Purpose or Case Report: Since the first fetal intervention performed in humans in the 1960s, fetal surgery has undergone remarkable advancements. Whether aimed at treating or preventing the progression of congenital conditions, in-utero interventions have been shown to significantly improve postnatal outcomes. Imaging has become an indispensable adjunct to fetal surgery, not only by precisely characterizing the congenital anomalies, but also by assessing and often quantifying postoperative results. As the number of fetal centers and eligible patients continues to expand, fetal radiologists need to be aware of the recent advances and provide appropriate guidance to fetal surgeons. This educational exhibit provides an overview of US and MRI imaging in the wide range of fetal interventions performed at major referral centers. Key imaging findings before and after fetal intervention will be presented, alongside detailed discussions on indications, techniques, and potential complications. Procedures covered include fetoscopy, vesicoamniotic and thoracoamniotic shunt placement, cyst aspiration, amnioinfusion, fetoscopic laser photocoagulation, intrauterine transfusion, amniotic band lysis, open neural tube defect repair, chorioangioma embolization, fetoscopic endotracheal occlusion, ex utero intrapartum treatment, and selective fetal reduction.
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