The term fetal surgery is used to mean that the baby is
operated due to some anomalies detected by methods such as ultrasound while in
the womb. From time to time, we come across news articles titled "Surgery
in the womb" related to this issue. Scientific studies have increased in
this regard especially in the last 25 years and such operations are performed
in rare centers.
Fetal surgery is applied in the correction of progressive
anatomical malformations that have harmful effects during pregnancy and life
threatening postpartum.
Conditions
where fetal surgery can be applied:
- Hydronephrosis, Congestion in the urinary system
- Congenital diaphragmatic hernia (CDH)
- Congenital cystic adenomatoid malformation of the lung
(CCAM)
- Congenital heart anomalies
- Sacrococcygeal teratoma (SCT)
- Hydrothorax
- Hydrocephalus
- Meningomyelocele, Spina bifida
- Twin to twin transfusion syndrome
Another result noticeable in the studies after the operations
performed on the fetus in the womb is that the wound heals in the fetuses
without creating a scar on the contrary. This may provide some advantages in
performing some surgeries such as cleft palate-lip before delivery. Because
scarring and scars due to surgery will be less.
It is not yet known at what period of pregnancy it is
appropriate to perform fetal surgery. The probability of miscarriage if
intervened before the 22nd gestational week increases the incidence of preterm
delivery if the operation is performed after the 30th gestational week. The incidence
of low incidence during the safe period is unknown.
Two different techniques, open and laparoscopic, can be used
in fetal surgery. The open method has started to be applied before. In the open
surgery, the uterus is reached through the incision made to the abdomen and the
fetus is taken out of the uterus through the incision made in the uterus. At
the end of the operation, the uterus and pregnancy amniotic membranes are
sutured and closed. In the laparoscopic (endoscopic) method, it is accessed into
the uterus with fine instruments through small holes of approximately 5
millimeters. In laparoscopic method, the risk of hypothermia (lowering of the
body temperature) to occur in the fetus in open surgery is reduced to a lesser
extent. The risk of preterm delivery is lower since laparoscopic method does
not make a large incision as in the uterus open method.
The most common complications that may occur due to fetal
surgery is preterm delivery. Other complications include uterine rupture,
complications such as amniotic fluid leaking out of the uterus.
-CHOROID PLEXUS CYST
-CORPUS CALLOSUM AGENESIS (CCA)
-MEGA SISTERNA MAGNA
-MEGALENCEPHALY
-MICROCEPHALY
