About Fetal Surgery

What is fetal surgery?

Of the approximately 4 million babies born in the United States each year, about 120,000 (3 percent) have a complex birth defect. Maternal-fetal specialists have long known that some birth defects could be successfully treated after birth. But as technology, fetal imaging and prenatal testing have improved in the past few decades, so too has our knowledge of fetal development.

Expanded diagnostic tools have allowed us to identify more precisely when conditions worsen during fetal development. This knowledge has helped us develop new ways to help babies sooner while in utero. Today, fetal therapy is recognized as one of the most promising fields in pediatric medicine, and prenatal surgery is becoming an option for a growing number of babies with birth defects.

Treating birth defects before birth

Fetal surgery allows us to intervene earlier. Using highly sophisticated surgical procedures, we are now able to treat certain disabling and life-threatening birth defects during fetal development instead of after birth, and to offer new hope to families.

Fetal surgery is a complex and challenging procedure, requiring the most expert, comprehensive care for both mother and unborn baby. Few medical teams have the skill and resources to perform such complex procedures, which can present significant risks for both mother and baby.

The Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia has been providing this care to patients since 1995, experience that helps us to deliver the best outcomes while minimizing the risks to both you and your baby. Be sure to ask these questions before you allow a clinical program to perform fetal surgery.

Our team continues to work to improve maternal safety, refine surgical and imaging techniques, and offer new solutions to conditions developing in utero. Researchers at the Center are actively pursuing stem cell and gene therapies as new options to treat specific birth defects and congenital conditions before birth.

Fetal surgery procedures performed at CHOP

Every week, the fetal surgery team at Children’s Hospital of Philadelphia performs in utero surgery procedures ranging from open fetal surgery to minimally invasive procedures.

Fetal interventions performed at Children’s Hospital include:

Fetal Surgeries for Congenital Anomalies

This chart showcases the number and types of fetal surgery procedures performed at Children's Hospital of Philadelphia's Center for Fetal Diagnosis and Treatment between 1995 and April 2019.

Total cases: 1,764

 
Fetoscopic procedures involving
multiples: 972
 
Open procedures for MMC,
SCT, CCAM: 397
 
Shunts - TA/VA/cystoscopy: 230
 
EXIT procedures: 97
 
Other: 48
 
EXIT procedures following open
fetal surgery: 13
 
Fetal cardiac procedures: 7

 

 

Prenatal surgery is not indicated in all cases. Many other patients with fetal anomalies are treated surgically after birth by CHOP's multidisciplinary team of experts.

 

What conditions can be treated with fetal surgery?

As the field of fetal medicine continues to advance, more and more babies will be treated before they are born. Birth defects we have successfully treated in utero with fetal therapies at Children’s Hospital include:

  • Amniotic band syndrome
  • Bronchopulmonary sequestration of the lung
  • Congenital cystic adenomatoid malformation of the lung (CCAM)
  • Congenital diaphragmatic hernia (CDH)
  • Congenital high airway obstruction syndrome (CHAOS)
  • Intrauterine transfusion (IUT)
  • Lower urinary tract obstruction (LUTO)
  • Mediastinal teratoma
  • Neck mass
  • Pulmonary agenesis
  • Sacrococcygeal teratoma
  • Spina bifida (myelomeningocele)
  • Twin reversed arterial perfusion sequence (TRAP sequence)
  • Twin-twin transfusion syndrome (TTTS)

One day soon, we hope to offer more fetal therapies to more expectant mothers and ultimately, help the next generation of babies enjoy healthier lives.

Learn more about what to expect when undergoing fetal surgery at Children's Hospital of Philadelphia.

November 2013


Next Steps
Pregnant Mom and Child

Choosing a Fetal Treatment Center

Know what questions to ask when considering fetal surgery so you can make an informed decision that is right for you and your baby.

Pregnant Mom and Child

What to Expect

From the moment of referral through delivery and postnatal care, your family can expect a supportive experience when you come to us with a diagnosis of a birth defect.


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