Fetal surgery and neonatal ICU admissions

Curr Opin Pediatr. 2020 Aug;32(4):619-624. doi: 10.1097/MOP.0000000000000900.

Abstract

Purpose of review: Fetal intervention is a dynamic field with wide-reaching implications on neonatal ICU admissions and the care of neonates with congenital anomalies. The aim of this review is to summarize recent advancements in fetal surgery and provide a broad understanding of how these topics interrelate.

Recent findings: Advancements in prenatal imaging and diagnosis have dramatically expanded the indications for fetal intervention. Most recently, there has been a large focus on evaluating minimally invasive strategies of fetal intervention, notably fetoscopic surgery, and the use of stem cells for fetal treatment of myelomeningocele. With the advances in fetal intervention, neonatal care has adapted to the needs of these various patients to help improve the outcomes of this unique population.

Summary: Fetal intevention relies on a multidisciplinary team from prenatal imaging and maternal fetal medicine to fetal surgery and postnatal subspecialty care, particuarly neonatology. Fetal intervention uniquely involves two patients, both mother and fetus, and therefore, has unique risks and considerations, particularly in the advancement of the field. As the number of conditions suited to fetal intervention grows, awareness and advancement of the postnatal intensive care necessary for these patients are essential.

MeSH terms

  • Female
  • Fetal Diseases / diagnostic imaging
  • Fetal Diseases / surgery*
  • Fetoscopy
  • Humans
  • Infant, Newborn
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Meningomyelocele / surgery
  • Pregnancy
  • Prenatal Care