Prenatal Surgery

Fetal surgery has expanded rapidly in its scope and scale since the first recorded procedure—an intrauterine blood transfusion to treat hemolytic anemia secondary to rhesus incompatibility—by Professor Sir William Liley in 1963 [1]. The most recognized and extensively studied application in neurosurgery is the prenatal repair of open neural tube defects, largely based on the landmark results of the Management of Myelomeningocele Study (MOMS) [2]. Hydrocephalus, encephalocele, and cerebral malformations have also been addressed prenatally [3]. However, clinical and technical debate aside, prenatal surgery involves complex ethical interactions between the parents, fetus, medical teams, healthcare organizations, and religious authorities, which this chapter shall seek to review.