we’re able to anticipate problems instead of simply reacting to them.”
The conference has also become an important educational forum for fellows, residents, sonographers, genetic counselors, and medical students, allowing learners to observe multidisciplinary decision-making in real time while gaining exposure to rare fetal conditions and the collaborative planning required to care for them.
As fetal diagnosis and fetal therapy continue to evolve, Zuckerwise envisions the conference serving as the foundation for continued growth of UVA’s fetal care program.
“A complex fetal diagnosis affects an entire family,” Zuckerwise says. “When we bring the right people together before a baby is born, we’re not just planning a delivery, we’re helping families move through one of the most uncertain moments of their lives with confidence, knowing an entire team is ready for them.”