Mayo Clinic's approach

In a caring and compassionate environment, highly skilled fetal surgery experts at Mayo Clinic Children's Center offer the most advanced procedures and technology for treating health problems before birth to make outcomes better. Coming to an informed decision about whether fetal surgery is the best approach involves:

  • Thorough and personalized medical assessment of you and your unborn baby.
  • On-site, top-quality laboratory services for fast and accurate results.
  • Discussion of the options, such as choosing between open fetal surgery or less-invasive procedures.
  • Evaluation of the potential benefits and risks of fetal surgery.
  • Education for you and key supporters of your choosing, with ample opportunity to answer questions.
  • Discussion of short-term and long-term follow-up care and how to transition to the Mayo Clinic areas that provide this care.

Your Mayo Clinic care team

With Mayo Clinic's approach, experts from multiple specialties come together to care for you and your child. This team approach results in the right treatment for you and your child.

Mayo Clinic's fetal surgery team includes experts in maternal and fetal medicine, pediatric surgery, neonatology, radiology and anesthesiology, as well as pediatric otolaryngology, pediatric nephrology, pediatric urology and pediatric neurosurgery, as needed. The team also can work with your local healthcare professional.

Advanced technology and treatment

Mayo Clinic experts use the latest diagnostic technology and treatment procedures to detect and treat health problems before birth. These may include:

  • Doing a fetal ultrasound (sonogram), such as a 3D or 4D ultrasound, Doppler ultrasound, or fetal echocardiography.
  • Scanning and printing a 3D model of the fetus before surgery to learn about the condition and plan for the fetal surgery.
  • Doing less-invasive types of fetal surgery for select conditions to make outcomes better for mothers and babies.
  • Doing open fetal surgery in more-complicated cases using advanced techniques to help fetal development, reduce disability and make outcomes better.

In utero spina bifida surgery

Narrator: In utero spina bifida surgery is a complex procedure which requires a team of experts from many Mayo Clinic specialties. Before the operation begins, the mother is put under deep general anesthesia to make sure both she and the baby are asleep.

Using ultrasound as a guide, surgeons make the first incision to access the uterus. Then in cases where the placenta blocks access to the uterus, the uterus is moved out of the mother's abdomen and turned.

Doctors make a one centimeter incision in the uterus and use a special stapler to secure blood flow. Then they fill the uterus with a solution.

The fetus floats to the top of the uterus and the spina bifida is exposed. Now doctors can begin the repair.

First, they close what's called the neural placode. Second, they suture the dura mater. Third, they close the skin.

Then they close the uterus, replace that into the mother's abdomen and close her incision.

NICU and NICU Follow-Up Clinic

Mayo Clinic's Newborn Intensive Care Unit (NICU) specializes in family-centered care of premature and critically ill newborn infants. Families are welcome at the baby's bedside. They will find many support spaces throughout the unit, such as family waiting areas and rooms, parent sleep rooms, and breastfeeding rooms.

Mayo's NICU Follow-up Clinic makes sure that the quality of care continues after babies are discharged from the NICU.

Expertise and rankings

Mayo Clinic Children's Center in Minnesota is one of only a few medical centers in the U.S. with the expertise to do fetal surgery to improve outcomes of babies with health problems before birth. These outstanding fetal surgeons and their experienced teams are recognized as national leaders in treatment and research.

Continuity of care

As part of the Mayo Clinic Children's Center, a team of Mayo experts from multiple specialties trained to treat health problems that require continued follow-up will care for your child after birth. They also will help manage the child's condition. For example, Mayo Clinic pediatric experts give the highest-quality care to children with spina bifida and manage any complications.

Mayo Clinic provides lifelong care for children with health problems after birth, so your child will be able to transition to adult care when the time arrives — and be assured that the highest-quality care will continue.

Locations, travel and lodging

Mayo Clinic has major campuses in Phoenix and Scottsdale, Arizona; Jacksonville, Florida; and Rochester, Minnesota. The Mayo Clinic Health System has dozens of locations in several states.

For more information on visiting Mayo Clinic, choose your location below:

Costs and insurance

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.

More information about billing and insurance:

Mayo Clinic in Arizona, Florida and Minnesota

Mayo Clinic Health System

Clinical trials

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

Nov. 20, 2024
  1. Ruano R, et al. Fetal surgery: How recent technological advancements are extending its applications. Expert Review of Medical Devices. 2019; doi:10.1080/17434440.2019.1641404.
  2. Rintoul NE, et al. Fetal intervention and surgery. In: Nelson Textbook of Pediatrics. 22nd ed. Elsevier; 2025. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  3. Lockwood CJ, et al., eds. Invasive fetal therapy. In: Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  4. Ruano R, et al. Regenerative Prophylaxis In Utero. Clinical Pharmacology & Therapeutics. 2019; doi:10.1002/cpt.1262.
  5. Winn HR, ed. Fetal surgery for myelomeningocele. In: Youmans and Winn Neurological Surgery. 8th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  6. Baumgarten HD, et al. Fetal surgery. Pediatric Clinics of North America. 2019; doi:10.1016/j.pcl.2018.12.001.
  7. Nassr AA, et al. Outcome of fetuses with lower urinary tract obstruction and normal amniotic fluid volume in the second trimester of pregnancy: A single center experience. Ultrasound in Obstetrics & Gynecology. 2019; doi:10.1002/uog.20288.
  8. Martin RJ, et al., eds. Surgical treatment of the fetus. In: Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 12th ed. Elsevier; 2025. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  9. Chestnut DH, et al., eds. Antepartum fetal assessment and therapy. In: Chestnut's Obstetric Anesthesia: Principles and Practice. 6th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  10. Paidas Teefey C, et al. Maternal fetal surgery: Intervention and management. Clinical Obstetrics and Gynecology. 2020; doi:10.1097/GRF.0000000000000534.
  11. Townsend CM Jr, et al. Fetal surgery. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  12. Goodnight WH, et al. Subsequent pregnancy outcomes after open maternal-fetal surgery for myelomeningocele. American Journal of Obstetrics & Gynecology. 2019; doi:10.1016/j.ajog.2019.03.008.
  13. Olutoye II OO, et al. Minimally invasive fetal surgery and the next frontier. Neoreviews. 2023; doi:10.1542/neo.24-2-e67.
  14. Evans LL, et al. Modern fetal surgery — A historical review of the happenings that shaped modern fetal surgery and its practices. Translational Pediatrics. 2021; doi:10.21037/tp-20-114.
  15. Miller R. Twin reversed arterial perfusion (TRAP) sequence. https://www.uptodate.com/contents/search. Accessed Aug. 1, 2024.
  16. Lissauer T, et al. Perinatal medicine. In: Illustrated Textbook of Paediatrics. 6th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Aug. 1, 2024.
  17. Ahn ES (expert opinion). Mayo Clinic. Aug. 30, 2024.