Fetal Surgery | In Depth

When is fetal surgery an option?

Fetal surgery becomes an option if your doctors predict that the fetus will not live long enough to make it to delivery or live long after birth.

  • Congenital diaphragmatic hernia (CDH)If doctors discover 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, your baby has enough function to live upon delivery and undergo further corrective surgery.
  • Fetal tumors: a life-threatening condition that can be treated in utero. Often, benign sacrococcygeal tumors early in development can grow very large and cause your baby's heart to work too hard to pump blood, causing heart failure and possible death. Guided by ultrasound imagery, your doctors can 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.

What are the risks associated with fetal surgery?

Before undergoing fetal surgery, you should understand and accept the risks associated with the procedure that your doctor has recommended.

The biggest risks of open fetal surgery include:

  • bleeding
  • infection
  • preterm labor
  • complications associated with anesthesia medications (rare)

After fetal surgery, both mother and fetus are monitored closely in the hospital. Mothers receive various medications to control pain, usually with an epidural, and receive a variety of medications to control and prevent preterm labor. Most of the open surgical techniques involve an incision in a part of the uterus that would require mothers to have any future children delivered via Cesarean section.

Fetal surgery also poses risks to the health of the fetus, but these risks are usually outweighed by the benefit of surgery, since usually surgery is performed to save the fetus's life or to have an increased improvement in function.

Be sure to discuss any risks of surgery fully with your doctor.