b2815 Tissue Engineering and Nanotheranostics “9.61x6.69”
30 Tissue Engineering and Nanotheranostics
which need to be applied for fetal implants for a more confident
approach towards fetal surgery.
Keywords: Fetal surgery, fetoscopy, tissue engineering, polymeric
implants, degradation, mechanical properties, inflammatory response.
1. Introduction
1.1. Fetal Surgery
Being an extremely sensitive field of surgery, fetal research has gar-
nered immense interest from the scientific community. Over the
years, there has been a revolution of research efforts to surgically treat
birth defects without posing any risk to the unborn baby and the
mother. These efforts range from open fetal surgery to minimally
invasive interventions to stem cell transplantation, but some conse-
quences such as preterm labor has not yet been solved.^1
Neural tube defects are one of most common birth defects, and
involve incomplete development of the neural elements. Subsequently,
improper development of adjacent bone and mesenchymal structures
are also observed. Fetal surgeries are carried out to rectify neural tube
defects, which are detected by ultrasound techniques in the first few
weeks of pregnancy. As these defects are detected, they need to be
repaired at the earliest to eliminate the risk of post-birth problems for
the child. The two most commonly occurring neural tube defects are
spina bifida and anencephaly.^2
1.2. Spina Bifida
Spina Bifida is the most frequently occurring neural tube defect in the
United States, affecting 0.05% of babies born annually (Fig. 1). Precisely
known as “split spine”, this defect leads to deficiencies in the develop-
ment of the brain, spinal cord and meninges (the protective covering
around the brain and spinal cord). Of the various spina bifida forms
myelomeningocele (MMC) is the most severe and emerges when neu-
ral elements are unsealed due to opening in the spine, inducing partial
or complete paralysis of the body parts beneath the spinal aperture.3,4
