Roughly 3% of U.S. newborns—about one in every 33—are born each year with a birth defect. While those statistics can be alarming, most fetal abnormalities can now be detected through routine prenatal screening. Early diagnosis not only allows doctors and families to plan appropriate care after delivery but, in some cases, enables treatment while the baby is still in the womb.
Thanks to advancements in imaging, anesthesia, and minimally invasive techniques, fetal surgery has become a vital part of modern maternal-fetal medicine. Once considered experimental, many of these procedures are now standard practice at specialized centers across the country.
Ultrasounds Reveal More Than a Baby’s Sex
Ultrasound imaging is a cornerstone of prenatal care, providing real-time views of the baby’s growth and the mother’s health. The technology uses high-frequency sound waves—not radiation—to create detailed images of the fetus.
Most patients undergo two or three ultrasounds over the course of pregnancy: an initial scan around 12 weeks, a comprehensive anatomy scan between 18 and 22 weeks, and another assessment between 28 and 32 weeks. Additional scans may be ordered if doctors detect potential complications.
These ultrasounds can identify structural abnormalities in the brain, heart, chest, abdomen, and limbs with high accuracy. However, no screening method is perfect. Some conditions develop later in pregnancy or require additional tests, such as fetal MRI, for confirmation. Expert interpretation by experienced clinicians remains critical.
Abnormal Findings Aren’t Always Dangerous
Unexpected findings on an ultrasound can cause significant anxiety, but not all results signal danger. Some findings turn out to be false positives caused by technical limitations or operator variance. Others represent benign conditions that resolve on their own, such as small fetal cysts that disappear later in pregnancy.
At NYU Langone’s Advanced Fetal Care Center, specialists emphasize comprehensive evaluation, communication, and clear next steps for families. When an abnormality does warrant concern, families receive personalized guidance and follow-up to understand the implications and available options.
Some Serious Conditions Can Be Treated Before Birth
A persistent myth in prenatal care is that nothing can be done before delivery when serious abnormalities are found. In fact, advances in fetal medicine have changed that reality.
Twin-to-twin transfusion syndrome, a rare condition affecting identical twins who share a placenta, was once nearly always fatal. Today, fetoscopic laser surgery between 16 and 26 weeks of pregnancy can correct the uneven blood exchange between twins, leading to survival rates of around 90%.
Spina bifida, another severe condition, can also be treated in utero. Through three small incisions in the uterus, surgeons can close the spinal opening to protect nerves and improve long-term mobility and brain development. Other repairable conditions include congenital diaphragmatic hernia, where abdominal organs press into the chest, and certain structural heart defects that impede normal development.
Fetal Surgery Is Now a Proven Option
Modern fetal surgeries use highly specialized, minimally invasive tools to reduce risk for both mother and baby. Depending on the diagnosis, surgeons may open the uterus temporarily or employ fetoscopic techniques using a camera less than a millimeter wide.
At NYU Langone’s Hassenfeld Children’s Hospital, multidisciplinary teams—including pediatric surgeons, maternal-fetal medicine specialists, and anesthesiologists—coordinate each case for optimal safety. Though fetal surgery is still performed in fewer than ten U.S. centers, its success rates continue to grow as new research, trials, and devices expand treatment options.
Every pregnancy—and every diagnosis—is unique. Experts recommend early consultation with specialized fetal centers to explore all possible interventions. Early detection, thorough evaluation, and advanced surgical care can significantly improve outcomes for both mother and child.
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