Prenatal Surgery

Prenatal surgery, also called fetal surgery, is medical treatment of the fetus before birth, while it is still in the womb. Most fetal therapies are "closed" procedures, performed without opening the womb. The rarest type of fetal surgery is known as "open surgery," in which the mother's abdomen and uterus are cut open to reveal the tiny fetus.

The success rate of open surgery

When doctors began performing open surgery, in the early 1980s, most of the fetuses died. Some physicians were critical of the attempts. They argued that a healthy woman was put at risk in order to attempt the rescue of a fetus that would most likely die anyway. Others supported the experimental surgery and declared that this was the fetus's only chance.

Today, open surgery remains a last resort for a small number of birth defects. It is appropriate only if it can result in the normal development of the fetus. Surgery that prolongs the lives of babies suffering from incurable health problems is not acceptable. Neither is surgery that puts the mother at excessive risk. In many cases, medical treatment after the baby is born offers an equal chance of success, provided that the pregnancy is carefully supervised and that delivery is planned at a well-equipped hospital with a neonatal intensive care unit.

Fetal reduction, the systematic killing of one or more fetuses in order to save those remaining, also raises ethical issues. To a certain extent, the issues duplicate those involved in the abortion debate: when is it ethical to kill a fetus? If a woman plans to abort the whole pregnancy unless a fetal reduction is done, is it wrong to kill some fetuses so that others may live? Many fetal surgeons will not perform fetal reductions.