What Is Urgent Fetal Surgery? Kourtney Kardashian’s Baby & IG Post

Fortunately, Kourtney and the baby are okay post-surgery, PEOPLE reported on Sept. 4. But the post may have you asking a lot of questions about what, exactly, fetal surgery is, and why a baby might have need to have a procedure before it is born.

Ahead, learn all about fetal surgery, how common it is, and how it works.

What is fetal surgery?

Fetal surgery is “a procedure performed on an unborn baby (fetus) in the uterus (in utero) to help improve the long-term outcome of children with specific birth defects,” per the Mayo Clinic. It’s also sometimes called in-utero or prenatal surgery, according to Cleveland Clinic.

If a pregnant person’s healthcare team thinks a fetus won’t make it to delivery or live long after birth, they may suggest this as an option. Fetal surgery can be performed as early as 16 weeks, but the most ideal time for surgery is between 22 and 26 weeks, per Cleveland Clinic.

Some birth defects can get worse as a fetus grows, so it’s important to have a surgery to address the issue before birth, the Mayo Clinic explains. It can help some children go through life significantly less disabled than if they were to have surgery after birth. This is especially true if the surgery is for conditions like spina bifida, which is when the neutral tube doesn’t close all the way, according to the CDC.

Why did Kourtney Kardashian have urgent fetal surgery?

Kourtney and Travis haven’t revealed why Kourt had to undergo urgent fetal surgery. But mom and baby are home safe, and that’s the most important thing right now! Stay tuned for more updates as Kourtney shares her story on Instagram.

What are the reasons for urgent fetal surgery?

Urgent fetal surgery can treat life-threatening birth defects. One example: if a developing baby has a large lung malformation, it could compress their heart, which could then lead to heart failure and death, according to Cleveland Clinic.

Here are some of the conditions that fetal surgery can treat, according to the Mayo Clinic, Cleveland Clinic, and the Boston Children’s Hospital:

• Amniotic band syndrome
• Bronchopulmonary sequestration of the lung
• Congenital cystic adenomatoid malformation (CCAM) of the lung
• Congenital diaphragmatic hernia (CDH)
• Congenital high airway obstruction syndrome (CHAOS)
• Fetal anemia
• Fetal tumors
• Lower urinary tract obstruction (LUTO)
• Mediastinal or pericardial teratoma
• Neck masses that cause airway compression (teratoma or lymphatic malformation).
• Sacrococcygeal teratoma (SCT)
• Spina bifida (myelomeningocele)
• Twin anemia-polycythemia sequence (TAPS)
• Twin reversed arterial perfusion (TRAP) sequence
• Twin-twin transfusion syndrome (TTTS)
• Monochorionic twin complications

How is fetal surgery done?

There are a few different techniques. During the surgery, the pregnant person usually takes pain medications through an epidural, and they also take meds that can prevent preterm labor, per the Boston Children’s Hospital.

• Open Surgery: Open surgery on a fetus involves giving a pregnant person a C-section under general anesthesia, and making an incision to reach the uterus, according to the Boston Children’s Hospital. Next, doctors make another incision in the uterus to reach the fetus, per Cleveland Clinic. From there, the surgeon operates on the baby, while keeping it in the uterus. Then, they close the uterus and abdomen.
• Fetoscopic (laser) Surgery: With this method, the pregnant person is operated on via small “keyhole” incisions in the uterus, according to the Cleveland Clinic. It’s mostly used to treat twin-to-twin transfusion syndrome, a diaphragmatic hernia, and tracheal balloon placements for congenital diaphragmatic hernia, per Johns Hopkins Medicine. A small camera at the end of a long tube (called a fetoscope or laparoscope) is inserted into the uterus and doctors operate laparoscopically through the tube. This type of fetal surgery is more common than open fetal surgery, according to the Boston Children’s Hospital.
• Fetoscopic Tracheal Occlusion: This procedure is experimental and used for fetuses with congenital diaphragmatic hernia and impaired lung development, per Johns Hopkins Medicine. This type of surgery essentially blocks the fetus’s trachea with a latex balloon to improve their lung development, and it can help babies with congenital diaphragmatic hernias survive.
• Fetoscopic Spina Bifida Repair: This minimally invasive procedure closes any neural tube defect, or spina bifida defect, in a fetus’ spine. It has “minimal impact on uterine integrity,” according to Johns Hopkins Medicine.
• Intrauterine Transfusion: For this treatment, an ultrasound is used to place a small needle through the pregnant person’s abdomen and into a fetal blood vessel, per Johns Hopkins Medicine. The fetus can then receive blood, platelets, or medications.
• Fetal Shunt Replacement: This method is used when there’s a renal or urinary abnormality in the fetus. These abnormalities are treated after draining the fetus’s bladder to test a urine sample, according to Johns Hopkins Medicine. Sometimes, stents are also used to drain extra fluid from the fetus’ chest.
• Ex-Utero Intrapartum Treatment (EXIT): Some fetal procedures can be performed at delivery, per Cleveland Clinic. The uterus is opened and the pregnant person partially delivers the baby, and then the baby is stabilized before its umbilical cord is cut and it’s separated from the placenta. This method is often used for babies with a blocked airway or a large tumor at birth.

How common is fetal surgery?

Fetal surgery is still relatively new—it’s existed for around 30 years and there are just 20 hospitals in North America that offer it, according to Cleveland Clinic.

But to put it in context, around 1 in 33 babies are born with a birth defect each year, per the CDC. (That’s 120,000 babies each year.) Urgent fetal surgery can help repair the defects.

How risky is fetal surgery?

There are some potential risks to fetal surgery, per Mayo Clinic, Cleveland Clinic, and the Boston Children’s Hospital. They can include:

• Blood loss
• Early labor
• Fetal death
• Infection
• Operative complications
• Placental abruption (this can stop the fetus from absorbing nutrients)
• Potential failure to treat the birth defect
• Side effects from medications, like low blood pressure or breathing too slowly or shallowly
• The current (or future) deliveries might need to be C-sections
• Uterine rupture after surgery
• Uterine scar thinning or reopening, which can be risky for future pregnancies
• Chorioamnionitis (a rare infection of amniotic fluid)
• Chorioamniotic membrane separation

How does fetal surgery work with an amniotic sac?

During an open fetal surgery, the mother’s abdomen is opened up and the fetus is partially removed so that the defect can be repaired, according to the Ann and Robert H. Lurie Children’s Hospital of Chicago. Special tools are used to control bleeding, like staplers, and fluid infusions are given to make sure the pregnant person doesn’t lose amniotic fluid during the procedure, per Cleveland Clinic.

Hopefully the rest of Kourtney’s pregnancy goes smoothly. I’m rooting for Kravis, always!

Addison Aloian (she/her) is the assistant love & life editor at Women’s Health. Outside of topics related to lifestyle, relationships, and dating, she also loves covering fitness and style. In her free time, she enjoys lifting weights at the gym, reading mystery and romance novels, watching (and critiquing!) the latest movies that have garnered Oscars buzz, and wandering around the West Village in New York City. In addition to Women’s Health, her work has also appeared in Allure, StyleCaster, L’Officiel USA, V Magazine, VMAN, and more.