About Fetal Surgery

Of the approximately 4 million babies born in the United States each year, about 120,000 (3 percent) have a complex birth defect. Maternal-fetal specialists have long known that some birth defects could be successfully treated after birth. But as technology, fetal imaging and prenatal testing have improved in the past few decades, so too has our knowledge of fetal development.

Expanded diagnostic tools have allowed us to identify more precisely when conditions worsen during fetal development. This knowledge has helped us develop new ways to help babies sooner while in utero, including with surgery before birth. Today, fetal therapy is recognized as one of the most promising fields in pediatric medicine, and prenatal surgery is becoming an option for a growing number of babies with birth defects.

Treating birth defects before birth

Fetal surgery allows us to intervene earlier. Using highly sophisticated surgical procedures before birth, we are now able to treat certain disabling and life-threatening birth defects during fetal development instead of after birth, and to offer new hope to families.

Fetal surgery is a complex and challenging procedure, requiring the most expert, comprehensive care for both mother and unborn baby. Few medical teams have the skill and resources to perform such complex procedures, which can present significant risks for both mother and baby.

The Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia has been providing this care to patients since 1995, experience that helps us to deliver the best outcomes while minimizing the risks to both you and your baby. Be sure to ask these questions before you allow a clinical program to perform fetal surgery.

Our Experience

The Center for Fetal Diagnosis and Treatment has the expertise, experience and compassion needed to perform the most complex fetal surgery procedures.

Our team continues to work to improve maternal safety, refine surgical and imaging techniques, and offer new solutions to conditions developing in utero. Researchers at the Center are actively pursuing stem cell and gene therapies as new options to treat specific birth defects and congenital conditions before birth.

Every week, the fetal surgery team at Children’s Hospital of Philadelphia performs in utero surgery procedures ranging from open fetal surgery to minimally invasive procedures.

Fetal interventions performed at Children’s Hospital include:

• Open fetal surgery for life-threatening or devastating fetal conditions
  • Open fetal surgery for myelomeningocele, the most severe form of spina bifida
  • Open fetal surgery for sacrococcygeal teratoma (SCT) resection
  • Open fetal surgery to remove CCAM
• Minimally invasive fetoscopic surgery, including:
  • Bladder and chest shunt placement
  • Fetoscopic endoluminal tracheal occlusion (FETO) for severe CDH
  • Fetoscopic laser ablation (LASER)
  • Bipolar cord coagulation (BCC)
  • Radio frequency ablation (RFA)
• Ex utero intrapartum treatment (EXIT)
• Fetal cardiac intervention
• In utero stem cell transplantation
• Intrauterine blood transfusions

As the field of fetal medicine continues to advance, more and more babies will be treated before they are born. Birth defects we have successfully treated in utero with fetal therapies at Children’s Hospital include:

• Amniotic band syndrome
• Bronchopulmonary sequestration of the lung
• Congenital cystic adenomatoid malformation of the lung (CCAM)
• Congenital diaphragmatic hernia (CDH)
• Congenital high airway obstruction syndrome (CHAOS)
• Intrauterine transfusion (IUT)
• Lower urinary tract obstruction (LUTO)
• Mediastinal teratoma
• Neck mass
• Pulmonary agenesis
• Sacrococcygeal teratoma
• Spina bifida (myelomeningocele)
• Twin reversed arterial perfusion sequence (TRAP sequence)
• Twin-twin transfusion syndrome (TTTS)

One day soon, we hope to offer more fetal therapies to more expectant mothers and ultimately, help the next generation of babies enjoy healthier lives.

Learn more about what to expect when undergoing fetal surgery at Children's Hospital of Philadelphia.

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November 2013