Fetal surgeons belong to a highly trained group of professionals that save thousands of babies every year by performing corrective procedures on an unborn infant. These procedures typically minimize an abnormality, which enables continued fetal growth and development while improving the chances of surviving extensive procedures after delivery. Anomalies often appear around the 20th week of gestation via ultrasound evaluations. Once discovered, physicians determine if and what type of fetal surgery becomes necessary.
Fetal Surgery Methods
Surgeons perform one of three types of fetal surgeries. Open fetal surgery closely resembles a Caesarean section. With the mother under general anesthesia, the surgeon makes an incision in the woman’s abdomen and partially removes the fetus. The baby continues receiving life support through the placenta while the physician performs the necessary corrections. Once completed, the fetus returns to the safety of the uterus and continues developing. Premature labor and delivery remains a high risk with the procedure necessitating that the mother stay on bedrest and receive medications that prevent the initiation of labor.
Fetendo surgery also presents a risk of early labor and delivery but offers a less invasive alternative. During the procedure, the surgeon inserts video imaging and delicate surgical instruments through a small incision into the abdomen and the uterus for making the necessary repairs. Fetoscopic surgery provides the least invasive option of all the procedures. The surgeon utilizes ultrasound as the guide for locating the anomaly. The mother undergoes spinal anesthesia while the infant receives relaxation and pain medication if necessary. Surgeons insert a needle sized imaging device and instrumentation into the uterus for performing the required corrections. This type of surgery presents little to no risk for pre-term labor and delivery. Some of the many problems corrected by fetal surgery include:
* Spina Bifida-This congenital disorder prevents the neural tube from forming and closing correctly around the spinal column. Studies indicate that infants undergoing fetal surgery have better results with fewer residual effects compared to infants undergoing post-delivery procedures.
* Hydrocephalus-The condition causes excess fluid in the brain and requires shunting for proper drainage. Surgeons in the United States no longer perform fetal surgery for this anomaly because of the many risks involved.
* Inborn Errors of Metabolism-The number of possible metabolism errors may create a vast array of physical symptoms possibly requiring correction through fetal surgery.
* Transplantation Immunology-Research continues on the prospect of preventing disease processes by transplanting stem cells in utero. Some of the options include blood stem cells for preventing sickle cell anemia and muscle stem cells for treating muscular dystrophies.
* Fetal Therapy-This term describes the branch of medicine that utilizes medication and/or surgery for treating diagnosed fetal anomalies. One type of therapy involves using a laser to divert blood circulation in fetuses displaying twin-to-twin transfusion syndrome.
Risks of Fetal Surgery
Besides the possibility of pre-term labor and delivery, many risks involving fetal surgery also include the possibility of hemorrhage and the development of an infection. As the mother receives an incision for the initial reparative process, women must undergo Caesarean section for delivery. Subsequent births most likely also require delivery by C-section. Following fetal surgery, families must additionally take into consideration the time needed for complete rest and recuperation.