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Fetal surgery becomes an option when doctors predict that the fetus will not live long enough to make it to delivery or live long after birth. For instance, if it is discovered on prenatal ultrasound that a fetus has a severe form of congenital diaphragmatic hernia, in which the liver is located in the chest and lung development is severely restricted, fetal therapy may alleviate the severity of the problem. This way, the baby has enough function to live upon delivery and undergo further corrective surgery.
Fetal tumors are another life-threatening condition that can be treated in utero. Often benign sacrococcygeal tumors early in development can grow very large and cause the baby's heart to work very hard to pump blood causing heart failure and possible death. Guided by ultrasound imagery, radiofrequency ablation can be used to cut off blood supply to the tumor. This maneuver hinders the tumor's growth so that the fetus can survive until it is delivered, and the tumor can be safety removed after birth.
Fetal surgery is now also being considered in the treatment of some severely disabling conditions that aren't life threatening, but could benefit from fetal intervention. For instance, research has found that if some types of spina bifida are caught early enough in gestation, a certain amount of spinal cord function can be preserved, which would dramatically alter the course of therapy for the better upon birth.
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