Surgery on a baby in the womb? Let's talk about fetal surgery.

As a mother-to-be, every movement of your baby in your womb, every image you see on a scan, is precious. But sometimes, when the doctor looks at a scan and says, "The baby seems to have a little problem," it's hard to put into words the fear and anxiety you feel. But don't worry. Today, medicine is very advanced. Some birth defects and medical conditions can be treated before the baby comes into this world, that is, inside your womb. That amazing medical procedure is what we call "Fetal Surgery." Let's talk about this simply.

What is Fetal Surgery?

Simply put, fetal surgery is surgery performed on your baby while he or she is still inside the womb. Some people also call it `in-utero surgery` or `prenatal surgery`.

Imagine, if a baby has a birth defect, that defect can gradually worsen as it grows inside the womb. But through this method, a team of specialists can treat the defect before the baby is born and reduce its impact. Sometimes this is necessary to save the baby's life and improve his future health. In less severe cases, doctors also call this "fetal intervention."

Depending on the baby's condition, these surgeries can usually be performed as early as 16 weeks. However, more complex surgeries are often performed between 22 and 26 weeks of pregnancy.

Why do you need to have this kind of surgery?

The main goal of this is to help the baby grow healthily. Some birth defects can be life-threatening. Others, while not life-threatening, may cause the baby to have some disability after birth.

Usually, these types of conditions are treated after the baby is born. However, there are some situations where the results are much better if treated while the baby is still in the womb. Treating them early can minimize damage to the baby's organs and help them stay healthy in the long run.

What kind of specialist team performs these surgeries?

This is never something that is done by one person. It takes a team of highly trained, multi-disciplinary specialists. The team typically includes:

• Specialists in Maternal and Fetal Medicine (maternal-fetal medicine specialists): Doctors who specifically look after the health of the mother and baby.
• Pediatric surgeons: Doctors who specialize in surgery on babies.
• Maternal and pediatric anesthesiologists: They carefully administer anesthesia to the mother and baby during surgery.
• Fetal Cardiologists : Specialists who look into problems with the baby's heart.
• Fetal imaging specialists: Those who examine the baby's condition very clearly using state-of-the-art scanning machines.
• Other surgeons who suit the baby's needs.

What are the main conditions treated with these surgeries?

There are several conditions that can be treated with fetal surgery . The table below shows some of them and a simple explanation of them.

What are the methods of performing the surgery?

Depending on your and your baby's health, the surgeon will choose the most appropriate method. There are three main methods.

1. Fetoscopic Surgery

This is like "keyhole surgery." The doctor inserts a tiny camera (fetoscope) and surgical instruments through a very small incision in your uterus. This leaves less scarring and shortens the healing time.

2. Open Surgery

In this, you will be given general anesthesia. Then, the surgeon will cut through your abdomen and uterus and go to where the baby is. Importantly, the baby will remain inside the uterus during the surgery. After the surgery, the uterus and abdomen will be carefully closed again, and the pregnancy will continue as normal.

3. Surgeries performed during childbirth (EXIT Procedures)

This is a very special procedure. The surgery is done during a cesarean section. You are given anesthesia and your uterus is relaxed. Then, the uterus is opened and the baby is not completely removed, but partially. Before cutting the umbilical cord, if the baby's airway is blocked, it is repaired, or something like a large tumor is removed. Only after the baby is stable is the umbilical cord cut and the baby is fully delivered.

What are the risks of this type of surgery?

Like any surgery, fetal surgery carries some risks. These risks can affect both the mother and the baby. It is important to be open and informed about them.

Making a decision about such a surgery is very complex. It requires deep consideration of the health of both mother and baby. It is important to discuss every decision carefully with your medical team.