Fetal surgery: correction of anatomic and constitutional defects

Area of Science:

• Perinatology
• Maternal-Fetal Medicine
• Pediatric Surgery

Background:

• Improved obstetrical care and advanced fetal diagnostics necessitate multidisciplinary management of pregnancies with congenital defects.
• Fetal therapy has evolved beyond Rh disease transfusions and lung maturation induction.
• Current fetal interventions include open correction for conditions like congenital hydronephrosis, diaphragmatic hernia, and sacrococcygeal teratoma.

Purpose of the Study:

• To review the expansion of fetal therapy for complex congenital anomalies.
• To highlight emerging in utero treatments such as hematopoietic stem cell transplantation and gene therapy.
• To emphasize the ongoing research focus on therapeutic efficacy and safety in fetal interventions.

Main Methods:

• Review of current literature on fetal diagnostic techniques and therapeutic interventions.
• Analysis of the evolution of fetal surgery and its expanding applications.
• Examination of ongoing research into novel prenatal treatments.

Main Results:

• Fetal therapy now encompasses surgical correction of major congenital anomalies.
• Investigational therapies include in utero hematopoietic stem cell transplantation and gene therapy.
• Research is actively exploring methods to enhance the effectiveness and safety of prenatal interventions.

Conclusions:

• Multidisciplinary care is crucial for managing pregnancies with prenatally diagnosed defects.
• The scope of fetal therapy has significantly broadened, offering new hope for complex conditions.
• Future research priorities include optimizing efficacy and ensuring maternal-fetal safety for advanced prenatal therapies.