A stitch in time: the past, present and future of foetal surgery

With the introduction of prenatal diagnosis, therapeutic intervention in the foetus became a theoretical feasibility. A number of procedures have since been developed, with the most successful treatments targeting twin-twin transfusion syndrome and myelomeningocoele (spina bifida). A number of other conditions were also initially believed to be suitable for foetal surgical intervention but have yet to bear therapeutic fruit. The purpose of this article is to explore the science behind foetal surgery, what has characterised the procedures which have a good evidence base for their use, and why more congenital abnormalities have not been targeted by this modality.