Fetal surgical intervention.

Despite advances in perinatal management, some congenital disorders continue to have significant morbidity and mortality both in utero and in the early postnatal period. In selected anomalies, fetal surgical intervention can alter the natural history of the disorder, leading to improved survival rates and functional outcomes. While therapies are primarily aimed at life-threatening disorders, some significantly morbid disorders may also be addressed prenatally. Potential indications for fetal surgery include mass lesions causing hydrops fetalis, congenital diaphragmatic hernia, myelomeningocele, urinary obstruction and disorders of twins. A thorough prenatal evaluation and extensive family counseling are necessary prior to intervention. Improvements in minimally invasive techniques may minimize the greatest challenge of fetal surgery, management of postoperative preterm labor.