For many families, the thrill of welcoming a new baby can also come with unforeseen obstacles. In the U.S., about 3% of newborns—roughly 1 in 33—are born with some form of birth defect each year.
Now, while this might sound alarming, it’s reassuring to know that nearly all fetal abnormalities can actually be spotted through prenatal ultrasounds.
Detecting issues early on gives both parents and doctors a chance to plan for care after birth. In certain situations, doctors may even take action before the baby arrives. Thanks to improvements in imaging technology, surgical tools, and anesthesia, healthcare teams are increasingly able to safely tackle complex conditions before delivery.
In this article, we’ll highlight conditions that may necessitate life-saving fetal surgery and clear up four myths surrounding crucial prenatal screenings.
Ultrasounds serve more purposes than just revealing your baby’s gender.
Ultrasound imaging plays a vital role in tracking both the baby’s growth and the mother’s health throughout pregnancy. These sophisticated diagnostic tools utilize high-frequency sound waves, avoiding radiation to produce detailed images and videos of the fetus.
Even women with low-risk pregnancies benefit from regular ultrasound checks, which deliver invaluable insights.
Typically, patients will undergo two or three ultrasounds during their pregnancy. The first detailed anatomical scan typically occurs in the first trimester, around week 12, followed by another between 18 and 22 weeks, and then a third in the second trimester around week 28 to 32.
If you do have concerns, additional scans might be suggested.
Ultrasounds can evaluate the baby’s brain, heart, chest, abdomen, and limbs. Most of the time, potential issues can be identified with impressive accuracy, helping families and medical teams prepare effectively.
However, keep in mind that no test is without flaws. Some issues might be subtle or emerge later in pregnancy, and further imaging tests, like a fetal MRI, may be required for clarification. Experience and careful examination are key here.
Not all abnormalities spell trouble.
It’s normal for parents to feel anxious when an ultrasound shows something abnormal.
At the New York University Langone Center for Advanced Fetal Care, our priority is to offer a comprehensive evaluation, address your questions, and outline clear next steps.
A misconception is that every flagged finding indicates danger. Actually, some results might turn out to be false positives due to limitations in technology or human error.
Some abnormalities can turn out to be harmless and resolve on their own. For example, many cysts observed in ultrasounds are benign.
While certain findings indeed need monitoring and possible treatment, we ensure families are well-informed about every potential scenario.
I often meet anxious parents facing unexpected discoveries. My role extends beyond just interpreting images; I aim to help families grasp what’s going on and how it might affect their baby.
If something serious arises, there are options available.
A common belief is that if a significant malformation is detected before birth, no action can be taken until the baby is born. That’s not the case at all. Advances in fetal medicine allow for the treatment or correction of many serious conditions even before delivery.
When parents hear of a problem, their first question is usually, “Can we do anything?” I appreciate being able to respond with, “Yes, we can.”
Take twin-twin transfusion syndrome, for instance. This rare but serious condition occurs when identical twins sharing a placenta unevenly exchange blood.
Years ago, this diagnosis was often fatal. Today, the survival rate for twins is about 90%, thanks to minimally invasive surgery that can be conducted between 16 and 26 weeks of pregnancy.
Most surgeries utilize fetoscopy, where a tiny camera and instruments are inserted through minuscule incisions to identify and seal off abnormal blood vessel connections on the placenta, helping balance the blood flow.
Another condition we can treat is spina bifida. This condition involves an opening in the fetal spine, which exposes delicate nerves and the spinal cord. Some fetuses might experience severe complications post-birth, like trouble walking or fluid buildup in the brain.
In this case, small incisions are made in the mother’s uterus to insert a camera and instruments, enabling doctors to repair and close the defect, ultimately shielding the nerves. This intervention can significantly enhance long-term outcomes concerning motor skills and brain development.
We can also address certain heart defects and congenital diaphragmatic hernias, affecting lung development due to abdominal organs moving into the chest.
What was once unfathomable is now part of routine care at selected centers across the nation, with results improving every day.
Fetal surgery isn’t just a concept anymore.
While the idea of undergoing surgery before birth may sound intimidating, advances in both technology and expertise have made these procedures remarkably safe and effective for a range of complex conditions.
All surgeries carry some level of risk, but minimally invasive fetal techniques can significantly lower complications for both mother and baby.
Depending on what’s being treated, either the uterus may be temporarily opened or minimally invasive fetoscopy techniques may be employed.
A multidisciplinary team—including pediatric surgeons, maternal-fetal medicine specialists, and anesthesiologists—manages each case to ensure the safest treatment possible.
However, fetal surgery isn’t suitable for every situation.
In some cases, it might be more appropriate to wait until after delivery or to plan a timely delivery while ensuring professional care is available.
This highlights the importance of thorough evaluations and individualized prenatal planning.
We are among fewer than ten centers in the U.S. that offer this specialized procedure. Our team is dedicated to innovation and has access to new clinical trials, research studies, and cutting-edge methods that continually push the boundaries of what’s possible.
Every pregnancy is different, and reaching out to a specialized fetal center early can provide families with more options and a higher likelihood of a positive outcome. Before despairing, it’s worth exploring the full spectrum of care at facilities like the Advanced Fetal Treatment Center.
