What is fetal surgery?
- Definition:
Fetal surgery or fetal intervention is defined as a procedure where we go inside the uterus to help a fetus who suffers from a certain problem. With recent development, and the advances in ultrasound techniques, our ability to detect fetal problems has advanced very rapidly over the last few decades. While detection rate is improving significantly with so many diseases accurately diagnosed before birth by genetic and imaging techniques, we only operate in certain specific indications before birth. We specifically operate pathologies with identifiable anatomic fetal or placental problems that cause ongoing damage to the developing fetus and can be corrected using fetal surgery techniques.
- Mother’s safety:
Whatever the indication or the fetal intervention, the most important consideration is the safety of the mother. All fetal surgeries are systematically maternal and fetal interventions, and our priority is the mother’s current health and future reproductive potential. The intervention is designed to benefit the fetus who has a problem, but the mother is an innocent bystander who assumes some risk for the sake of her unborn fetus. In weighing the risks versus the benefits of an intervention, the most important consideration is the mother, her health, her family, and her ability in the future to have other children.
- In utero blood transfusion
- Vesico-amniotic shunting
- Thoracoamniotic shunting
- Laser photocoagulation of vascular anastomoses in twin to twin transfusion syndrome
- Cord coagulation in TRAP (twin reversed arterial perfusion) syndrome or acardiac twinning
- Amniotic band ablation
- Tracheal plug for CDH (congenital diaphragmatic hernia)