Mayo Clinic's approach

In a caring and compassionate environment, highly skilled fetal surgery experts at Mayo Clinic Children's Center offer the most advanced procedures and technology for treating fetal defects before birth to improve outcome. Coming to an informed decision about whether fetal surgery is the best approach involves:

  • Thorough and personalized medical assessment of both you and your unborn baby
  • On-site, top-quality laboratory services for fast and accurate results
  • Discussion of the options, such as choosing between open fetal surgery or less invasive procedures
  • Evaluation of the potential benefits and risks of fetal surgery
  • Education for you and key supporters of your choosing, with ample opportunity to get questions answered
  • Discussion of short-term and long-term follow-up care and how to transition to the Mayo Clinic areas that provide the necessary care

Your Mayo Clinic care team

With Mayo Clinic's collaborative multispecialty approach, experts for both you and your child come together. This team approach results in a personalized treatment plan and patient-centered care.

Our fetal surgery multispecialty team includes experts in maternal and fetal medicine, pediatric surgery, neonatology, radiology and anesthesiology, as well as pediatric otolaryngology, pediatric nephrology, pediatric urology and pediatric neurosurgery, as needed. Our team also works to establish collaborative relationships with your home physician.

Advanced technology and treatment

Mayo Clinic experts use the latest diagnostic technology and treatment procedures for detecting and treating birth defects. These include:

  • Doing a fetal ultrasound (sonogram), such as a 3D or 4D ultrasound, Doppler ultrasound or fetal echocardiography
  • Scanning and printing a 3D model of the fetus before surgery to assess the condition and accurately plan for the fetal surgery
  • Performing less invasive types of fetal surgery for select conditions to improve outcomes for both mothers and babies
  • Performing open fetal surgery in more-complicated cases using advanced techniques to help fetal development, reduce disability and improve outcomes

In utero spina bifida surgery

Narrator: In utero spina bifida surgery is a complex procedure which requires a team of experts from many Mayo Clinic specialties. Before the operation begins, the mother is put under deep general anesthesia to make sure both she and the baby are asleep.

Using ultrasound as a guide, surgeons make the first incision to access the uterus. Then in cases where the placenta blocks access to the uterus, the uterus is moved out of the mother's abdomen and turned.

Doctors make a one centimeter incision in the uterus and use a special stapler to secure blood flow. Then they fill the uterus with a solution.

The fetus floats to the top of the uterus and the spina bifida is exposed. Now doctors can begin the repair.

First, they close what's called the neural plaque code. Second, they suture the dura mater. Third, they close the skin.

Then they close the uterus, replace that into the mother's abdomen and close her incision.

NICU and NICU Follow-up Clinic

Mayo Clinic's Newborn Intensive Care Unit (NICU) specializes in family-centered care of premature and critically ill newborn infants. Families are welcome at the baby's bedside and will find many support spaces throughout the unit, such as family waiting areas and rooms, parent sleep rooms and breast-feeding rooms.

Mayo's NICU Follow-up Clinic ensures continuity of quality care after the baby's discharge from the NICU.

Expertise and rankings

Mayo Clinic Children's Center in Minnesota is one of only a few medical centers in the United States with the expertise to perform fetal surgery to improve outcomes of babies with birth defects. These outstanding fetal surgeons and their experienced teams are recognized as national leaders in both treatment and research.

Continuity of care

As part of the Mayo Clinic Children's Center, a multispecialty team of Mayo experts trained in treating birth defects that require continued follow-up will care for your child after birth and help manage his or her condition. For example, Mayo Clinic pediatric experts provide the highest quality care for children with spina bifida and manage any complications.

Mayo Clinic provides lifelong care for children with birth defects, so your child will be able to transition to adult care when the time arrives — and be assured that the highest quality care will continue.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

Mayo Clinic in Arizona, Florida and Minnesota

Mayo Clinic Health System

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

March 24, 2021
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  3. Kilby M, et al. Percutaneous laser ablation of the feeding vessel in pulmonary sequestration or hybrid lesions. Ultrasound in Obstetrics & Gynecology. 2017; doi: 10.1002/uog.17506.
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  9. Sananes N, et al. Two-year outcomes after diagnostic and therapeutic fetal cystoscopy for lower urinary tract obstruction. Prenatal Diagnosis. 2016; doi: 10.1002/pd.4771.
  10. Sananes N, et al. Technical aspects and effectiveness of percutaneous fetal therapies for large sacrococcygeal teratomas: cohort study and literature review. Ultrasound in Obstetrics & Gynecology. 2016; doi: 10.1002/uog.14935.
  11. Maselli KM, et al. Advances in fetal surgery. Annals of Translational Medicine. 2016; doi: 10.21037/atm.2016.10.34
  12. Goodnight WH, et al. Subsequent pregnancy outcomes after open maternal-fetal surgery for myelomeningocele. American Journal of Obstetrics & Gynecology. 2019; doi: 10.1016/j.ajog.2019.03.008.
  13. Abbasi N, et al. Fetal amenia. Ultrasound in Obstetrics & Gynecology. 2017; doi: 10.1002/uog.17555.
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  15. Miller R. Diagnosis and management of twin reversed arterial perfusion (TRAP) sequence. https://www.uptodate.com/contents/search. Accessed Aug. 29, 2019.
  16. Farmer DL, et al. The management of myelomeningocele study: Full cohort 30-month pediatric outcomes. American Journal of Obstetrics & Gynecology. 2018; doi.org/10.1016/j.ajog.2017.12.001.
  17. Huber C, et al. Update on the Prenatal Diagnosis and Outcomes of Fetal Bilateral Renal Agenesis. Obstetrical and Gynecological Survey. 2019; doi: 10.1097/OGX.0000000000000670.

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