Fetal surgery, or as it is called in Turkey “in-utero treatment,” which makes it possible to recognize the problems of an unborn child in the womb, has become possible thanks to the development of technology and advances in anesthesia and perinatal medicine. The decisive factors determining the need for surgery or in-utero treatment are both the high risk of irreversible consequences in the absence of intervention and the fact that the superiority of intrauterine intervention over postpartum intervention is confirmed.
Today, there are some diseases in which treatment in the womb gives the unborn child a better chance of life than intervention after birth. Also, in-utero treatment is usually accompanied by fewer possible problems with the child’s health in the long term. In the case of such diseases, in-utero treatment (fetal therapy) should be considered as a priority treatment option. In situations where the superiority of in-utero treatment over treatment after birth still cannot be fully proven scientifically, fetal therapy is considered experimental and is not offered as a standard treatment option.
In-utero treatment is carried out by an injection of medications sometimes into the mother’s body and its subsequent entry into the child’s body through the placenta (transplacental treatment), sometimes into the umbilical cord of the child, and sometimes into the fluid in which it is located (amniotic fluid). In cases where an in-utero treatment is required, it is performed in the form of open surgery and sometimes endoscopic (fetoscopic) surgery.
Thanks to intrauterine treatment, babies can have an increased chance of being born healthy or with the least number of abnormalities. Such practices are also superior to postpartum surgery, and finally, these methods, which expose mother and baby to reasonable risks, still have an acceptable level of success.
Fetal therapy means treating an unborn baby while it is still in the womb. Fetal therapy includes a wide range of methods, starting from ones as simple as an injection of medications into the mother's body and its subsequent entry into the child's body through the placenta, and ending with open or closed (fetoscopic) intrauterine operations.
Fetal surgery is resorted to by pregnant women who have been found to have problems with their babies.
Like any other surgery, fetal therapy involves risk. Open surgery operations can cause bleeding of the mother, associated with anesthesia and the operation itself, as well as lung problems (if it is general anesthesia), infection, and risks related to the uterus. Apart from that, all fetal surgery operations, varying depending on the form of the operation, carry the risk of miscarriage, premature birth, organ injuries, premature amniotic fluid discharge, and other similar problems.
Methods of fetal therapy can sometimes include injections of medications into the mother's body and its subsequent entry into the child's body through the placenta (transplacental treatment) or into the amniotic fluid. Sometimes it can be in the form of umbilical cord exposure (cordocentesis), open operations (laparotomy), open operations on the uterus (laparotomic hysterectomy), as well as closed operations (endoscopic/fetoscopic). The choice of method depends on the type of problem.