Descripción general

La cirugía fetal, un procedimiento en el que se realiza una cirugía a un bebé nonato (feto), se ofrece ante algunas enfermedades para mejorar el resultado a largo plazo después del parto.

Por ejemplo, los cirujanos podrían realizar una cirugía fetal abierta si se le ha diagnosticado al feto espina bífida antes del nacimiento (en forma prenatal).

En un tipo de espina bífida, el mielomeningocele, un orificio en la piel de la espalda del feto hace que parte de la médula espinal y los recubrimientos queden expuestos al líquido amniótico del útero. Si el médico descubre que tu bebé nonato tiene mielomeningocele, podría recomendarte una cirugía fetal abierta para tratar la enfermedad.

En algunos casos, la cirugía fetal tiene mejores resultados que la cirugía después del parto.

Comprehensive health centers that have fetal surgery expertise and experience can treat many birth defects in utero, including:

Types

Methods for treating these conditions at highly specialized health care centers with fetal surgery expertise include:

  • Fetoscopic endoluminal tracheal occlusion (FETO) for severe CDH
  • In utero open or fetoscopic repair of myelomeningocele, the most severe form of spina bifida
  • Open fetal surgery for SCT resection
  • Open fetal surgery to remove CCAM of the lung
  • Shunt placements
  • Fetal vesicoamniotic shunt (VAS) and fetal cystoscopy for bladder obstruction
  • Fetoscopic laser ablation for TTTS and TAPS
  • Bipolar cord coagulation for TRAP sequence
  • Radiofrequency ablation for fetal tumors
  • Ex utero intrapartum treatment (EXIT)
  • Fetal cardiac intervention
  • Intrauterine blood transfusion
  • Serial amnioinfusions for bilateral renal agenesis and complex renal diseases

    Fetal surgery: Birth defects and treatment procedures

    Por qué se hace

    Before a baby is born, early intervention using fetal surgery can treat life-threatening birth defects and improve outcomes in some cases. For example, if a baby has been diagnosed before birth with spina bifida, surgeons might perform open fetal surgery or a less invasive procedure using a fetoscope.

    Riesgos

    Potential risks of the procedure — both the risks to you and those to the unborn baby — should be explained by the doctor. These risks include rupture of the uterus after surgery (uterine rupture), fetal death, operative complications, early labor and potential failure to treat the birth defect.

    Resultados

    When done by fetal surgery experts in select babies, this early intervention can have better results than surgery after delivery. This means that children with spina bifida, for example, may be significantly less disabled as they go through life than they would have been if they had surgery after birth.

    Estudios clínicos

    Explora los estudios de Mayo Clinic para exámenes y procedimientos al aprender los investigadores cómo mantener sana a la gente en la práctica clínica.

    Cirugía fetal - atención en Mayo Clinic

    April 17, 2019
    1. McLone DG, et al. Overview of the management of myelomeningocele (spina bifida). http://www.uptodate.com/home. Accessed Dec. 9, 2015.
    2. American College of Obstetrics and Gynecology Committee on Obstetric Practice. Committee Opinion No, 550, Maternal-fetal surgery. Obstetrics & Gynecology. 2013;121:218.
    3. Adzick NS. Fetal surgery for spina bifida: Past, present and future. Seminars in Pediatric Surgery. 2013;22:10.