Fetal Surgery

Fetal surgery, also known as antenatal or prenatal surgery, is a branch of maternal-fetal medicine covering a broad range of surgical techniques used to treat congenital abnormalities in a fetus still within the pregnant uterus. There are three main types: open fetal surgery, which completely opens the uterus to operate on the fetus; minimally invasive fetoscopic surgery, which uses small incisions guided by fetoscopy and sonography; and percutaneous fetal therapy, which places a catheter under continuous ultrasound guidance. The goal of contemporary fetal intervention is to interrupt the disease process before secondary damage to the fetus's organs occurs, shifting the focus from anatomic repair to disease management, and the field draws on surgery, obstetrics and gynecology and pediatrics, especially the subspecialties of neonatology and maternal-fetal medicine, and is usually performed only at specialist centers because of its high risk and technical complexity. Because fetal intervention carries risk to both the fetus and the pregnant patient, including a greater risk of complications in future pregnancies from the vertical uterine incision typically used, the longer duration of the operation, and the later cesarean section required to deliver the baby, it is undertaken only where the risk of leaving the condition untreated is considered to outweigh these added risks.