56. Fetal Surgery
- John T. Queenan MD3,
- Catherine Y. Spong MD4,
- Charles J. Lockwood MD5
Published Online: 4 JAN 2012
DOI: 10.1002/9781119963783.ch56
Copyright © 2012 John Wiley and Sons, Ltd
Book Title
Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition
Additional Information
How to Cite
Ball, R. H. and Lee, H. (2012) Fetal Surgery, in Queenan's Management of High-Risk Pregnancy: An Evidence-Based Approach, Sixth Edition (eds J. T. Queenan, C. Y. Spong and C. J. Lockwood), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119963783.ch56
Editor Information
- 3
Department of Obstetrics and Gynecology, Georgetown University School of Medicine, Washington, DC, USA
- 4
Bethesda, MD, USA
- 5
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA
Publication History
- Published Online: 4 JAN 2012
- Published Print: 24 FEB 2012
ISBN Information
Print ISBN: 9780470655764
Online ISBN: 9781119963783
- Summary
- Chapter
- References
Keywords:
- fetal surgery;
- open fetal surgery (hysterotomy);
- indications, for fetal surgical interventions;
- risks to pregnancy, preterm labor, membrane premature rupture;
- open fetal surgery techniques;
- initial uterine entry, Bruner–Tulipan trocar;
- hysterotomy, fetal surgical approach;
- fetoscopic surgery, UCSF and endoscopic approaches (Lap-FETENDO);
- congenital diaphragmatic hernia, and fetoscopic surgery;
- less invasive FETENDO, FIGS, in fetal intervention
Summary
The first open maternal-fetal operation was performed nearly 30 years ago. The indications for intervention have remained largely constant from the first decade of fetal surgery to the start of the fourth decade and the basic tenets of fetal surgery also have remained consistent. The three basic tenets are: (1) the pregnant woman should undergo minimal risk to her health; (2) the fetal disease should be severe and progressive; and (3) fetal intervention should have a high likelihood for reversing fetal disease. While the diseases treated have remained the same, the approach to fetal interventions has changed dramatically. Initial fetal surgical procedures depended on maternal laparotomy and hysterotomy. This approach evolved into maternal laparotomy with uterine endoscopy and most recently into percutaneous approaches. It appears that the less invasive approaches are associated with a less complicated postoperative recovery for the mother, but morbidity is not eliminated.