Fetal surgical intervention

Despite advances in perinatal management, some congenital disorders continu e to have significant morbidity and mortality both in utero and in the earl y postnatal period. In selected anomalies, fetal surgical intervention can alter the natural history of the disorder, leading to improved survival rat es and functional outcomes. While therapies are primarily aimed at life-thr eatening disorders, some significantly morbid disorders may also be address ed prenatally. Potential indications for fetal surgery include mass lesions causing hydrops fetalis, congenital diaphragmatic hernia, myelomeningocele , urinary obstruction and disorders of twins. A thorough prenatal evaluatio n and extensive family counseling are necessary prior to intervention. Impr ovements in minimally invasive techniques may minimize the greatest challen ge of fetal surgery, management of postoperative preterm labor.