Fetal Surgery

Fetal surgery is intervention performed on the baby while it is still in the womb, and it represents the highest tier of fetal therapy. It is reserved for specific life-threatening or severely disabling conditions where strong evidence shows that operating before birth significantly improves the outcome compared with waiting until delivery.

Twin-to-twin transfusion syndrome (TTTS) occurs in identical twins who share one placenta, when blood flows unevenly between them through shared vessels, endangering both babies. Fetoscopic laser treatment uses a fine telescope passed into the womb to seal the abnormal connecting vessels, correcting the imbalance. It is the most effective treatment for severe TTTS and can be life-saving for both twins.

The advanced interventions we offer include fetoscopic laser for TTTS, tracheal occlusion (FETO) for severe congenital diaphragmatic hernia, intrauterine transfusion for fetal anaemia, and vesicoamniotic shunting for obstructive uropathy where the bladder cannot drain. Each is offered only for carefully selected cases where the evidence supports operating before birth.

An intrauterine transfusion delivers donor blood directly to a baby who has become severely anaemic in the womb, often due to blood-group incompatibility or infection. It is performed under continuous ultrasound guidance by a subspecialist and can be repeated as needed to keep the baby stable until delivery is safe. It is a well-established, life-saving fetal therapy.

Fetal surgery is a multidisciplinary event involving fetal medicine subspecialists, paediatric surgeons and specialised anaesthesia, performed under strict sterile conditions. These are high-precision, evidence-based procedures offered only when the expected benefit outweighs the risks. The whole team plans each case individually and discusses the specific risks and expectations with you in detail beforehand.

Our unit provides this advanced in-utero surgical capability to patients across Abu Dhabi and Al Ain, so families do not necessarily need to travel abroad for these interventions. Cases are usually referred after a diagnosis is made on a scan or invasive test, and referrals from other specialists are welcome. Given the specialised nature of this care, we recommend discussing insurance coverage and planning with our team early.