For decades, modern medicine has largely accepted a simple sequence: diagnose a congenital defect before birth, deliver the baby safely, and then begin the long process of surgical correction and recovery. That sequence is now beginning to change. A new generation of fetal surgery is moving treatment from the neonatal intensive care unit into the womb itself, raising the possibility that some birth defects may be corrected before they have the chance to inflict irreversible damage.

The significance of this shift extends well beyond a single successful operation. It reflects a broader transformation in medical thinking. Instead of merely preparing parents for difficult outcomes, clinicians are increasingly attempting to alter those outcomes before birth. That distinction is profound. It changes prenatal medicine from observation to intervention. The implications are especially important for conditions where damage worsens with every passing week in the womb. If surgeons can safely restore normal development before birth, they are not simply shortening hospital stays. They may be preserving organ function, reducing........

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