Overview

Foetal surgery is crucial due to its ability to address congenital anomalies and life-threatening conditions in the early stages of pregnancy, optimising outcomes for both the foetus and the expectant mother. Unlike traditional postnatal interventions, foetal surgery offers the unique advantage of treating abnormalities while the foetus is still developing, often reducing potential complications and improving long-term impacts. Conditions such as neural tube defects, congenital heart abnormalities, and twin-to-twin transfusion syndrome necessitate prompt intervention, making foetal surgery a critical option. Early identification and correction of foetal anomalies can prevent further damage to vital organs and promote healthier foetal development.

What is foetal surgery?

Foetal surgery, also known as prenatal surgery, is a medical procedure performed on an unborn baby while still in the mother's womb. It aims to treat or correct certain developmental abnormalities and conditions before birth. This highly specialised surgical intervention is typically reserved for cases where the condition poses a significant risk to the foetus or threatens its overall well-being.

Why is foetal surgery required?

Foetal surgery is required in certain cases; let's check out the following:

Correcting structural abnormalities: Foetal surgery is often recommended when a developing foetus is diagnosed with structural abnormalities that can impact their health and development. Some common conditions that may require surgical intervention include:

Spina bifida
Congenital diaphragmatic hernia (CDH)

Chest X-ray of the newborn patient diagnosed as Congenital diaphragmatic hernia

- Twin reversed arterial perfusion (TRAP) sequence

Managing Life-Threatening Conditions: Foetal surgery may be required to address life-threatening conditions that pose significant risks to the health and survival of the foetus. Conditions such as

- Congenital heart defects
- Lower urinary tract obstruction (LUTO)

Optimising Long-Term Outcomes: Foetal surgery can improve long-term outcomes for babies with certain conditions. By intervening early in the development process, doctors can prevent or minimise damage that may otherwise occur if left untreated until birth.

- Twin-to-twin transfusion syndrome (TTTS)

Twin-to-twin transfusion syndrome (TTTS)

Open neural tube defects

Procedure of Foetal Surgery

Here are the key steps and considerations during foetal surgery:.

Patient evaluation: Before foetal surgery is considered, a thorough evaluation of the mother and the unborn child is conducted.

Choosing the right candidates: Not all cases are suitable for foetal surgery. The decision to proceed is based on careful consideration of various factors, including the potential benefits of treatment and the risks associated with the procedure.

Surgical techniques:

Open Foetal Surgery: In cases where direct visualisation and manipulation are necessary, open foetal surgery is performed. This involves making an incision in the mother's abdomen and uterus to access the foetus.
Minimally Invasive Foetal Surgery (Fetoscopy): Minimally invasive techniques involve smaller incisions and the use of a fetoscope, a tiny camera that allows visualisation inside the uterus.
Image-guided foetal interventions: Utilising advanced imaging techniques such as ultrasound or MRI, surgeons can guide instruments to the affected area without direct visualisation. This approach is commonly used for conditions such as congenital lung lesions.
Anaesthesia and monitoring: The mother is placed under general anaesthesia to ensure her comfort and safety during the procedure.
Postoperative care: Following foetal surgery, close monitoring ensures the well-being of both the mother and the unborn child.
Long-term follow-up: Monitoring the child's development and addressing potential health concerns that may arise postnatally is essential.

When to Consult a Doctor

You can also get in touch with the expert Gynaecology doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Conclusion

Foetal surgery represents a remarkable frontier in the field of medicine, offering hope to families facing the challenges of foetal abnormalities. The continual evolution of foetal surgery techniques underscores the commitment of medical professionals to pushing the boundaries of what is possible in the pursuit of healthier beginnings.

FAQs About Foetal Surgery

Q. What conditions can be treated with foetal surgery?
A. Foetal surgery is used to address various congenital conditions such as neural tube defects (e.g., spina bifida), congenital diaphragmatic hernia, twin-twin transfusion syndrome, and certain tumours.

Q. How is foetal surgery performed?
A. Foetal surgery can be performed using different techniques, including open foetal surgery, where an incision is made in the mother's abdomen and uterus; minimally invasive fetoscopy, involving small incisions and a camera; and image-guided interventions using advanced imaging techniques such as ultrasound or MRI.

Q. What are the most common foetal surgeries?
A. The most common foetal surgeries include interventions for conditions such as spina bifida, twin-twin transfusion syndrome (TTTS), congenital diaphragmatic hernia (CDH), and certain heart defects.

Q. What are the potential risks and benefits of foetal surgery?
A. Potential benefits include correcting or improving the foetal condition, leading to better outcomes after birth. However, foetal surgery also carries risks, including preterm labour, maternal complications, and potential harm to the tus. The decision to undergo foetal surgery involves careful consideration of these factors.

Q. Is foetal surgery always the best option for treating congenital conditions?
A. Foetal surgery is not always the best option, and the decision depends on the specific diagnosis, the severity of the condition, and other individual factors.

References

https://my.clevelandclinic.org/health/treatments/24945-fetal-surgery
https://www.mayoclinic.org/tests-procedures/fetal-surgery/about/pac-20384571