Generally, the techniques are divided into two categories:
- Open fetal surgery: A hysterotomy (Cesarean section) is performed and the fetus is partially removed so that the area that needs surgery is exposed. After we perform corrective surgery, the fetus is returned and the uterus is closed.
In some cases, surgery on the fetus is scheduled to coincide with delivery. Surgery is done on the baby after Cesarean section, but before the cord is cut, so that the fetus is sustained by the mother's placenta and doesn't have to breathe on his own.
This method, known as an EXIT (ex utero intrapartum treatment) is usually used when the fetus suffers from a congenital defect that blocks the airway, such as a cervical teratoma. EXIT gives surgeons time to perform multiple procedures to secure your baby's airway, so that by the time the cord is cut and your baby has to breathe, he has an unblocked airway.
- Fetoscopic surgery: This type of surgery, which employs minimally invasive techniques, is used more often than open surgery. Surgeons can use fiber-optic telescopes and specially designed instruments to enter the uterus through small surgical openings to correct congenital malformations without major incisions or removing the fetus from the womb.
This alternative is less traumatic and reduces the chances of preterm labor.