Fetal Intervention & Surgery

Fetal interventions describes the wide range of in-utero procedures that may be needed to aid in the growth and development of the baby. This can be guiding a camera into the uterus to get a closer look or repair a defect, or fetal surgery in which the baby is operated on in-utero to allow for a safe delivery later. The experienced specialists in the Fetal Center will discuss your options with you and determine if you may be a candidate for an intervention or surgery based on your diagnosis.

We provide these services:

  • Laser surgery for Twin to Twin Transfusion Syndrome (TTTS): TTTS occurs in identical twin pregnancies when one twin receives more blood flow than the other twin from shared blood vessels. This can be life threatening for both twins if it goes untreated. Laser surgery can seal off the blood vessels allowing for better blood flow and a higher probability of a healthy outcome.
  • Treatment for Twin Reversed Arterial Perfusion (TRAP): TRAP is an extremely rare occurrence in identical twin pregnancies. One twin develops normally, while the other develops abnormally often missing a heart and other vital organs. Specialized treatment and intervention is managed by specialists in the Fetal Center.
  • Shunt placement: Shunts, or connections, can be placed in utero if the baby is experiencing certain types of blockage and fluid is unable to drain. This can be done various ways depending on where the shunt needs to be inserted, and the doctor will explain the different options to you.
  • Percutaneous Umbilical Blood Sampling (PUBS): Usually performed after 18 weeks of pregnancy, a needle guided by ultrasound is inserted into the umbilical cord to obtain a blood sample. The blood is tested to guide further management. In some cases a fetal blood transfusion is needed and performed through the same needle.
  • Ex Utero Intrapartum Treatment (EXIT) procedure: EXIT procedures most commonly occur if the baby will experience a compressed airway at birth. This involves a standard Cesarean section as late in the pregnancy as possible. At birth, the baby is partially removed from the uterus. The fetal surgeon operates on the baby while still connected to the mother’s umbilical cord. After the surgery, the Cesarean section is completed.
  • Fetoscopy: Fetoscopy is used when doctors need to gain access to the placenta, amniotic sac, umbilical cord and the baby in utero. A small incision is made in the mother’s abdomen and a camera is inserted. A fetoscopy is usually the first step in many fetal interventions.
  • Pleurocentesis: Pleurocentesis is the removal of fluid from the thoracic cavity in the baby’s lungs. A thin needle is inserted and the fluid extracted and tested as needed.
  • Vesciocentesis:Vesciocentesis is a procedure that takes a sample of urine from the baby’s urinary tract for testing, and also allows for drainage when treating urinary tract abnormalities.
  • Amniotic Band Syndrome (ABS) intervention: In certain cases, the amniotic bands that have formed around the baby’s limbs may need to be cut. This is done using a small camera inserted into the uterus (fetoscopy) to allow the specialist to cut the bands.
  • Treatment for heart defects:In collaboration with the Heart Institute, some heart defects can be treated through EXIT procedures or in utero depending on the diagnosis.

The Fetal Center team can offer more information about surgical procedures and interventions in utero. To discuss your case with a member of the medical team, call 901-287-6981.

Contact Fetal Center