About

Stephen J. Fenton, MD, FACS, FAAP, is a renowned fetal, neonatal, and minimally invasive pediatric surgeon, providing advanced care for children with complex congenital and acquired conditions including congenital lung malformations, congenital diaphragmatic hernia, sacrococcygeal teratoma, gastroschisis, and giant omphaloceles. Dr. Fenton is widely recognized for his expertise in advanced open and fetoscopic procedures. He is an Associate Professor of Pediatric Surgery at the University of Utah Spencer Fox Eccles School of Medicine and a pediatric surgeon at Primary Children’s Hospital. His surgical practice includes comprehensive care for infants and children with conditions such as congenital lung malformations, diaphragmatic hernia, sacrococcygeal teratoma, gastroschisis, omphalocele, chest wall deformities, hernias, undescended testicle, hydrocele, gallbladder removal, feeding tube placement, appendectomy, vascular access, and gastroesophageal reflux disease. Dr. Fenton’s practice also encompasses comprehensive fetal care, including ex utero intrapartum therapy (EXIT) for airway obstruction, open fetal surgery for fetal conditions, and fetoscopic repair of fetal conditions such as myelomeningocele. He is the founder and Director of the Grant Scott Bonham Fetal Center at Primary Children’s Hospital, the region’s first comprehensive fetal care program with full interventional capabilities, where he has introduced groundbreaking fetal therapies. Additionally, he founded the Utah Pediatric Trauma Network (UPTN), a statewide coalition dedicated to improving pediatric trauma care through evidence-based guidelines, injury prevention, and telehealth-driven regionalization. His research focuses on trauma systems optimization, resource utilization, and outcome improvement for children across Utah and the Mountain West, with a commitment to advancing regionalized, data-driven care models that enhance access and reduce costs for pediatric patients and families.

Research topics

• Anesthesia
• Cardiology
• Internal medicine
• Medicine
• Surgery
• Intensive care medicine

Selected publications

• Effect of a statewide pediatric trauma collaborative on preventable transfer rates and character

  The Journal of Trauma: Injury, Infection, and Critical Care · 2026-01-27

  article

  BACKGROUND: The Utah Pediatric Trauma Network (UPTN), established in 2019, is a collaboration of hospitals in Utah that have implemented evidence-based guidelines to optimize pediatric trauma care. This study aimed to determine whether the establishment of the UPTN correlated with a change in the amount and character of preventable transfers (PTs) to the state's only Level I pediatric trauma center. METHODS: Children with traumatic injuries transferred between 2013 and 2023 were retrospectively analyzed. The exposure was a transfer that occurred after the establishment of the UPTN on January 1, 2019. A PT was a child discharged within 48 hours of arrival without surgical intervention or advanced imaging studies. RESULTS: During this period, 6,036 children were transferred. There were 3,025 transferred pre-UPTN, while 3,011 were transferred post-establishment. The rate of preventable transfer before the establishment was 36% versus 29% after (p < 0.001). Following the establishment of the UPTN, there was a significant change in the proportion of each injury type that was transferred. A lower percentage of patients had an intracranial bleed (15% vs. 20%, p < 0.001), isolated skull fracture (6.8% vs. 8.8%; p = 0.004), or a blunt solid organ injury (4.3% vs. 5.5%, p = 0.031). There was an increase in the proportion of transferred patients that had an orthopedic injury (36% vs. 28%, p < 0.001) with a significant decrease in PT rate (10% vs. 15%, p = 0.003). In addition, after the UPTN was established, the preventable transfer rate for intracranial bleed significantly decreased from 47% to 37% (p < 0.001). CONCLUSION: In this study, we found that following the establishment of a trauma network that standardized pediatric trauma guidelines across a region, the rate of preventable transfer decreased. Traumatic brain injuries saw the largest decrease in the proportion of transfers and the rate of preventable transfers. These findings give evidence of trauma networks being a practical tool for decreasing overtriage. LEVEL OF EVIDENCE: Prognostic/Epidemiological; Level III.

  PublisherDOI

• Congenital diaphragmatic hernia: are improvements in ECMO &amp; survival sustainable over time?

  Journal of Perinatology · 2026-03-13

  article
  PublisherDOI

• Hybrid approach to closure in fetoscopic myelomeningocele repair

  Neurosurgical Focus Video · 2026-04-01

  articleOpen access

  Neural tube defects (NTDs) affect 2 in 1000 births worldwide. Myelomeningocele (MMC) represents a severe NTD, often with permanent neurological sequelae. The randomized multicenter Management of Myelomeningocele Study (MOMS) showed that open prenatal (compared to postnatal) myelomeningocele closure could reverse hindbrain herniation, lower rates of shunt insertion for hydrocephalus, and improve neurological function, with the trade-off of increased maternal complications and premature birth. Fetoscopic approaches may have equivalent benefits to open fetal MMC closure with fewer maternal complications. The hybrid approach to fetoscopic repair (primary closure vs biosubstitute patch) described in this video can be tailored to individual fetal anatomy and promote comparable epithelialization over time. The video can be found here: https://stream.cadmore.media/r10.3171/2026.1.FOCVID25222.

  PublisherDOI

• Muscle flap repair vs. patch repair in reducing recurrence in congenital diaphragmatic hernia: systematic review with Meta-Analysis

  Pediatric Surgery International · 2026-02-23

  article
  PublisherDOI

• Computed tomography in the evaluation of pediatric trauma: We are still overdoing it!

  Injury · 2026-03-21

  articleOpen accessSenior author

  BACKGROUND: Many studies have attempted to define which injured children should undergo computed tomography (CT) imaging. Specifically, the Pediatric Emergency Care Applied Research Network (PECARN), a conglomerate of pediatric trauma centers, prospectively collected data on a large population of patients and have published multiple studies with recommendations on when to image based on the likelihood of a clinically important injury. Using these data and others, the Utah Pediatric Trauma Network (UPTN) created guidelines to help determine when imaging of injured children should be performed at our participating non-pediatric hospitals (non-PED1). The purpose of this study was to evaluate compliance to these guidelines. METHODS: The UPTN REDCap® database was retrospectively reviewed between 1/2019-12/2022. An analysis of injured Utah children who underwent CT imaging based on UPTN guidelines was performed. RESULTS: Of the 5224 cases reviewed, 4162 (80 %) underwent CT scan for evaluation, of which 3275 (79 %) received CT imaging at a non-PED1 center. Those treated at a non-PED1 hospital tended to be older (mean 10.2 v. 9.1 years, p = 0.002) and more likely to be ≥ 14 years (33 %v.28 %,p = 0.003). They were also less likely to have a traumatic brain injury (81 %v.91 %,p < 0.0001) or an orthopedic injury (14 %v.21 %,p < 0.0001). Children treated at non-PED1 hospitals were less likely to undergo a CT of the head (59 % v. 88 %,p < 0.0001) and abdomen (18 % v. 32 %,p < 0.0001), but more likely of the chest (17 %v.11 %,p = 0.01) or a pan scan (13 %v.8 %,p = 0.001). Compliance to guidelines was lower compared to the PED1 center for CT of the head (67 %v.87 %,p < 0.0001). Overall, compliance increased in the later years of the study for cervical spine and abdomen/pelvis (p = 0.0002,p < 0.0001 respectively), and decreased for head (p = 0.001). CONCLUSIONS: Across Utah, CT imaging is highly utilized in the evaluation of injured children. Non-compliance to imaging guidelines was found to be highest for imaging of the cervical-spine, chest, and abdomen. STUDY TYPE/LEVEL OF EVIDENCE: Level III, Prognostic/epidemiological.

  PublisherDOI

• Creation of the Utah Pediatric Trauma Network to Close the Gap in the Care of Injured Children

  Current Trauma Reports · 2025-10-27

  article1st authorCorresponding
  PublisherDOI

• Less is more: ECMO utilization and outcomes in congenital diaphragmatic hernia

  Journal of Pediatric Surgery · 2025-08-19 · 2 citations

  articleOpen access

  PURPOSE: Infants with congenital diaphragmatic hernia (CDH) have varying degrees of pulmonary hypoplasia leading to cardiopulmonary derangements such as pulmonary hypertension. Extracorporeal membranous oxygenation (ECMO) can be necessary for survival in some patients. Our institution implemented a change in the NICU critical care management guideline for neonates with CDH in 2016. Indications for ECMO remained the same in the revised guideline. This study evaluated survival and surgical outcomes in CDH patients who underwent repair before and after this guideline change. METHODS: Using an internal institutional registry, we identified a retrospective cohort of all CDH patients treated at our institution between January 2003 and December 2024. Patients were stratified based on year of birth before 2016 or 2016 and after. A retrospective chart review was conducted to extract primary and secondary outcome variables, which were analyzed using bivariate comparisons. RESULTS: A retrospective cohort of 389 patients with CDH was identified. Two hundred twenty-nine patients were treated before 2016, and 160 during or after 2016. ECMO was performed on 71 (31.0 %) patients prior to 2016 and 15 (9.4 %) patients during or after 2016 (p < 0.001). ECMO runs and repairs on ECMO significantly decreased for patients with the most severe defect sizes (C, D). Survival was not significantly different for A, B, or C defects and was significantly improved in the most severe defects (D) (90.9 % vs 42.9 %, p < 0.001) after the guideline change. Complications from ECMO, massive bleeding events, and thrombosis were not statistically different between time points. CONCLUSION: Changes in clinical management guideline, but not indications for ECMO, resulted in fewer ECMO runs and fewer CDH repairs on ECMO. Overall survival improved, including a significant improvement in survival for the most severe defect subgroup (D). ECMO complications, bleeding, and clotting were not different between groups, indicating that the risks of ECMO were not affected by the guideline changes. LEVEL OF EVIDENCE: IV.

  PublisherOA PDFDOI

• Long-term outcomes after muscle flap repair in congenital diaphragmatic hernia: A retrospective study at a single institution

  Journal of Pediatric Surgery · 2025-08-18 · 1 citations

  articleOpen access

  PURPOSE: Infants with large congenital diaphragmatic hernia (CDH) defects pose a clinical challenge. Despite evidence that muscle flap repair (MFR) has lower recurrence rates than patch repair (PR), MFR remains uncommon and understudied. This study evaluated long-term outcomes in CDH patients who underwent MFR compared to PR at a single institution. We hypothesized that patients who underwent MFR have lower recurrence rates than patients who underwent PR. METHODS: Using an internal institutional registry, we identified all CDH patients who underwent repair between 1998 and 2024. Patients were stratified based on repair type, excluding primarily and non-repaired patients. Long-term follow-up was obtained through our institutional pulmonary hypoplasia clinic and retrospective chart review, with supplementary phone calls made to patients who were lost to follow-up. Our primary outcome was CDH recurrence and secondarily wound infection, small bowel obstruction (SBO), abdominal wall hernia, scoliosis and pectus excavatum. Analysis was done using bivariate comparisons. RESULTS: A retrospective cohort of 456 patients with CDH from 1998 to 2024 was identified. 71 patients were not repaired, and 246 underwent primary repair. The remaining 139 patients underwent complex repair: 108 MFR and 31 PR. 32 did not survive after repair to discharge from NICU (19 MFR and 13 PR). 12 patients were lost to follow-up and we have reliable long-term follow-up in 95 patients. Of these, there are 80 MFR and 15 PR. The median follow-up time was 5 years [IQR 3-11]. Demographics were similar across cohorts. In the MFR group, 5/80 (6.3 %) had a recurrence compared to 7/15 (46.7 %) in the patch group (p=<0.001). PR had a significantly higher rate of infection than MFR. SBO and hernia rates were similar across groups. Scoliosis and chest wall deformity rates were similar, with five patients requiring operative intervention for scoliosis and one requiring minimally invasive repair of pectus excavatum. CONCLUSION: MFR is a viable treatment option for large CDH defects and has a lower recurrence rate than PR. In this long-term follow-up study, MFR did not result in a higher rate of infection, bowel obstruction, hernia, chest wall deformity, or scoliosis. LEVEL OF EVIDENCE: IV.

  PublisherOA PDFDOI

• Analysis of preventable transfers from Montana to out-of-state pediatric trauma centers: A multicenter collaboration

  The Journal of Trauma: Injury, Infection, and Critical Care · 2025-09-19

  article

  INTRODUCTION: Because of the limited number of verified pediatric trauma centers (PTCs), transferring pediatric trauma patients to specialized facilities is essential for providing high-level trauma care. However, preventing transfers that are unnecessary is also crucial. For a state such as Montana, where there is no verified in-state PTC, understanding the types of transfers that could be prevented is critical to improving pediatric trauma care in this rural state. The purpose of this study was to identify and describe patients who underwent preventable transfer from hospitals across Montana to three Level I PTCs in surrounding states. METHODS: We performed a multicenter retrospective review of all trauma patients younger than 18 years who underwent transfer from hospitals in Montana to the three closest out-of-state Level I PTCs from 2013 to 2022. The primary outcome, preventable transfer, was defined as discharge within 48 hours without advanced imaging (computed tomography or magnetic resonance imaging) or surgical intervention. We performed a secondary analysis to identify "possibly preventable transfers," which was defined as patients who could have been safely managed at an in-state Level I adult trauma center with certain pediatric specific capabilities. RESULTS: Of 339 total patients transferred, 39 patients (12%) met the criteria for preventable transfer, and 63 patients (19%) met the criteria for possibly preventable transfer. The majority of preventable transfers were traumatic brain injuries (72%), followed by isolated orthopedic injuries (13%). Possibly preventable transfers included traumatic brain injuries (35%) and isolated orthopedic injuries (32%), among others. The median distance traveled was 544 miles for both groups, with an interquartile range of 413 to 558 miles for preventable transfers and 419 to 558 miles for the possibly preventable transfers. CONCLUSION: A significant proportion (31%) of pediatric trauma patients in Montana who underwent long-distance transfer to out-of-state Level I PTCs could potentially have received appropriate care closer to home. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.

  PublisherDOI

• Congenital diaphragmatic hernia: Exclusion criteria for repair or ECMO?

  Journal of Pediatric Surgery · 2025-10-01

  articleOpen access
  PublisherOA PDFDOI

Frequent coauthors

• Katie W. Russell

  University of Utah

  46 shared

• Eric R. Scaife

  Primary Children's Hospital

  34 shared

• Joshua B. Alley

  Texas A&M University

  19 shared

• Bradley A. Yoder

  Utah Valley Regional Medical Center

  17 shared

• Christian C. Yost

  University of Utah

  17 shared

• Richard M. Peterson

  17 shared

• Kris W. Hansen

  University of Utah

  16 shared

• Michelle J. Yang

  Primary Children's Hospital

  15 shared

Labs

• University of Utah Fetal CenterPI

Education

• B.A., Spanish

  University of Utah

• M.D.

  Creighton University

• Other, General Surgery Residency

  University of Utah

• Other, Pediatric Surgery Fellowship

  Children’s Hospital of Philadelphia