Affiliations: Division of Pediatric Surgery and Fetal Treatment Center, Department of Surgery, University of California, San Francisco, CA, USA
Note: [] Corresponding author: Hanmin Lee, Professor of Surgery, Pediatrics and Obstetrics, Gynecology and Reproductive Health Sciences, Division of Pediatric Surgery, Director, Fetal Treatment Center, 513 Parnassus Avenue, HSW-1601, Box 0570, San Francisco, CA 941430570, USA. Tel.: +1 415 476 2538; Fax: +1 415 476 2314; E-mail: [email protected].
Abstract: Fetal intervention is indicated to treat selected neurological anomalies. The introduction of prenatal ultrasound and novel surgical techniques helped advance the use of fetal surgery for neurological disorders, most notably in cases of fetal myelomeningocele. Interventions for hydrocephalus (e.g. serial cephalocentesis, ventriculoamniotic shunts) were among the first treatments attempted by fetal surgeons, but results have been poor. Myelomeningocele is the most widely accepted neurological indication to offer fetal surgery, having recently been studied in a randomized controlled trial. Fetal intervention including prenatal gene and stem cell therapy holds promise for treating other neural tube defects and congenital neurovascular malformations, but further investigation is needed before new roles for fetal surgery are indicated.
