Finding out that your unborn baby has a serious or life-threatening condition is terrifying. But you should not feel alone. Every year in the United States, about 120,000 babies are affected by birth defects; that’s about one in every 33 babies. While it’s easy to feel overwhelmed by all the information you receive about your diagnosis, it is important to realize that there are more potentially life-saving opportunities for your baby than ever before. One of those opportunities is fetal surgery. The need for fetal surgery is rare, but for certain conditions it offers remarkable help and hope for babies that are still growing in their mother’s wombs.
Thanks to advancements in imaging technology and early diagnosis (usually within the first three months), doctors are able to recognize and surgically treat some conditions quickly and effectively. Learning about your baby’s birth defect in advance means that you have time to prepare emotionally, and your doctors can develop the best possible care plan for you and your baby.
When Care Can’t Wait
Although most problems do not require fetal surgical intervention, surgeries on unborn babies can save lives and improve outcomes for certain defects. For example, fetal surgery for spina bifida may help dramatically minimize the baby’s disabilities and quality of life growing up. Other conditions, from bladder outlet obstruction to congenital diaphragmatic hernia and twin-to-twin-transfusion syndrome, can be treated surgically in the womb with amazing results and happy endings.
As you’re making decisions about your baby’s care, you’ll want to learn as much as you can about fetal surgery. While fetal surgery is extremely rare and recommended as an option in less than one-tenth of 1 percent of all pregnancies, fetal surgery outcomes are impressive and offer significantly beneficial results for many babies.
Fetal Surgery is Safer than Ever Before
When fetal surgery is recommended, it is important to know that it is safer today than ever before for both mother and baby. As one of the newest surgical specialties, fetal surgery began in the late 1960s and has improved dramatically, especially in the past three decades. Tools for diagnosing and treating conditions in utero have also become more sophisticated, and advancements have enhanced the quality significantly since the 1990s.
Below is information you need to know:
Types of Fetal Surgery
When fetal surgery is required, doctors will choose one of three types:
Open fetal surgery
In this type of surgery, doctors open the uterus completely to operate on the fetus while it is still in the womb. They close the uterus after surgery and allow the pregnancy to continue. Open fetal surgery is recommended when the fetus has a defect that will worsen as it develops. This includes conditions such as congenital pulmonary airway malformation (CPAM), spina bifida and complete blockages of the heart that require the placement of a pacemaker.
Minimally invasive fetoscopic surgery
As the name implies, this form of fetal surgery is less invasive than open fetal surgery and entails fewer risks. Doctors make small incisions and use a fetoscope, a small device that allows them to view the inside of the uterus during surgery. They also use sonography to guide their movements through the uterus.
This type of surgery can be used for conditions such as twin-to-twin transfusion syndrome (TTTS), release of amniotic band syndrome (ABS) and release of cord entanglement in monoamniotic twins, among others.
Ultrasound-guided fetal intervention
The least invasive of the three types of fetal surgery, ultrasound-guided fetal procedures use continuous ultrasound direction to guide doctors during treatment. These procedures may or may not require an incision and are often performed while the mother is awake but sedated.
This type of intervention can treat conditions such as bladder outlet obstruction and twin reversed arterial perfusion sequence (TRAP), and it can also be used to perform intrauterine blood transfusions.
An EXIT Procedure May be Performed at Birth
A fourth type of procedure, called Ex-Utero Intrapartum Treatment (EXIT), happens at birth rather than in the womb. It is designed to help babies whose conditions might make it difficult or impossible for them to breathe after delivery.
This treatment is a modified cesarean delivery. The baby is partially delivered, and while he or she is still receiving nutrients and oxygen through the umbilical cord, doctors establish an airway to allow the baby to breathe. They then clamp the cord and complete the delivery.
What to Look for in a Fetal Treatment Center
When it’s time to choose a provider for your baby’s care, you need to know that you’re in the best hands possible. Fetal Care Center Dallas is a fetal surgery center with one of only a handful of physician groups in the U.S. that is able to provide you and your unborn baby with the most sophisticated, comprehensive therapies available today. The outcomes of our open fetal surgeries are some of the best in the world.
We are connected with the resources at the Fetal Care Center at Medical City Children’s Hospital and Medical City Women’s Hospital with our physicians and pediatric subspecialists all working within the same healthcare complex. This team is composed of members specializing in fetal and neonatal surgery, fetal and pediatric cardiology, genetic counseling, maternal-fetal medicine, anesthesiologists, neonatologists, radiologists and perinatal psychologists. Depending upon the needs of your child, you can expect to interact with these and potentially an even more extensive variety of medical specialists.