Fetal Surgery

1 What is a Fetal Surgery?

A procedure in which surgery is performed on an unborn baby or fetus is called fetal surgery that is offered in some conditions to improve the long-term outcome of delivering the baby.

If a fetus has been diagnosed before birth or prenatally with spina bifida, your surgeon may perform open fetal surgery.

Myelomeningocele which is an opening in the skin on the fetus’ back that causes part of the spinal cord and coverings to be exposed to amniotic fluid in the uterus is one type of spina bifida.

Fetal surgery has better results than surgery after delivery in some cases.

2 Reasons for Procedure

Here are the most common reasons to undergo fetal surgery.

Each year there are cases in which babies are born with a complex birth defect. Parents sometimes are often left with options of choosing to treat the conditions after birth or to abort the fetus.

Some of the birth defects are complicated by the labor and delivery process and some may progress quickly after birth leading to significant disability or death.

Fetal surgery can offer early intervention so parents can treat such defects before they become more serious.

3 Potential Risks

Some of the potential risks of fetal surgery include:

  • infection in the lining of the uterus
  • infection of the incision
  • premature labor and delivery
  • gestational diabetes
  • bleeding; infertility
  • leakage of the amniotic fluid
  • complications associated with anesthesia

4 Preparing for your Procedure

In preparing for the fetal surgery, your doctor may order imaging exam and diagnostic tests such as Ultrasound, Chorionic villus sampling or CVS, Alpha-fetoprotein (AFP) testing and Amniocentesis.

Once a congenital abnormality has been diagnosed, your doctor will assess the condition to evaluate if the fetus is a candidate for fetal surgery.

Mostly the most severe conditions that are certain to cause significant disability or fetal death are treated with fetal surgery.

In preparation for surgery, betamethasone – which is a steroid – will be given to speed up the lungs of the fetus.

The doctor will conduct a physical examination and will monitor the uterine contractions and fetal heart rate.

The mother will be instructed not to eat and drink after midnight the day of the surgery and she may undergo some blood tests to match it in case there is a need for blood transfusion.

5 What to Expect

Here you can find out what to expect from your fetal surgery.

Fetal surgery is done by making an incision through the abdomen and the uterus is partially removed from the body.

The amniotic fluid will be drained from the uterus and will be kept in a warmer for replacement after the surgery is done.

A hysterotomy will be done and an instrument called uterine stapler will be used to make an incision and at the same time placing staples around the perimeter of the incision to minimize the bleeding in the uterus.

Your surgeon will then perform surgery on the fetus through the opening in the uterus to locate the abnormality and remove it.

This surgery is used for myelomeningocele to close the exposed spine, CCAM to remove the cystic mass and SCT to remove the tumor.

Delivery for this fetus and all subsequent children will have to be performed by cesarean section because of the nature of the fetal surgery.

6 Procedure Results

The results of fetal surgery will depend on the reason for the procedures.

Successful results of fetal surgery generally include stopping the progression of the congenital malformation or reversing potential complications that will arise without intervention.

7 Related Clinical Trials