Noninvasive, Minimally-Invasive and Surgical Interventions

The Cincinnati Children's Fetal Care Center specialists treat many fetal conditions once considered life-threatening or only treatable after birth. While many conditions can be managed through noninvasive therapies, some fetal conditions require surgery.

Thankfully, expectant mothers experiencing high-risk pregnancies have access to one of the best fetal surgery facilities in the country.

The Fetal Care Center is one of only three fetal surgery centers in the United States with the expertise to perform the full range of fetal surgical interventions, including open fetal surgery.

Since 2004, we have performed more than 1,850 fetal surgical procedures.

Our Facilities

The Fetal Care Center features a dedicated fetal surgery unit at Cincinnati Children’s Hospital Medical Center. The operating room is specifically designed for open fetal surgery, minimally invasive fetoscopic surgery and complex ex-utero intrapartum treatment (EXIT) procedures. The unique design and inclusion of surgical equipment, medical video equipment, voice activation and image management solutions enable our surgeons to operate with the highest level of efficiency and communication, ensuring the best possible outcome.

The operating room is big enough for two operating teams, allowing us to perform surgery on both the mother and baby in the same location during EXIT procedures. Likewise, our collaborative team includes specialists who focus on the mother and baby during these procedures so that the needs of both are handled with equal care.

The center includes inpatient and outpatient facilities. Five state-of-the-art recovery rooms are designed for women admitted for recovery after fetoscopic surgery, open fetal surgery or an EXIT procedure.

The center also includes an ultrasound suite, exam room, consultation rooms, three “nesting” rooms (you, your baby and family can rest after your procedure) and conference facilities.

In addition, a unique hybrid cardiac catheterization lab, part of the Heart Institute at Cincinnati Children’s, provides neonatal cardiac catheterization, combined neonatal open heart / catheter procedures and fetal cardiac interventions.

Many fetal surgeries performed during the middle of pregnancy can be done with a minimally invasive technique. Surgeons place miniature cameras, or “scopes,” and small surgical instruments through small incisions in the mother’s abdomen, allowing the fetal surgeon to reach and operate on the baby, umbilical cord or placenta without making a major incision in the mother’s abdomen and uterus.

Anesthesiologists provide local or epidural anesthetics to keep the mother comfortable during surgery. After surgery, the post-operative room at the Fetal Care Center provides a specialized location where mothers can recover under the care of our team of maternal-fetal experts.

Since 2004, we have performed 1,673 fetoscopic procedures.

When fetal procedures performed during the middle of pregnancy cannot be done using scopes, our surgeons will perform them through open surgery.

Because this type of surgery requires an incision in the uterus, our anesthesiologists medicate the mother to prevent contractions. We give both the mother and baby general anesthesia so that they do not feel anything during the procedure.

Since 2004, our fetal surgeons have performed 83 open fetal surgeries (excluding EXITs) at the Fetal Care Center.

Ex-utero intrapartum therapy (EXIT) is a specialized type of fetal surgery performed at the end of pregnancy. It is used in cases where waiting to operate until after delivery would pose a severe risk to the baby’s health, such as:

  • Large head or neck tumors  that require a specialized breathing tube right after delivery
  • Severe heart or lung problems requiring immediate support with an extra corporeal membrane oxygenation (ECMO) heart-lung machine

Surgeons make an incision in the mother’s abdomen, perform the necessary surgery to treat the baby and complete the delivery. Both mother and baby receive general anesthesia so that they do not feel any sensation during the EXIT procedure.

Since 2004, the Fetal Care Center has performed 83 EXIT procedures.

Recovery rooms in the Fetal Care Center allow mothers to stay close to their babies, who are cared for in the Newborn Intensive Care Unit at Cincinnati Children’s after EXIT procedures. Our team of maternal, fetal and neonatal specialists will care for the mother and baby during their postoperative recovery.

Post-surgical care in the Fetal Care Center is provided by high-risk obstetrics nurses with extensive experience managing high-risk deliveries. Our nursing team is specially trained to care for mothers and babies undergoing fetal surgery. We assign two nurses to each patient.

The recovery rooms in the Fetal Care Center allow you and your baby to begin recovery immediately after surgery. They feature sophisticated monitoring equipment that allows our team to closely monitor your and your baby’s recovery. In the case of EXIT procedures, you will recover in close proximity to the NICU where your baby is recovering.

For More Information

For more information or to request an appointment, contact the Cincinnati Children's Fetal Care Center at 1-888-338-2559 or use our online form.

Contact us.

Conditions Treated by Fetal Surgery

Fetal surgery scheduled in the middle of pregnancy, or "midgestation," may be necessary for many fetal conditions, including:

Bladder Outlet Obstruction (BOO)

Congenital Pulmonary Airway Malformation (CPAM)

Severe Spina Bifida / Myelomeningocele (MMC)

Twin-Twin Transfusion Syndrome (TTTS)