Advances and Updates in Fetal and Neonatal Surgery

We are delighted to focus on fetal and neonatal surgery in this issue of Clinics in Perinatology. Tremendous advances in fetal and neonatal treatment have been made in the last 10 years with the recognition that there is a continuum of care from fetal diagnosis and potential therapy through neonatal care. Both fetal surgical care and neonatal surgical care are multidisciplinary fields that rely on the expertise of perinatologists, neonatologists, pediatric surgeons, anesthesiologists, and many other maternal and pediatric specialists.

Fetal surgery has matured from a field of case reports and single-institution, small case series to national and international registries and prospective randomized trials with rigorous scientific methodology. These efforts have been largely driven by collaborative fetal care consortia, such as the International Fetal Medicine and Surgery Society, Eurofetus, and the North American Fetal Therapy Network. Only with such collaboration across multiple centers can the field of fetal intervention, encumbered by relatively small numbers of cases at each center, best share data and analyze results. Of course, balanced within fetal surgery is the need to provide excellent care for the fetus while maintaining a prioritization on maternal health and safety for the pregnant woman. Similar to fetal surgery, neonatal surgery has made great strides over the last decade. Advances in neonatal care and pediatric anesthesia have paralleled the technical advances in pediatric surgery, which has allowed effective treatment of neonates with complex surgical and medical conditions. The multidisciplinary collaboration among neonatologists, pediatric anesthesiologists, and pediatric surgeons is the foundation of advances in neonatal care as we strive for shorter hospital stays and less morbidity, as well as for survival. As this neonatal care evolves, more attention to long-term outcomes is needed to truly understand the impact of our fetal and neonatal surgical therapies.

We are delighted to share the expertise of many of the world’s leaders with their thoughtful review of the literature and their centers’ experiences on the subjects covered in this issue of Clinics in Perinatology. We are incredibly grateful to the authors for their excellence in clinical care and their well-written articles. We hope that the following pages will help educate, inform, and inspire our colleagues around the world. We dedicate this effort to the many patients and their families who have been under our care and bravely and graciously allowed us to be a part of their lives. They educate, inform, and inspire us.