Fetal Surgery

  • Foong-Yen Lim
  • Timothy M. Crombleholme


The extraordinary advances in molecular genetics and the ongoing technologic innovations in medical imaging now make it possible to prenatally diagnose virtually any condition with a high level of confidence. This has afforded the opportunity to consider prenatal treatment for an ever-expanding list of conditions and to avoid or minimize irreparable organ injury or death that can occur if treatment is delayed until after delivery. Fetal therapy has expanded the list of conditions that are considered for medical treatment including high-risk congenital pulmonary airway malformations (CPAM), fetal arrhythmias, congenital adrenal hyperplasia (CAH), and congenital diaphragmatic hernia (CDH). The indications for open fetal surgery have expanded with the development of interventions for myelomeningocele (MMC), sacrococcygeal teratoma (SCT), bladder outlet obstruction (BOO), and CPAM. Perhaps the most striking area of growth in fetal intervention has come in the field of fetoscopic techniques, which are used to treat conditions such as twin–twin transfusion syndrome (TTTS), twin reversed arterial perfusion (TRAP) sequence, and CDH.


Congenital Diaphragmatic Hernia Congenital Adrenal Hyperplasia Bladder Outlet Obstruction Congenital Diaphragmatic Hernia Fetal Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Abe K, Hamada H, Chen YJ, et al. Successful management of supraventricular tachycardia in a fetus using fetal magnetocardiography. Fetal Diagn Ther. 2005;20:459–62.CrossRefPubMedGoogle Scholar
  2. Bianchi DW, Crombleholme TM, D’Alton ME, editors. Fetology: ­diagnosis and management of the fetal patient. New York: McGraw-Hill; 2000.Google Scholar
  3. Biard JM, Johnson MP, Carr MC, et al. Long-term outcomes in children treated by prenatal vesicoamniotic shunting for lower urinary tract obstruction. Obstet Gynecol. 2005;106:503–8.CrossRefPubMedGoogle Scholar
  4. Breur JM, Visser GH, Kruize AA, et al. Treatment of fetal heart block with maternal steroid therapy: case report and review of the literature. Ultrasound Obstet Gynecol. 2004;24:467–72.CrossRefPubMedGoogle Scholar
  5. Deprest J, Jani J, Lewi L, et al. Fetoscopic surgery: encouraged by clinical experience and boosted by instrument innovation. Semin Fetal Neonatal Med. 2006;11:398–412.CrossRefPubMedGoogle Scholar
  6. Harrison MR, Evans MI, Adzick NS, editors. The unborn patient. 3rd ed. Philadelphia: WB Saunders; 2001.Google Scholar
  7. Hedrick HL, Flake AW, Crombleholme TM, et al. Sacrococcygeal teratoma: prenatal assessment, fetal intervention, and outcome. J Pediatr Surg. 2004;39:430–8. Scholar
  8. Kohl T, Hering R, Bauriedel G, et al. Fetoscopic and ultrasound-guided decompression of the fetal trachea in a human fetus with Fraser ­syndrome and congenital high airway obstruction syndrome (CHAOS) from laryngeal atresia. Ultrasound Obstet Gynecol. 2006;27:84–8.CrossRefPubMedGoogle Scholar
  9. Lim FY, Crombleholme TM, Hedrick HL, et al. Congenital high airway obstruction syndrome: natural history and management. J Pediatr Surg. 2003;38:940–5.CrossRefPubMedGoogle Scholar
  10. Marwan A, Crombleholme TM. The EXIT procedure: principles, ­pitfalls, and progress. Semin Pediatr Surg. 2006;15(2):107–15.CrossRefPubMedGoogle Scholar
  11. Nimkarn S, New MI. Prenatal diagnosis and treatment of congenital adrenal hyperplasia. Pediatr Endocrinol Rev. 2006;4:99–105.PubMedGoogle Scholar
  12. Peranteau WH, Wilson RD, Liechty KW, et al. Effect of maternal betamethasone administration on prenatal congenital cystic adenomatoid malformation growth and fetal survival. Fetal Diagn Ther. 2007;22:365–71.CrossRefPubMedGoogle Scholar
  13. Rossi AC, D’Addario V. Laser therapy and serial amnioreduction as treatment for twin-twin transfusion syndrome: a metaanalysis and review of literature. Am J Obstet Gynecol. 2008;198:147–52.CrossRefPubMedGoogle Scholar
  14. Sutton LN. Fetal surgery for neural tube defects. Best Pract Res Clin Obstet Gynaecol. 2008;22(1):175–88.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Pediatric SurgeryCincinnati Children’s Hospital Medical CenterCincinnatiUSA

Personalised recommendations