Fetal intervention – modern technology helps children come to life healthy

“Early detection and intervention at the right time helps save the life of the fetus, reduce the burden of birth defects, and improve the quality of the population in the future,” Prof. Dr. Nguyen Duy Anh, Director of the National Obstetrics Hospital, said at the meeting. Fourth Fetal Medicine Conference on May 29.

Medicine considers the uterus to be a “special forbidden palace”. Unfortunately, the fetus has malformations. In many cases, without early intervention, it can die in the womb or be born with damage to the brain, heart, liver, or lungs. Many children do not have the opportunity to be born because birth defects are discovered in the womb.

Today, the new concept of obstetrics is that “the fetus is also a patient” and needs to be examined, diagnosed and treated promptly. Modern exploration, treatment, endoscopy… techniques help doctors intervene in the fetus right in the womb to correct defects and give birth to healthy babies.

Fetal intervention techniques have been deployed around the world for about 20 years. Vietnam conducted its first fetal intervention at the end of 2019, and has now mastered many modern techniques such as treating twin-twin transfusion syndrome, congenital heart intervention, diaphragmatic hernia, and handling defects that cause postpartum respiratory failure.

Many large hospitals such as Central Obstetrics, Hanoi Obstetrics, Tu Du, Hung Vuong… currently perform fetal intervention techniques. Typically, two hospitals, Tu Du and Children’s Hospital 1 (HCMC), successfully performed transuterine cardiac catheterization to save the life of fetuses with severe heart defects, and were honored as one of 12 Vietnamese medical achievements in 2023.

Twin-to-twin transfusion syndrome is considered a deadly pregnancy complication – an unavoidable tragedy in twins sharing a different placenta. At that time, the two fetuses had abnormal blood vessel connection, leading to uneven blood distribution between the fetuses. This is a dangerous condition for both fetuses, with a mortality rate of 90-100% if not intervened in the womb.

Currently, doctors “turn the tables” and save the lives of twin babies with blood transfusion syndrome through laser intervention to connect the placental blood vessels in the amniotic chamber. 85-90% of fetuses survive thanks to blood circulation interventions like this, according to hospital statistics, equivalent to the capacity of major fetal medicine centers in the world.

However, Mr. Anh believes that the biggest challenge today is the lack of specialized human resources, equipment and support mechanisms. Fetal intervention requires highly qualified doctors, precise operations and a modern resuscitation system. In developed countries, on average, there is only one complete fetal intervention center for every 10 million people.

Therefore, he proposed building a nationwide synchronous prenatal screening network, helping grassroots health care providers detect abnormalities early and promptly transfer patients to specialized centers. At the same time, the health sector needs to increase investment in infrastructure, human resource training and insurance payments for fetal intervention techniques.

At the conference, Minister Dao Hong Lan said that the strategy for developing Vietnam’s health sector in the new phase identifies fetal medicine as one of the key specialties that needs to be prioritized for development, along with precision medicine, genetic medicine and high-tech medicine.

The Ministry of Health is continuing to perfect the legal corridor, develop policies, professional procedures and economic-technical norms to universalize prenatal screening services, early detection of fetal abnormalities as well as develop specialized intervention techniques.