Type of Surgery
Information
Last updated: 11/24/2009
Detection of many birth defects is possible through the use of sophisticated imaging and diagnostic techniques such as:
- Ultrasound. This imaging technique uses a machine that transmits high frequency sound waves to visualize structures in...
the human body, including the uterus and fetus. Ultrasound is used to determine the size, position, and age of the fetus; to measure the amount of amniotic fluid; and to assess the fetus for any congenital abnormalities. - Chorionic villus sampling (CVS). Cells are collected from the placenta with a thin plastic tube inserted through the cervix (opening to the uterus) or a needle inserted through the abdomen. The cells may then be analyzed for possible genetic disorders.
- Alpha-fetoprotein (AFP) testing. AFP is a protein made by the developing fetus. Large amounts of AFP in the mother's bloodstream may indicate certain fetal abnormalities.
- Amniocentesis. A needle is inserted through the woman's abdomen and into the uterus to procure a sample of amniotic fluid. Fetal cells in the fluid are then analyzed for possible genetic disorders.
Once a congenital abnormality has been diagnosed, the condition will be assessed to determine if the fetus is eligible for fetal surgery. Generally only the most severe conditions that are certain to cause fetal death or significant disability are treated with fetal surgery. If fetal surgery is indicated, the parents will meet with the team of health care providers that will be involved in the surgery.
To prepare for the surgery, the steroid betamethasone will be given in order to speed up the development of the fetus's lungs. A complete history and physical examination will be performed. A monitor will be used to track uterine contractions and fetal heart rate. The patient will be instructed to refrain from eating and drinking after midnight the day of surgery, and will sign a surgical consent. Blood samples may be taken for laboratory tests and to type match the patient's blood in case a blood transfusion is necessary. An intravenous (IV) catheter will be used to infuse fluids and/or medications to the patient.
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Slide show describing the surgeries available to treat fetuses in the womb and some of the problems that can be treated with fetal surgery and heart malformations, neural tube defects, and gastrointestinal tract deformities.
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Other Information
Open fetal surgery is an invasive form of fetal intervention in the treatment of birth defects where the pregnant uterus is opened up for direct surgery on the fetus.
Open fetal surgery is similar in many respects to a normal cesarean section performed under general anesthesia, except that the fetus remains dependent on the placenta and is returned to the uterus. A hysterotomy is performed on the pregnant woman. Once the uterus is open and the fetus is exposed, the fetal surgery begins. Typically, this surgery consists of an interim procedure intended to allow the fetus to remain in utero until it has matured enough to survive delivery and neonatal surgical procedures. Upon completion of the fetal surgery, the fetus is put back inside the uterus and the uterus and abdominal wall are closed up.
The mother remains in the hospital for 3-7 days for monitoring and is required to subsequently deliver the baby via a second cesarean section. Often babies who have been operated on in this manner are born pre-term.
Open fetal surgery has proven to be reasonably safe for the mother. For the fetus, safety and effectiveness are variable, and depend on the specific procedure, the reasons for the procedure, and the gestational age and condition of the fetus.
Other Information
an obstetrician/gynecologist is a physician specialist who provides medical and surgical care to women and has particular expertise in pregnancy, childbirth, and disorders of the reproductive system.
From: womenshealthchannel.com
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