Fetal (intrauterine) surgery: when it is indicated
Reviewed on July 17, 2026
Learning that surgery can be done while still during pregnancy is at once hopeful and full of questions. Intrauterine (or fetal) surgery is a real option in specific situations and, in neurosurgery, its main use is in the treatment of myelomeningocele. This text calmly explains what it is, when it is indicated and what weighs on this very important decision.
What intrauterine surgery is
It is a procedure performed on the baby while still inside the womb, before birth. Instead of waiting for delivery to operate, the team corrects certain malformations during pregnancy, when this can benefit development.
In neurosurgery, the most established indication is closure of myelomeningocele, the most severe form of spina bifida. The surgery can be done open, with an incision in the uterus, or by fetoscopy, with less invasive techniques.
When it is indicated
The main neurosurgical indication is myelomeningocele diagnosed before birth, in cases that meet specific eligibility criteria. The goal is to protect the exposed spinal cord and, in some cases, reduce the need for a shunt for hydrocephalus and improve leg function.
Not every pregnancy with this malformation is a candidate. Gestational age, features of the lesion, the mother's health and other factors are carefully assessed before recommending the procedure.
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Request a second opinionRisks, benefits and what weighs on the decision
Fetal surgery can bring important gains, but it also involves risks for mother and baby, such as premature birth. That is why the decision compares the possible benefits with these risks, always individually.
These procedures are performed at specialized centers by multidisciplinary teams. Choosing between operating during pregnancy or after birth is one of the most delicate decisions parents face.
Why a second opinion helps
Because it involves strict eligibility criteria, significant risks and a specific time window, intrauterine surgery is exactly the kind of decision where an independent second opinion brings reassurance.
It helps confirm the diagnosis, review whether the pregnancy meets the criteria and clarify realistic expectations for each path. Having another qualified analysis supports the family at a time of difficult, time-sensitive decisions.
Frequently asked questions
Does fetal surgery cure myelomeningocele?
It does not eliminate all consequences of the malformation, but it can reduce some impacts, such as the need for a shunt for hydrocephalus and movement problems, in selected cases. Results vary with each situation.
Can every pregnancy with spina bifida have intrauterine surgery?
No. There are specific eligibility criteria that consider gestational age, the features of the lesion and the mother's health. In many cases, closure after birth is the recommended option.
How do I get a second opinion about fetal surgery?
On Revidra you upload the prenatal exams, including ultrasounds and fetal MRI, and receive a written, structured opinion from an independent specialist on eligibility and options.
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Request a second opinionEducational content, for informational purposes. It does not replace consultation, diagnosis or treatment with a physician, nor does it constitute a teleconsultation or emergency care.