Martin Walker, MD, a maternal-fetal medicine specialist with Eastside Maternal-Fetal Medicine and the Evergreen Fetal Therapy Program in Seattle, Washington, is among a select group of physicians with the training and expertise to provide minimally-invasive surgical options to treat conditions that threaten a baby’s health and life while still in the womb. He is one of only a few physicians in the world trained in fetoscopic laser photocoagulation which is used to treat twin-to-twin transfusion syndrome (TTTS). Usually diagnosed between 16-26 weeks of pregnancy, without treatment most babies affected by TTTS do not survive, and those who do can have severe health issues and lifelong complications.
Becoming a fetal therapy specialist
It takes decades of training to acquire the complex skills needed to provide life-saving therapies to a baby before the baby is even born. For Dr. Walker, his journey began more than 30 years ago. With the formal title of maternal-fetal specialist, which is an OB/GYN with additional training in fetal complications and high-risk pregnancies, Dr. Walker is board certified in both obstetrics/ gynecology and maternal-fetal medicine. He received his medical degree at the University of Nottingham Medical School in the United Kingdom and completed his obstetrics and gynecology residency at the University of Toronto. He then completed a fellowship program in maternal-fetal medicine both at the University of Toronto and the University of California, San Diego.
Dr. Walker received additional training in fetal therapy as a visiting fellow with the Harris Birthright Center at King’s College Hospital in London, under the direction of Professor Kypros Nicolaides, who is considered one of the pioneers of fetal medicine. Dr. Walker finished his training in 2003 and has been performing fetoscopic procedures ever since. To date, he has completed approximately 500 fetoscopic laser ablations with a 75 percent survival rate of both twins, and a 95 percent survival rate of one twin, results that are as good as, or better than, any in the world.
Dr. Walker has presented, taught and published extensively on a variety of maternal-fetal medicine topics, both in the United States and internationally. He is one of the founding members of the North American Fetal Therapy Network, an organization dedicated to research and education in the field of fetal therapy.
Philosophy of care
As a recognized fetal therapy expert, Dr. Walker consults with patients who travel from all across the Pacific Northwest to see him at Eastside Maternal-Fetal Medicine and the Evergreen Fetal Therapy Program. The practice has an established reputation of compassion and excellence, where Dr. Walker works alongside Dr. Bettina Paek who is the co-director of the program and also a skilled fetal therapist in her own right.
As a practice, team members emphasize the critical role of collaboration and communication. They have developed close relationships with referring physicians and are available 24/7 to support patients through consultation, monitoring and intervention.
“A family facing the uncertainty of their baby’s future deserves the best we have to give,” said Dr. Walker. “No parent expects to be in this situation. Our fetal therapy program combines our training, expertise, technology and compassion to do as much as we can for each family.”
In addition to TTTS, the practice treats a variety of conditions, including:
- Fetal Anemias, including Rh sensitization/isoimmunization and viral infections
- Lower Urinary Tract Obstruction
- Fetal Pleural Effusion (CPAM, chylothorax or Bronchopulmonary Sequestration)
- Twin Reversed Arterial Perfusion (TRAP) Sequence or Acardiac Twin
- Selective Intrauterine Growth Restriction (SIUGR)
- Discordant Anomalies in Monochorionic Pregnancies
- Amniotic Band Syndrome
- Twin Anemia Polycythemia Sequence
The future of fetal therapy
“Fetal therapy is not a new field of medicine, but it is one that has made incredible advancements in recent years, and I believe it will continue to change the face of perinatal care,” said Dr. Walker. As minimally-invasive procedures become more common, and risks are reduced for both mother and baby, outcomes will continue to improve.
Fetoscopic repair of spina bifida, for example, is showing similar results as the more invasive open surgical alternative. Other procedures, including diaphragmatic hernia and fetal cardiac abnormality repairs, show promise. Fetal therapy experts are also exploring the benefits of stem cell treatments to treat genetic abnormalities.
“It is exciting to be a part of this evolving field,” said Dr. Walker. “While the number of patients who require fetal therapy is still small — and that’s a wonderful thing — those who do face these challenges now have access to the best technology and techniques that medicine can offer.”