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Prenatal Surgery

Future Developments

Fetal surgery is no longer limited to a few techniques. With advances in knowledge and improvements in equipment, new opportunities for the treatment of more birth defects will emerge. The unexpected discovery that fetuses heal without scarring suggests that cleft palate and other facial defects might be conducive to repair in the womb. Further research is needed, however, before surgery can be justified for conditions that are not life-threatening.

Advances in fetal surgery are expected to benefit other fields of medicine as well. New strategies to prevent early labor in fetal-surgery patients, for instance, can be applied to any pregnant woman who is at risk for early labor. In a similar fashion, new tools developed for fetal surgery may find other uses in medicine. Further understanding of scarless healing may also lead to innovations in the treatment of adult surgical patients.

Resources

Books

Casper, Monica. The Making of the Unborn Patient: A Social Anatomy of Fetal Surgery Newark, NJ: Rutgers University Press, 1998.

Edelson, Edward. Birth Defects. New York: Chelsea House Publishers, 1992.

Kolata, Gina. The Baby Doctors. New York: Delacorte Press, 1990.

Periodicals

Begley, Sharon. "The Tiniest Patients." Newsweek (June 11, 1990): 56.

Bruner, J.P., et al. "Fetal Surgery for Myelomeningocele and the Incidence of Shunt-Dependent Hydrocephalus." Journal of the American Medical Association 17, no. 282-19 (November 1999): 1819-25.

Cauldwell, C.B. "Anesthesia For Fetal Surgery." Anesthesiology Clinics of North America 20, no. 1 (2002): 211-226.

Fowler, Steven F. "Fetal Endoscopic Surgery: Lessons Learned And Trends Reviewed." Journal of Pediatric Surgery 37, no. 12 (2002): 1700-1702.

Harrison, Michael R. "Fetal Surgery." Fetal Medicine special issue of The Western Journal of Medicine (September 1993): 341-49.

Holloway, Marguerite. "Fetal Law." Scientific American (September 1990): 46-47.

Jobe, A.H. "Fetal Surgery For Myelomeningocele." New England Journal of Medicine 347, no. 4 (2002): 230-231.

Ohlendorf-Moffat, Pat. "Surgery Before Birth." Discover (February 1991): 59-65.

Olutoye, O.O., and N.S. Adzick. "Fetal Surgery for Myelomeningocele." Semin Perinatol no 6. (December 2000): 462-73.

Sullivan, Kerry M., and N. Scott Adzick. "Fetal Surgery." Clinical Obstetrics and Gynecology 37 no. 2 (June 1994): 355-69.

Winn, D. "Obstetrical Issues In Minimally Invasive Fetal Surgery." Pediatric Endosurgery and Innovative Techniques 6, no. 2 (2002): 125-129.

Liz Marshall

KEY TERMS

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Amniocentesis: —A method of detecting genetic abnormalities in a fetus; in this procedure, amniotic fluid is sampled through a needle placed in the uterus; fetal cells in the amniotic fluid are then analyzed for genetic defects.
Chorionic villi sampling: —A procedure in which hair-like projections from the chorion, a fetal structure present early in pregnancy, are suctioned off with a catheter inserted into the uterus. These fetal cells are studied for the presence of certain genetic defects.
Closed surgery: —Medical treatment performed on the fetus without opening the mother's uterus.
Diaphragmatic hernia: —A serious birth defect caused by a hole in the diaphragm, the muscle that divides the abdominal and chest cavities.
Fetal reduction: —Surgery performed to abort one or more fetuses in a multiple pregnancy.
Open surgery: —Surgery performed directly on the fetus by opening the mother's abdomen and uterus.
Premature labor: —Uterine contractions that occur before the fetus is 37 weeks old, the age it can be born safely.
Twin-twin transfusion syndrome: —A condition in which abnormal blood vessels link one healthy fetus and one unhealthy fetus in a multiple pregnancy.
Ultrasound: —Another term for ultrasonic waves; sometimes reserved for medical applications.

Additional topics

Science EncyclopediaScience & Philosophy: Positive Number to Propaganda - World War IiPrenatal Surgery - History Of Fetal Surgery, Closed-womb Surgery, Open Surgery, Ethical Issues, Future Developments - Fetal reduction