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| Fetal surgery | |
|---|---|
 Schematic illustration of endoscopic fetal surgery for twin-to-twin transfusion syndrome | |
| Other names | Antenatal surgery |
| ICD-9-CM | 75.36 |
Fetal surgery, also known as antenatal surgery or prenatal surgery,[1] 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. There are three main types:[2] open fetal surgery, which involves completely opening the uterus to operate on the fetus; minimally invasive fetoscopic surgery, which uses small incisions and is guided by fetoscopy and sonography; and percutaneous fetal therapy, which involves placing a catheter under continuous ultrasound guidance.
Fetal intervention is relatively new. Advancing technologies allow earlier and more accurate diagnosis of diseases and congenital problems in a fetus.
Fetal surgery draws principally from the fields of surgery, obstetrics and gynecology, and pediatrics- especially the sub-specialties of neonatology (care of newborns), maternal-fetal medicine (care of high-risk pregnancies), and pediatric surgery. It often involves training in obstetrics, pediatrics, and mastery of both invasive and non-invasive surgical techniques. Because of the very high risk and technical complexity of fetal surgery, the procedure is usually performed at specialist centers.
Fetal intervention involves risk to fetus and pregnant patient alike. In addition to the general risks associated with any surgery, there is also a risk that scarring of the uterus will lead to difficulties with future pregnancies.[citation needed] This risk is higher than for a typical Cesarean section, for several reasons:
- the incision is usually a classical vertical one, with a greater risk of complications in subsequent pregnancies;
- the longer duration of the surgery, while the fetal intervention is performed;
- a second surgery is required days or weeks later – a Caesarean section to deliver the baby, which brings its own set of risks.
- ^ The Encyclopedia of Children's Health
- ^ O'Connor, Kathleen (November 20, 2012). "Ethics of Fetal Surgery". The Embryo Project Encyclopedia. Arizona State University. Retrieved April 20, 2017.