Pregnancy Q&A: Intrauterine Surgery, Hot Tubs, Surfing

Connie L. Agnew, M.D., answers your questions about pregnancy.


New Frontiers

Is intrauterine surgery on pregnant women actually possible, or is it still experimental?

The safety and effectiveness of performing surgery on a fetus in utero to correct congenital defects have not been conclusively proven. Intrauterine surgery is therefore restricted to select medical centers throughout the United States, where the risks and benefits to fetus and mother can be closely monitored and researched.

Although this surgery is considered for several conditions, the greatest research is taking place in the area of spina bifida. While it can't correct this defect, surgery may prevent it from worsening during pregnancy. There are potential complications for mother and baby, however: It's major abdominal surgery for the woman, requiring anesthesia and posing the risk of postoperative infection and/or bleeding. The most significant risk to the fetus is preterm delivery.

So, as is often the case in medicine, while we are able to target the conditions that might benefit from this procedure, we continue to research its use and recognize that it will likely be many years before intra-uterine surgery is performed routinely.

Safe Tubbing

My husband and I use our hot tub almost every day. Can I continue to do so now that I'm pregnant?

I'd advise you to skip it. Soaking in a hot tub can cause an abnormally high body temperature, and research seems to show an association between elevated temperatures in pregnant women and neural-tube defects in the developing baby. Furthermore, high temperatures put you at risk for dehydration and preterm labor.

So while a nice, hot soak might sound like just the thing for your aching muscles, hot tubs--and saunas, too, for that matter--are best avoided throughout pregnancy. Instead, opt for taking baths in water that's under 100° F. It should not be hot enough to elicit sweating, which can lead to dehydration.

Go Easy, Gidget

I'm an avid surfer and just found out I'm pregnant. Is it safe to hit the waves any time during the next nine months?

As is the case with many activities, such as horseback riding and skiing, the concern with surfing is the risk of blunt abdominal trauma and injury to the fetus. Most obstetricians--myself included--therefore consider the sport to be safe only through the first trimester, when the uterus is confined to the lower pelvic region. Once the uterus expands into the upper abdomen, it becomes more vulnerable to a blow to the belly, as might be caused by a surfboard.

If you do choose to go surfing early on and sustain such a blow, tell your doctor. You and your baby will most likely be fine, but he may want to examine you just to be safe.

Even if you're an experienced surfer, your smartest course of action is to be patient—the waves will be waiting for you after the baby is born.