Fetal Surgery Cutting into the new trend


Spina bifida: a condition where the spine doesnt fully enclose the nerves, and the skin is not as protective of the spine as it should be

Cerebral palsy: when a person is incapable of their body, usually limbs

Amniotic fluid: the fluid inside of the womb with the child, protecting the infant

Stillborn: when an infant is born dead

In utero: a fetus inside the womb

Hydrocephalus: fluid build up in the brain

Is fetal surgery safe for mother and child?

Fetal Surgery involves cutting open the abdomen, moving the organs surrounding the uterus, carefully slicing and taking out the uterus to do a procedure for an infant's health. Although the infant is the main patient, the mother is a large part of the procedure. The mother has to be healthy and stable to also be operated on. The procedure is for the child, but are the health risks too much for the mother? Dave Andrusko, author of “Baby could have been aborted, but fetal surgery corrects rare heart condition”, states, “Tom Avril added that they told Rice and her partner Mike Roussin, Justin ‘probably would not survive. Rice’s own health was at risk,and she might have to terminate the pregnancy.’” This is sad reality of fetal surgery. Many mothers do have health risks when undergoing the procedure. Many mothers will have to terminate pregnancies due to major complications. While there has been specific circumstances for the surgery, many procedures are done to fix spina bifida, but that could even be too risky.During a study done by Joseph Bruner and Noel Tulipman at vanderbilt University, they operated on four infants who had spina bifida in utero. Of the four, two died and the other two were born prematurely. Since surgeons have been doing this procedure, many children have been victims of premature birth, and some have sadly miscarried due to the stress on the uterus. While the procedures now can be very dangerous, throughout the short history of prenatal surgery, there have been advancements to the practices of fetal surgery.

What has been done to make fetal surgery safer and less invasive?

Fetal surgery, an already invasive, forward bound, and very skillful subspecialty. Trying to make the craft less invasive has been a task, but they have made major strides, and will continue to. Although many surgeries have been done, some procedures are not very safe. In fact, a woman's uterus can rupture, leaving her and her child with major health issues along with being born pre maturely. Up to 5% of the children who were born prematurely developed cerebral palsy. Once these results came back, many surgeons were trying to figure out ways to make these procedures safer. According to Maggie Jones, “In 1997, Tulipan suggested a more direct, and bold, approach -- one that had been used in other maternal-fetal surgeries: they lifted the uterus out and cut it open.” This approach was much safer. By taking the uterus out, they did not have to worry bout the amniotic fluid getting into to mother's body surrounding the uterus. And they could restore the amniotic fluid and uterus more securely. AS safe as procedures can be, there is always an opposing side to the practice.

What conditions can be operated on?

Not all conditions can be operated on inside the womb. This is because the risk of a stillborn or miscarriage is too high to continue. The only understanding doctors need is that not all infants will benefit from the surgery. “Spina bifida, a condition that nearly 2000 babies are born with each year. The most dangerous form, myelomeningocele, can be fatal if left untreated”(Murray, Peter). This condition is usually operated on because of the urgency that surrounds it. This condition is when the spine does not fully close around the nerves, and in turn, the skin is less protective surrounding the area. If not operated on, this can lead to bladder and bowel issues, and hydrocephalus . Some conditions are less likely to be operated on because of the risk that it causes. When it comes to heart surgery, many doctors and mothers prefer to wait until the child is born to let the heart develop as far as it can go. Around 40,000 children a year are diagnosed and born with CHD, or Congenital heart defects. Of those, about 25% of them have to be operated on within the first year(“Congenital heart defects”). Most children who are diagnosed with CHD are more likely to live if they wait after their born. If they are urgent, many doctors will opt for an emergency cesarean section, or a C-section. This way, they are out of the womb, in the NICU ( Neonatal intensive care unit), and able to be operated on and under higher observation. Babies all over the world are diagnosed and born with many different conditions. How medicine has helped in tremendous ways. The big question is, if they can operate on the child, should they.

Does Fetal Surgery Cause Controversy?

With everything in the known world there is controversy. There’s controversy on natural resources, civil rights, and women's rights. So logically, there is major controversy over this as well. Maggie Jones author of “ A Miracle, and Yet” states, “This leap has not come without controversy. Some doctors and ethicists have criticized surgeons for cutting into the womb without strong evidence that the surgery even works.” While there have been trials, there has not been enough success to confirm that it works well enough to declare it a safe and successful practice. Not only has fetal surgery not yet been proven effective, the trials that is has done has been risky. In the course of a year, over 1600 babies are diagnosed with CDH in the United States alone. There is a 50% survival rate, so 800 of those children will die. The reality of fetal surgery is that many conditions, you cannot operate on. Fortunately, CDH is one that you can, but it has a high risk factor. Fetal surgery is a widely speculated practice due to its unusual approach. So the only question is where is it heading?

Where is Fetal Surgery headed?

Many practices in the medical field are always growing, it is necessary for safety that the practice keeps evolving. In surgery specifically evolution and growth is very important. The ways surgeons cut, replace and repair is always changing, and for the better.Fetal surgery is not a practice to never change. Alan Flake, a pediatric surgeon at the Children's Hospital of Philadelphia states, "I think these techniques will be considered somewhat Neanderthal," he says. "To me, the real future of fetal treatment is applying stem cells or gene therapy to the fetus." The future lies within the imagination of the next generation,and this is what surgeons are doing.Applying stem cells to an infant in utero will reduce the stress on the mother and child, also making the procedure less invasive. Along with the idea of injecting stem cells. The theory is quite sound and safe. “Delivery of stem cells in utero might make the procedure less risky. If doctors could deliver blood-forming stem cells from the child's mother or father—a half match—in utero, the fetus's weakened immune system might allow the cells to take hold”(Willyard, Cassandra). The stem cells will repair the acquired disability. The half match will strengthen the probability of the infant taking the cells. With many advancements in medicine, we can expect sudden and effective changes to fetal surgery.


Andrusko, Dave. "Baby could have been aborted, but fetal surgery corrects rare heart condition." NRL News Today Baby could have been aborted but fetal surgery corrects rare heart condition Comments. NRL News Today, 07 Dec. 2016. Web. 20 Feb. 2017.

Blakeslee, Sandra. "FETUS RETURNED TO WOMB FOLLOWING SURGERY." The New York Times. The New York Times, 06 Oct. 1986. Web. 20 Feb. 2017.

Costello | Times Staff Writer, Daniel . "Too much risk?" Los Angeles Times. Los Angeles Times, 26 Sept. 2005. Web. 20 Feb. 2017.

"Data and Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 12 Oct. 2016. Web. 20 Feb. 2017.

Jones, Maggie. "A Miracle, and Yet." The New York Times. The New York Times, 14 July 2001. Web. 20 Feb. 2017.

"Midwest Fetal Care Center Launches Open Fetal Surgery Program." Children's Hospitals and Clinics of Minnesota. N.p., 17 Jan. 2017. Web. 20 Feb. 2017.

Murray, Peter. "In Utero Surgery – More Common Today, But No Less Miraculous." Singularity Hub. N.p., 09 Apr. 2012. Web. 20 Feb. 2017.

Tegna. "New fetal surgery treats birth defect in womb." KARE. N.p., n.d. Web. 20 Feb. 2017.

Willyard, Cassandra. "Tinkering in the womb: the future of fetal surgery." Nature News. Nature Publishing Group, 01 Nov. 2008. Web. 20 Feb. 2017.


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