Fetal surgery typically involves opening the gravid uterus (with either a traditional Cesarean surgical incision or through single or multiple fetoscopic port incisions), surgically correcting or palliating a fetal abnormality, and returning the fetus to the uterus and restoring uterine closure.
Fetal surgery should be performed only when a successful procedure is necessary for fetal survival, or improves the long term outcome or survival of the fetus following birth. The procedure should only be performed when there is not a significant risk for morbidity or mortality in the mother, or in premature labor as a result of the procedure.
A vesico-amniotic shunt is indicated for lower urinary tract obstruction in fetuses. Blockage of the urinary tract in utero related to conditions such as urethral atresia, posterior urethral valves, or “triad syndrome,” can result in decreased fetal lung formation (pulmonary hypoplasia). A vesico-amniotic shunt between the bladder and amniotic space, can prevent pulmonary hypoplasia.