As Kourtney Kardashian revealed she had foetal surgery - is prenatal surgery available in the UK?

Kourtney Kardashian revealed she was rushed into emergency fetal surgery to save the life of her and her husband's unborn child. 

On Wednesday (6 September) the reality star shared a post for an update on how she and her baby is doing. 

In her post, she wrote: “As someone who has had three really easy pregnancies in the past, I wasn’t prepared for the fear of rushing into urgent foetal surgery. I don’t think anyone who hasn’t been through a similar situation can begin to understand that feeling of fear. I have a whole new understanding and respect for the mamas who have had to fight for their babies while pregnant.”

In the UK, care during your pregnancy is known as antenatal care, pregnancy care or maternity care.

So what is antenatal care, what screenings do the UK offer and what type of surgery can be done on a fetus? Here is what you need to know. 

What is antenatal care?

According to the NHS, antenatal care is delivered by your midwife and doctor and checks the health of mother and baby. 

To begin having antenatal care, the expectant can book an appointment with their GP or directly with the midwife as soon as they find out their pregnant.

The GP surgery or a children's centre can pass over contact details to the nearest midwifery service, and it's best to see a midwife or GP as early as possible. 

The NHS says antenatal appointments should take place in a setting where you feel able to discuss sensitive issues, such as domestic abuse, sexual abuse, mental health problems or drugs.

What antenatal screenings do people receive?

People expecting their first child will have 10 antenatal appointments.

Tests such as screening for sickle cell and thalassaemia (inherited genetic disorders), should be done before hitting 10 weeks pregnant.

For other pregnancies, there are 7 appointments, but sometimes there may have more – for example, if a medical condition is developed.

The screening tests offered during pregnancy in England are either ultrasound scans and/or blood.

Ultrasound scans may detect conditions such as spina bifida and blood tests can show whether there is a higher chance of inherited conditions such as sickle cell anaemia and thalassaemia, and whether there are infections like HIV, hepatitis B or syphilis.

Blood tests combined with scans can help find out how likely it is that the baby has Down's syndrome, Edwards' syndrome or Patau's syndrome.

A screening for Down's syndrome, Edwards' syndrome and Patau's syndrome will be offered around the time of the dating scan, which happens around 11 to 14 weeks pregnant.

The 20 week scan checks the physical development of the foetus, although it cannot pick up every condition. It looks in detail at the baby's bones, heart, brain, spinal cord, face, kidneys and abdomen and tests for these conditions:

• anencephaly
• open spina bifida
• cleft lip
• diaphragmatic hernia
• gastroschisis
• exomphalos
• serious cardiac abnormalities
• bilateral renal agenesis
• lethal skeletal dysplasia
• Edwards' syndrome, or T18
• Patau's syndrome, or T13

What types of fetal surgery exist in the UK?

In the UK, there are two types of fetal surgery - open fetal surgery and fetoscopic surgery. 

In 2019, NHS England commissioned a service to carry out open fetal surgery for babies diagnosed with spina bifida.

Only two centres in the UK offer this, at University College London Hospitals NHS Foundation Trust (UCLH) / Great Ormond Street Hospital for Children NHS Foundation Trust (GOSH) in London and University Hospitals Leuven, in Belgium. 

‘Open’ fetal surgery involves making an opening in the mother’s abdomen and womb to operate on the baby’s back and close the lesion.

This surgery is carried out before the 26th week of pregnancy. 

In Fetoscopic surgery, for spina bifida, the ‘keyhole’ approach is taken where surgeons operate on the baby’s back through small holes made in the mother’s abdominal wall.

However, fetoscopic surgery is not currently available on the NHS.