Many years ago, specialists at Children's Hospital of Philadelphia recognized an obstacle in diagnosing and treating fetal abnormalities and babies born with life-threatening defects.The babies had to be delivered at adult hospitals, then transferred to Children's Hospital. This added medical and logistical challenges for hospitals and the families.

Now, the hospital is celebrating a milestone in its solution to the problem: the 1,000th baby was recently born in its Special Delivery Unit.

Opened in 2008, it was the first pediatric facility designed for mothers whose babies are diagnosed during pregnancy with defects in vital organs such as the spine, heart, or intestines.

Maternal-fetal medicine specialist Julie S. Moldenhauer, director of the unit, said it reflects advances in fetal medicine. Birth defects affect one in every 33 U.S. births, federal data show. With ultrasound and MRI, many life-threatening abnormalities can be evaluated in detail while the fetus is still in the womb.

Although most repairs are still done after birth, Children's is a pioneer of fetal surgery. Last year, it and two other hospitals published a 10-year study showing fetal surgery for severe spina bifida — a hole in the spine — reduces permanent disability. Children's often performs an in utero laser repair of a blood vessel defect unique to identical twins. In another special delivery, the baby remains attached to the placenta while undergoing airway surgery.

The $20 million, eight-bed unit includes social workers and psychologists, because families tend to be under terrible stress. "It's kind of bittersweet because you're having a baby, but you know your baby is going to go" to the neonatal intensive care unit, Moldenhauer said. "And in some cases, your baby is not going to survive, and you know that."

Indeed, the unit is named for donors Lynne and Bill Garbose, whose first baby, Emily, died of a rare heart defect three days after birth. Lynne had a cesarean section in a Washington, D.C., hospital, then the baby was rushed to a pediatric hospital 30 minutes away.

"We knew there was a real void," Lynne said. "We are so proud to be associated" with the Special Delivery Unit.

— Marie McCullough