Value of Fetal Surgery Is Called Into Question

Surgery intended to correct fetal deformities in the womb is risky and often of questionable value in preventing birth defects and retardation, according to emerging medical consensus.

Such surgery, pioneered about five years ago, has been used largely in attempts to rescue fetuses from the disastrous effects of obstructive hydrocephalus, a buildup of water on the brain, and obstructive uropathy, a urinary blockage.

Early enthusiasm for these procedures has been dampened by disappointing results, including those published in last week’s New England Journal of Medicine.

“The mood now of the physicians is that it’s been overdone and it should not be done except on an experimental, investigational basis,” said Dr. Arnold Colodny of Children’s Hospital in Boston. “No beneficial results have been shown.”

The latest analysis, compiled by Winnipeg physician Frank A. Manning, shows that hydrocephalus surgery does not seem to reduce the damage suffered by babies who survive. However, it suggests a possible role for surgery in some cases of urinary blockage.

“Prenatal medicine is here to stay,” said Dr. John C. Fletcher, a bioethicist at the National Institutes of Health. “But I think there is a loss of enthusiasm about fetal surgery.”

--Compiled from Times staff and wire service reports.