Foetal surgery improving all the time

WHAT IS IT?

Foetal surgery involves operating on the foetus before birth. It is done to correct, or limit the damage from congenital abnormalities that cannot be equally well treated after birth.

The uterus is open (similar to a cesarean secton) and the foetus is exposed, the foetal surgery begins. Typically, this surgery consists of an interim procedure intended to allow the fetus to remain in utero until it has matured enough to survive delivery and neonatal surgical procedures. Upon completion of the foetal surgery, the foetus is put back inside the uterus and the uterus and abdominal wall are closed up.

The mother remains in the hospital for 3-7 days for monitoring and is required to subsequently deliver the baby via a cesarean section. Often babies who have been operated on in this manner are born pre-term.

Surgery can be performed on a baby 22 weeks after conception. Doctors use technology developed for astronauts to monitor the health of unborn patients. A radio transmitter can be implanted into the mother's uterus which sends information about vital signs to doctors. Foetal surgery inevitably causes premature birth and the radio device can also help here. If contractions are caught early enough, drugs can stop the delivery process, allowing the tiny patient time to rest and recover.

WHAT IS IT USED TO TREAT?

Complex birth defects are a leading cause of death and illness among newborns. They affect some three percent of all live births. Sophisticated imaging techniques and advances in diagnostic testing have made many of these anomalies detectable before birth. Although most birth defects are best managed by medical and surgical care after delivery, an increasing number of simple anatomic abnormalities have been successfully corrected before birth.

• Congenital diaphragmatic hernia (if indicated at all, it is now more likely to be treated by endoscopic fetal surgery)

• Congenital cystic adenomatoid malformation

• Congenital heart disease

• Myelomeningocele (a severe form of spina bifida)

• Pulmonary sequestration

• Sacrococcygeal teratoma

 

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