With the development of advanced radiological techniques like fetal ultrasound and fetal MRI, many malformations are now being diagnosed while the baby is still in its mother’s womb. Some of these conditions are amenable to treatment before birth and are tackled by Fetal surgery. Rest of the conditions may be treated at birth or soon after birth and fall under the heading of Neonatal surgery.
- Fetal surgeries are performed on babies while they are still in the womb. These are performed for conditions which have potential to hamper the baby’s proper development.
- Neonatal surgeries are performed on newborns and babies up to one month of age. They are performed for conditions which are either detected at birth or which even when detected in-utero can wait till birth for proper management.
- Both the modalities are highly risky and they require management by multidisciplinary teams for fruitful outcomes.
Birth defects treated by Fetal surgery:
Fetal surgery is used to treat babies while they are still in their mother’s womb. It is found to be helpful in treating conditions like Amniotic band syndrome, Twin anemia-polycythemia sequence, Bronco-pulmonary sequestration, Spina bifida, Neck masses, Lower urinary tract obstructions, Congenital high airway obstructions to name a few.
Diseases treated by neonatal surgery
This is performed on newborn babies and up to one month of age. Some common diseases are Anorectal malformations, Atresia of Esophagus and Intestine, Hypertrophic pyloric stenosis, Gastroschisis, Omphalocele, Necrotising enterocolitis, Congenital diaphragmatic hernia, Inguinal Hernia, Lung cysts and tumors, Spina bifida, Hydrocephalus, Posterior urethral valves etc.
Techniques for Fetal and Neonatal surgery
Fetal surgery is mainly conducted in four ways depending on the condition of the baby and the mother. These are: Needle based surgery, Fetoscopic surgery, Open fetal surgery and EXIT procedure (EX utero Intrapartum Treatment). There are only a few centers for fetal surgery in India. Neonatal surgery may be performed either in the conventional open way or via Minimal Access route like Thoracoscopy and Laparoscopy.