Progress in fetal surgery: A buoyant start or watchful reluctance? Perspectives for India

The transvaginal ultrasound, high-frequency transducers, and improved processing speed of the ultrasound have improved demonstration of structural abnormalities. [...]3D and 4D ultrasound technologies provide real-time images and multiplanar views expanding antenatal diagnosis and fetal interventions. 4D ultrasound has been used to guide the cauterization of an umbilical cord in twin–twin transfusion syndrome. [8] The hysterotomy in open fetal surgery approach in the second trimester is usually done in the body or fundal uterine region, where the muscle fibers have a helicoidal distribution. [...]a zone of weakness is generated and uterine rupture may be caused even by only uterine distension during the further course of pregnancy. [...]while the standard of treatment for most fetal anomalies remains planned delivery at a tertiary center with appropriate neonatal intensive care facilities, few conditions may benefit from fetal surgical intervention.