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.
Facts
FAQs
How do open and fetoscopic fetal surgery differ for spina bifida repair?
Fetoscopic repair uses tiny incisions and may be safer for future pregnancies; open surgery has the most evidence.
Both approaches repair spina bifida before birth. Children's Hospital of Philadelphia says fetoscopic repair uses several tiny incisions in the uterus to pass a small camera and instruments, so it avoids the larger incision of open fetal surgery. It may make vaginal delivery possible and may be safer for future pregnancies, but it is newer and its long-term results are still being studied. The hospital says open fetal surgery remains the approach with the most evidence behind it. This describes one center's published account, not advice for any one pregnancy.
Connections
Treats
Source Fetal surgery (Wikipedia)
Source Fetal surgery (Wikipedia)
Sources
1. Wikipedia
Wikipedia contributors, Wikimedia Foundation
2. Fetal surgery (Wikipedia)
https://en.wikipedia.org/wiki/Fetal_surgery, lead section
Fetal surgery, also known as antenatal surgery or prenatal surgery, is a growing branch of maternal-fetal medicine that covers any of a broad range of surgical techniques that are used to treat congenital abnormalities in fetuses who are still in the pregnant uterus.
History (origin-year)
Fetal surgical techniques were first developed at the University of California, San Francisco, in 1980 using animal models.
Treats: Spina Bifida, Indications
Prenatal repair of spina bifida is available in specialty centers.
Treats: Congenital Diaphragmatic Hernia, Indications
Other conditions that potentially are treated by open fetal surgery include: Congenital diaphragmatic hernia (if indicated at all, it is now more likely to be treated by endoscopic fetal surgery) Congenital cystic adenomatoid malformation Congenital heart disease Pulmonary sequestration Sacrococcygeal teratoma
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