Fetal Surgery
What is it?
Fetal surgery is a highly complex surgical intervention to repair birth defects in the womb that requires the most expert care for both mother and unborn baby. [1]
The procedure is performed on an unborn baby while he/she is still in their mother’s uterus, with the intention of helping to improve the long-term outcome of the child with the specific birth defect. Because these defects often worsen as a foetus develops, fetal surgery done by a team of experts focuses on treating and improving the conditions before birth. [2]
In open fetal surgery, the mother is anaesthetised, an incision is made in the lower abdomen to expose the uterus, the uterus is opened using a special stapling device to prevent bleeding, the surgical repair of the foetus is completed, the uterus followed by the maternal abdominal wall are closed, and the mother awakened. The overall process is similar to a caesarean section (C-section). After surgery, the expecting mother is required to remain in hospital for 3 to 7 days, and will need to deliver her baby via C-section, often preterm. The pregnancy must be supervised closely by an obstetric specialist for preterm labour and medications to control preterm labour are required until delivery. [3]
What that is used to treat?
Comprehensive health centres that have fetal surgery expertise and experience can treat many birth defects in utero, including:
- Amniotic band syndrome
- Bronchopulmonary sequestration of the lung
- Congenital cystic adenomatoid malformation (CCAM) of the lung
- Congenital diaphragmatic hernia (CDH)
- Congenital high airway obstruction syndrome (CHAOS)
- Fetal anaemia
- Lower urinary tract obstruction (LUTO)
- Mediastinal teratoma
- Neck mass
- Sacrococcygeal teratoma (SCT)
- Spina bifida (myelomeningocele)
- Twin anaemia-polycythemia sequence (TAPS)
- Twin reversed arterial perfusion (TRAP) sequence
- Twin-twin transfusion syndrome (TTTS) [2]
Doctors perform heart surgery on 25 week old fetus
In early October 2013, Surgeons in Los Angeles have for the first time performed a life-saving procedure on a tiny fetus inside its mother's womb after practising on a grape.Using a hair-fine wire, a miniature needle, a tiny balloon and a catheter they successfully carried out the operation on the unborn child's heart - which is about the size of a walnut.It was a medical first for the surgical team at CHA Hollywood Presbyterian Medical Center, in Los Angeles, and according to the LA Times, it appears to have been a success.
Read more here from DailyMail...
In-womb surgery saves Navy couple's twins
Crystal Springer was 22 weeks pregnant when she and husband Nick learned their twin babies had a rare condition called ‘Twin Twin Transfusion Syndrome’. This is when one of the foetuses gives up most of its blood and nutrients to the other through shared blood vessels on the placenta.
They went right from the doctor's office to Eastern Virginia Medical School to meet with Jena Miller, MD, a Maternal-Fetal Medicine specialist. She recommended a laser procedure - performed in the womb - to separate the blood vessels.
A baby's life was saved by a pioneering operation carried out when she was still in her mother's womb.
Michelle Cannon had been advised to have an abortion after receiving the devastating news that her unborn daughter had a rare and usually deadly condition. Fluid was building up in the baby's chest and crushing her lungs, but at 22 weeks she was too premature to be delivered.Yet her 31-year-old mother refused to abandon hope, and after hours of online research came across "in-womb surgery" - a procedure which has been carried out only a few times in the world."There was no way we were going to give up on her," said Miss Cannon, who lives in Doncaster with her partner Gareth Dawson, 24. 'I burst into tears when I was told the news. But one thing was for certain, we were adamant we were going to keep this baby."
Frankie Lavis
A "MIRACLE" baby who had surgery in the womb to treat a birth defect is now able to stand with support - something her mother never dreamed would happen.
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