Prenatal Surgery

The first successful fetal surgery, a blood transfusion, was performed by A. William Liley in 1963 in Auckland, New Zealand. He used x rays to see the fetus and guide his needle. Liley's success was unparalleled for years, however. Most doctors considered the pregnant womb as sacrosanct and untouchable. To treat the fetus as a patient, separate from its mother, was unthinkable. That view began to change in the early 1970s with the spread of several new diagnostic tools.

With the introduction of the ultrasound machine, a doctor could bounce sound waves into the pregnant Preparation for prenatal surgery. Illustration by Hans & Cassidy. Courtesy of Gale Group. woman's abdomen and create an image of the fetus on a TV-like screen. Amniocentesis and chorionic villi sampling procedures made it possible to remove fetal cells from the pregnant uterus for genetic testing. These tests could determine the presence of Down syndrome and other genetic diseases. With these new tools of prenatal diagnosis, it was possible to identify abnormalities in fetuses as young as two or three months old. Yet this information often left parents with only a few limited choices. They could choose to abort a severely deformed fetus, or they could prepare for the medical treatment of their baby as soon as it was born.

A few medical researchers began imagining another option: could these fetuses be treated before birth? Beginning in the late 1970s, several young physicians began studying obstetrics, genetics, and pediatric surgery in their quest to perform fetal therapy. International Fetal Medicine and Surgery Society was created in order to support one another's efforts and share information. This group and another international organization known as the Fetoscopy Study Group provided a forum where new techniques in fetal medicine are presented and debated. Since then, using a variety of procedures, fetal surgeons have successfully drained a blocked bladder, removed abnormal growths from a lung, and repaired a diaphragm, the muscle that divides the abdominal and chest cavities.