After more than two decades of experimental and clinical work, fetal surgery is an accepted treatment option for highly selected fetuses with life-threatening anomalies. Fetal lung masses associated with hydrops are usually fatal. These lesions can be resected in utero if they are predominantly solid or multicystic. Fetal sacrococcygeal teratoma complicated with progressive high output cardiac failure may benefit from in-utero resection of the tumor. Important lessons have been learned about perioperative management and maternal, fetal, and neonatal outcomes after open fetal surgery.

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