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Fetal Surgery

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Development Stage

Early Stage

Focused ultrasound research is in the laboratory phase and is not yet available for patients.

Clinical Trials

Focused ultrasound for this condition is being researched in clinical trials.

International Approval

Focused ultrasound is approved to treat this condition outside the US. Patients can seek commercial treatment at participating international sites.

FDA Approved

The US Food and Drug Administration has approved focus ultrasound for this condition. Patients can seek commercial treatment at participating sites.

Early Stage

Clinical Trials

International

FDA Approved

Focused ultrasound for this condition is being researched in clinical trials.

Focused Ultrasound Therapy

Focused ultrasound is a noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with a variety of diseases that may be treated in utero. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.

How it Works
Where the beams converge, focused ultrasound produces various biological effects which may enable temporary or permanent repair to be made without surgery. Much of this work is still in the preclinical phase, but some of it has progressed to early patient treatment (neonatal twin-twin transfusion syndrome).

One mechanism of action is the use of ultrasound energy to destroy target tissue through cavitation (histotripsy) or thermal ablation. Similarly, this mechanism could help treat defects like twin-twin transfusion syndrome (ablation of vessels), fetal bladder obstructions and a range of CHDs (atrial-septal defects, valvuloplasty, tetralogy of fallot). However, for research to progress past the preclinical and anecdotal stages, more studies are needed to further explore safety and efficacy.

Advantages
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.

Clinical Trials

clinical trial in London, England, is treating patients with twin pregnancies with twin-twin perfusion abnormalities with focused ultrasound.

The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/

Find a Treatment Site

Search for a treatment center or clinical trial near you.

Regulatory Approval and Reimbursement

Focused ultrasound treatment for intra-uterine conditions are not yet approved by regulatory bodies or covered by medical insurance companies.

Notable Papers

De La Fournière B, Cambronero S, Huissoud C, Estienne L, Rohfristch A, Basso M, Allias F, Dehay C, Ménard AB, Dubernard G, Philip CA, Melodelima D. Selective occlusion of placental vessels using non-invasive focused ultrasound delivered by a toroidal transducer: Preclinical application in a pregnant monkey model for the treatment of twin-twin transfusion syndrome. Ultrasonics. 2026 Mar 6;164:108045. doi: 10.1016/j.ultras.2026.108045. PMID: 41818900 

Danialy A, Fakhari N, Piorkowska K, Wang T, Baranger J, Nowak S, Villemain O, Drake JM, Van Mieghem T, Waspe AC. High Intensity Focused Ultrasound-Induced Ablation of the Intra-Abdominal Umbilical Vessels in a Rabbit Fetus: A Model Treatment of Twin-Reversed Arterial Perfusion Sequence. Prenat Diagn. 2025 Nov 8. doi: 10.1002/pd.70010. PMID: 41204944 

Ichizuka K, Seo K, Izudepski T, Nagatsuka M. High-intensity focused ultrasound for noninvasive fetal therapy. J Med Ultrason (2001). 2022 Mar 12. doi: 10.1007/s10396-022-01199-2.

Raghuram H, Keunen B, Soucier N, Looi T, Pichardo S, Waspe AC, Drake JM. A robotic magnetic resonance-guided high-intensity focused ultrasound platform for neonatal neurosurgery: Assessment of targeting accuracy and precision in a brain phantom. Med Phys. 2022 Feb 17. doi: 10.1002/mp.15540.

Lindley KJ, Bairey Merz CN, Asgar AW, Bello NA, Chandra S, Davis MB, Gomberg-Maitland M, Gulati M, Hollier LM, Krieger EV, Park K, Silversides C, Wolfe NK, Pepine CJ; American College of Cardiology Cardiovascular Disease in Women Committee and the Cardio-Obstetrics Work Group. Management of Women With Congenital or Inherited Cardiovascular Disease From Pre-Conception Through Pregnancy and Postpartum: JACC Focus Seminar 2/5. J Am Coll Cardiol. 2021 Apr 13;77(14):1778-1798. doi: 10.1016/j.jacc.2021.02.026.

Davis MB, Arendt K, Bello NA, Brown H, Briller J, Epps K, Hollier L, Langen E, Park K, Walsh MN, Williams D, Wood M, Silversides CK, Lindley KJ; American College of Cardiology Cardiovascular Disease in Women Committee and the Cardio-Obstetrics Work Group. Team-Based Care of Women With Cardiovascular Disease From Pre-Conception Through Pregnancy and Postpartum: JACC Focus Seminar 1/5. J Am Coll Cardiol. 2021 Apr 13;77(14):1763-1777. doi: 10.1016/j.jacc.2021.02.033.

Shaw CJ, Rivens I, Civale J, Botting KJ, Allison BJ, Brain KL, Niu Y, Ter Haar G, Giussani DA, Lees CC. Maternal and fetal cardiometabolic recovery following ultrasound-guided high-intensity focused ultrasound placental vascular occlusion. J R Soc Interface. 2019 May 31;16(154):20190013. doi: 10.1098/rsif.2019.0013. PMID: 31039691

Click here for additional references from PubMed.