Over the years several approaches have been developed for conducting fetal surgery, depending on patient’s condition and the best ways to repair the abnormality in the uterus. As other medical interventions, fetal surgery has its risks and complications on both the fetus and the mother. To ensure that the surgery is effective and safe, some criteria have been adopted.
Fetal surgery can be defined as an operation conducted on fetuses with life threatening conditions or non lethal conditions …show more content…
Applying each of the approaches depend on the case condition and its severity. The less invasive procedure is similar to the laparoscopic approach in adults where the surgeon uses a fetoscope to visualize the fetus at the time of the surgery and small instruments are inserted through small incisions in the uterus with the guide of an ultrasound. The incisions are made away from the placenta to avoid damaging it and to reduce the risk of bleeding during surgery. (Iqbal, Hirose, & Lee, 2010)
The open fetal surgery is used when the defect cannot be fixed by the fetoscopic approach. In the open surgery approach, the abdomen is opened through a low incision on the abdomen. Ultrasound device is used to map out the placenta and choose the suitable place for the incision in order to avoid damaging the placenta and to optimize the exposure of the fetus. A tube is inserted into a small incision in the uterus to collect the amniotic fluid. After that, an incision is made using a special staple device that designed specifically for fetal surgery to prevent bleeding. After operating on the fetus, the amniotic fluid is reinjected into the uterus, the incision is closed using absorbable sutures. Complications of this surgery on the mother include the risk of uterine rapture and caesarean section with this pregnancy and future pregnancies. It also can cause extensive blood loss, infection of the uterine incision and the complications that could arise from the general or spinal anaesthesia and the drugs that used to control uterine contractions. (Iqbal, Hirose, & Lee,