Intrauterine surgery requires appropriate preparation. A very thorough and precise diagnosis of both mother and fetus is necessary before qualifying for surgery. Ultrasound examinations are performed to assess the general well-being of the fetus as well as to determine the type and location of the defect to be operated on. Cardiotocography is also necessary to assess the fetal heart function as well as the state of tension in the uterine muscle. Genetic tests are also necessary to exclude chromosomal aberrations that contraindicate open fetal surgery. Unfortunately, not all defects are suitable for intrauterine surgical intervention. Contraindications include, but are not limited to, the aforementioned chromosomal aberrations of the foetus, a heavy obstetric history of the mother, or there are other contraindications on the part of the mother or the foetus to the procedure.

After the operations, patients must be under very close medical supervision. It is essential to take medication to inhibit uterine contraction activity in order to reduce the risk of premature contraction and preterm labour. Regular analytical examinations of the mother's blood as well as ultrasound of the foetus are also performed. Doppler ultrasound allows an accurate assessment of fetal well-being. The centre where such operations are carried out must be equipped with appropriate specialised equipment of the highest quality as well as have a team of specialists with the necessary training and preparation. Every pregnant woman who is scheduled for foetal surgery must be thoroughly informed of the possibility of post-operative complications, the risks that this entails for the mother and the foetus as well as the benefits that intrauterine correction of the defect in question may bring.

The intrauterine correction of fetal malformations is a procedure that requires close cooperation between doctors of many specialities. It requires the cooperation of a team of gynaecologists who perform the caesarean section during which the pregnant uterus is removed, paediatric surgeons who perform the operation on the foetus, as well as neonatologists, psychologists and many other specialists. The team of anaesthesiologists, whose task is to administer the appropriate anaesthetics that simultaneously inhibit the uterine contractile activity, also plays an extremely important role. They not only ensure that both mother and foetus are properly anaesthetised, but also that the risk of premature uterine contraction is reduced. The anaesthesia reaches the foetus via the placenta, but in some cases analgesics are also administered directly to the foetus. The cooperation of a multi-specialist team allows the procedures to run smoothly, minimise the risk of failure and be increasingly safe for both mother and foetus.

Surgical treatment of the foetus can be carried out through so-called open intrauterine surgery or endoscopic surgery. The choice of method depends on the type of defect to be operated on. Open fetal surgery involves rolling out the uterus with the foetus onto the mother's abdomen and then performing surgery on the foetus. Endoscopic operations are much less invasive procedures. They require only three small uterine incisions necessary for the insertion of a camera and micro-tools, with which the operation is carried out while observing the surgical field on a monitor.

This type of procedure is most commonly used to treat fetal heart defects. The fetal heart is very small, so these procedures require great precision on the part of the operating doctors. In the case of a meningo-spinal hernia, partial extraction of amniotic fluid is carried out during the operation, which is stored in special containers for the duration of the operation, and after the operation is reinjected into the amniotic sac or supplemented with saline solution.