Fetoscopy
Prenatal Diagnosis
Pregnancy
Trisomy 10: first-trimester features on ultrasound, fetoscopy and postmortem of a case associated with increased nuchal translucency. (1/96)
We report a case of the prenatal diagnosis of trisomy 10 in a fetus presenting with an increased nuchal translucency thickness (5 mm) on a routine first-trimester anomaly scan at 12 weeks' gestation. Multiple abnormalities were diagnosed by ultrasound and fetoscopy. Karyotyping on chorionic villus sampling led to the diagnosis of homogeneous trisomy 10 which was confirmed by in situ hybridization on fetal tissue samples. Postmortem examination confirmed major anatomical malformations, including facial cleft, arthrogryposis of the upper and lower limbs and bilateral diaphragmatic hernia, and also revealed hypoplastic lungs, right renal agenesis and a complex cardiac malformation. Trisomy 10 is an uncommon chromosomal abnormality that is likely to be associated with increased fetal nuchal translucency. This case also emphasizes the value of a detailed anomaly scan in high-risk patients in the first trimester of pregnancy. (+info)Closure techniques for fetoscopic access sites in the rabbit at mid-gestation. (2/96)
Operative fetoscopy may be limited by its relatively high associated risk of preterm prelabour rupture of membranes. The objective of this study was to study closure techniques of the access site for fetoscopy in the mid-gestational rabbit. A total of 32 does (288 amniotic sacs) at 22 days gestational age (GA; term = 32 days) underwent 14 gauge needle fetoscopy, by puncture through surgically exposed amnion. Entry site was randomly allocated to four closure technique groups: myometrial suture (n = 14), fibrin sealant (n = 15), autologous maternal blood plug (n = 13), collagen plug (n = 14); 16 sacs were left unclosed (positive controls), and the unmanipulated 216 sacs were negative controls. Membrane integrity, presence of amniotic fluid and fetal lung to body weight ratio (FLBWR) were evaluated at 31 days GA. Following fetoscopy without an attempt to close the membranes, amniotic integrity was restored in 41% of cases (amniotic integrity in controls 94%; P = 0.00001). When the access site was surgically closed, the amnion resealed in 20-44% of cases, but none of the tested techniques was significantly better than the others or than positive controls. Permanent amniotic disruption was associated with a significantly lower FLBWR in all groups. In conclusion, the rate of fetoscopy-induced permanent membrane defects in this model did not improve by using any of the closure techniques tested here. (+info)Fetoscopic transesophageal electrocardiography and stimulation in fetal sheep: a minimally invasive approach aimed at diagnosis and termination of therapy-refractory supraventricular tachycardias in human fetuses. (3/96)
BACKGROUND: Therapy-refractory supraventricular tachycardia commonly results in hydrops and death in human fetuses. The purpose of this study in fetal sheep was to assess the feasibility of a minimally invasive fetoscopic approach for fetal transesophageal electrocardiography and stimulation aimed at diagnosis and termination of these tachycardias. METHODS AND RESULTS: We studied a total of 10 fetal sheep (87 to 103 days of gestation; term=145 days). We entered the amniotic cavity using a percutaneous fetoscopic approach and placed various electrophysiology catheters into the fetal esophagus. We recorded the number of animals in which fetoscopic transesophageal electrocardiography and stimulation were successful and assessed pacing success and thresholds for different catheters. In addition, we monitored for potential adverse effects from stimulation and for other complications of the operation. Recording of transesophageal electrocardiograms was successful in all fetal sheep. Capture during stimulation was successfully documented by additional fetal bipolar surface electrocardiograms in 7 fetuses. In fetuses in which fetal surface electrocardiograms were not recorded, pacing stimulus artifacts interfered with documentation of capture. Although stimulation thresholds were high, the maternal rhythm was not affected by fetal stimulation. CONCLUSIONS: Fetoscopic fetal transesophageal electrocardiography and stimulation are feasible in fetal sheep. This minimally invasive approach might have the potential to improve diagnosis and management of therapy-refractory supraventricular tachycardias in human fetuses. (+info)Prognostic factors in severe twin-twin transfusion syndrome treated by endoscopic laser surgery. (4/96)
OBJECTIVE: The aim of this study was to investigate clinical and sonographic parameters, in particular Doppler blood flow measurements, in severe second-trimester twin-twin transfusion syndrome before and after endoscopic laser coagulation of the placental vascular anastomoses, to correlate these data with fetal outcome and to determine whether fetal blood flow measurements could help to estimate the probability of fetal survival. METHODS: In 121 cases of severe twin-twin transfusion syndrome examined between 17 and 26 weeks of gestation, the following investigations were performed: fetal biometry, placental location, deepest pool of amniotic fluid, echocardiography and Doppler sonography of the umbilical arteries and the ductus venosus of both twins before and after fetoscopic laser ablation of the placental anastomoses. RESULTS: The overall survival rate was 64% (156/242). Both fetuses survived in 48% (58/121) and one fetus survived in 33% (40/121), resulting in 81% (98/121) of pregnancies with at least one survivor. Gestational age at the time of the procedure and placental location had no significant influence on fetal survival. The amniotic fluid volume drained after laser coagulation correlated significantly (p = 0.038) with the risk of miscarriage or extremely premature delivery within 4 weeks of the procedure. Intertwin discrepancy in abdominal circumference showed a significant negative correlation (p = 0.004) with the probability for survival of donor fetuses. Before the procedure, 19% (23/121) of donor twins and 5% (6/121) of recipient twins showed absent or reversed end-diastolic flow in the umbilical artery (p = 0.001). This finding had no significant influence on the survival rate of donors. An increase of waveform indices in the umbilical artery 1 day after the procedure compared to immediately after the procedure correlated significantly with a lower probability for survival of donors (p = 0.042) and recipients (p = 0.018). Before the procedure, 37% (45/121) of recipient twins and 9% (10/113) of donor twins showed absent or reversed flow during atrial contraction in the ductus venosus (p < 0.0001). This finding had a significant negative influence on the survival rate of recipient fetuses (p = 0.02). Furthermore, an increase of waveform indices in the ductus venosus 1 day after the procedure compared to immediately after the procedure correlated significantly with a lower probability of survival in recipients (p = 0.005). CONCLUSIONS: Fetoscopic laser coagulation of the placental vascular anastomoses in severe mid-trimester twin-twin transfusion is a potentially corrective and effective, minimally invasive procedure. Doppler investigation of the umbilical and fetal circulations provides important information on the fetal condition, prognosis and therapeutic effects of the intervention. Signs of congestive heart failure in the recipient may reduce the probability of survival, whereas increased placental resistance in the donor before the procedure is not necessarily associated with a reduction in the probability of survival after laser coagulation. (+info)Intrauterine sling: a complication of the stuck twin syndrome. (5/96)
Stuck twin syndrome usually presents with polyhydramnios in the recipient sac and severe oligohydramnios in the donor sac. The donor is displaced against the uterine wall and remains adherent in that position. We present a case in which the diagnosis was more complicated, owing to the suspension of the stuck twin by a sling within the sac of the recipient. A monochorionic diamnionic twin gestation was complicated by twin-twin transfusion syndrome at 18 weeks of gestation. In our example, the stuck twin was suspended by a sling from the placenta. The sling band represented the intertwin membrane that was folded upon itself. Amniotic fluid from the recipient twin was present in three dimensions around the stuck twin, except for the sling band. The suspension of the stuck twin by a sling within the amniotic fluid of the recipient is an unusual manifestation of the stuck twin syndrome. (+info)Matrix metalloproteinases -2 and -9 and their endogenous tissue inhibitors in fetal membrane repair following fetoscopy in a rabbit model. (6/96)
The cellular mechanisms underlying fetal membrane repair are poorly understood. Matrix metalloproteinases (MMP) and the endogenous tissue inhibitors of metalloproteinases (TIMP) play a key role in the control of turnover of extracellular matrix in fetal membranes at normal parturition and preterm prelabour rupture of the fetal membranes (PPROM). The time course of secretion of MMP-2 (72 kDa, gelatinase A) and MMP-9 (92 kDa, gelatinase B) and TIMP into extra-embryonic coelomic, allantoic and amniotic fluids in a rabbit model was examined. Furthermore, to evaluate their role in fetal membrane repair, the changes induced by fetoscopy at mid-gestation (23 days; gestation length is 32 days) were investigated. Zymography showed predominantly secretion of latent MMP-2 at 18, 23 and 30 days of gestation in all gestational compartments. Reverse zymography detected a broad range of TIMP activity with molecular weights of 27-30 kDa (TIMP-1, glycosylated TIMP-3 and TIMP-4), 24 kDa (unglycosylated TIMP-3) and 21 kDa (TIMP-2). Following fetoscopy, both MMP-2 and TIMP increased significantly in amniotic fluid and extra-embryonic coelomic fluid, but not in allantoic fluid, as demonstrated by densitometric analyses. These findings indicate a modulating role for MMP and TIMP in the repair processes following a surgically induced fetal membrane defect. (+info)Transabdominal first trimester embryofetoscopy as a potential approach to early in utero stem cell transplantation and gene therapy. (7/96)
OBJECTIVE: To explore the potential of embryofetoscopy for early diagnosis and for access to the fetal circulation in the first trimester of gestation. DESIGN: Transabdominal embryofetoscopy was performed in 14 patients scheduled for termination of pregnancy using a 1-mm semirigid fibreoptic telescope with a 18 gauge examination sheath and a single-chip digital camera. A 25 gauge needle was inserted through an additional 21 gauge side port to access the fetal circulation. RESULTS: Fetal head, face, abdomen, complete upper and lower limbs could be visualized in over 80% of cases. On the contrary, the fetal back and external genitalia could be examined in detail only in some cases (35.7% and 64.3%, respectively). Injection of 10-20 ml saline improved visibility in 43% of cases. Funipuncture was successful in two of three attempts. CONCLUSIONS: Our experience suggests that embryofetoscopy is a useful tool for early diagnosis in the first trimester of pregnancy. Funipuncture is possible thus providing the means for an early intravascular stem cell application. (+info)Fetoscopic direct fetal cardiac access in sheep : An important experimental milestone along the route to human fetal cardiac intervention. (8/96)
BACKGROUND: Fetal cardiac interventions by direct ultrasound-guided approaches or open fetal cardiac surgery have been fraught with technical difficulties, as well as with significant maternal and fetal morbidity in humans. Therefore, the purpose of our study in sheep was to assess the feasibility and potential of fetoscopic direct fetal cardiac access. METHODS AND RESULTS: In 15 anesthetized pregnant ewes (88 to 109 days of gestation; term, 145 days), 3 to 4 trocars were percutaneously placed in the uterus. Using videofetoscopic equipment, we assessed the feasibility of achieving direct fetal cardiac access. Minimally invasive direct fetal cardiac access by operative fetoscopy was achieved in 10 of the 15 fetal sheep. In 7 fetuses, the approach was successfully tested for fetal cardiac pacing (n=5) or antegrade fetal cardiac catheterization (n=2). Access was not achieved in 5 fetuses because of bleeding complications (n=2) or because the fetoscopic setup could not be established (n=3). All but 2 fetal sheep were alive at the end of the procedure. Acute fetal demise resulted from maternal hypotension or kinking of the fetal inferior caval vein by sternal suspension. Six ewes continued gestation; 3 of these went to term, with a normal fetal outcome. Two ewes died from septicemia 3 and 7 days after the procedure, and 1 ewe aborted 1 month after the procedure. CONCLUSIONS: Minimally invasive direct fetal cardiac access by operative fetoscopy is feasible in fetal sheep. The fetoscopic approach carries important potential for fetal cardiac pacing, antegrade fetal valvuloplasties, and resection of fetal intrapericardial teratomas in human fetuses. (+info)Fetoscopy is a minimally invasive surgical procedure that allows direct visualization of the fetus and the intrauterine environment through the use of a fiber-optic scope. It is typically performed during the second trimester of pregnancy to diagnose or treat various fetal conditions, such as twin-to-twin transfusion syndrome, congenital diaphragmatic hernia, or spina bifida. The procedure involves inserting a thin tube called a fetoscope through the mother's abdomen and uterus to access the fetus. Fetoscopy can also be used for taking fetal tissue samples for genetic testing.
It is important to note that while fetoscopy can provide valuable information and treatment options, it does carry some risks, including preterm labor, premature rupture of membranes, infection, and bleeding. Therefore, the decision to undergo fetoscopy should be made carefully, in consultation with a medical professional, and based on a thorough evaluation of the potential benefits and risks.
Prenatal diagnosis is the medical testing of fetuses, embryos, or pregnant women to detect the presence or absence of certain genetic disorders or birth defects. These tests can be performed through various methods such as chorionic villus sampling (CVS), amniocentesis, or ultrasound. The goal of prenatal diagnosis is to provide early information about the health of the fetus so that parents and healthcare providers can make informed decisions about pregnancy management and newborn care. It allows for early intervention, treatment, or planning for the child's needs after birth.
Pregnancy is a physiological state or condition where a fertilized egg (zygote) successfully implants and grows in the uterus of a woman, leading to the development of an embryo and finally a fetus. This process typically spans approximately 40 weeks, divided into three trimesters, and culminates in childbirth. Throughout this period, numerous hormonal and physical changes occur to support the growing offspring, including uterine enlargement, breast development, and various maternal adaptations to ensure the fetus's optimal growth and well-being.
Gestational age is the length of time that has passed since the first day of the last menstrual period (LMP) in pregnant women. It is the standard unit used to estimate the age of a pregnancy and is typically expressed in weeks. This measure is used because the exact date of conception is often not known, but the start of the last menstrual period is usually easier to recall.
It's important to note that since ovulation typically occurs around two weeks after the start of the LMP, gestational age is approximately two weeks longer than fetal age, which is the actual time elapsed since conception. Medical professionals use both gestational and fetal age to track the development and growth of the fetus during pregnancy.
Fetoscopy
Spina bifida
North American Fetal Therapy Network
Fetendo
Pinard horn
Hutzel Women's Hospital
Amniocentesis
Jan Mohr
Acrocephalosyndactyly
Fetal surgery
Stillbirth
Born alive rule
Percutaneous umbilical cord blood sampling
Twin-to-twin transfusion syndrome
Fetoscope
Maternal-fetal medicine
Hysterotomy
Visible light imaging
Laparoscopy
Kypros Nicolaides
Twin anemia-polycythemia sequence
List of MeSH codes (E04)
List of MeSH codes (E01)
Endoscopy
ICD-9-CM Volume 3
Fetoscopy - Wikipedia
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December 2021 UOG Highlights
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Acardiac twinning, with pump twin demise
Transfusion3
- Many procedures available to women with high-risk pregnancies were first developed by our partners at Yale School of Medicine's department of Obstetrics, Gynecology and Reproductive Sciences including noninvasive fetal anemia assessment, percutaneous umbilical blood sampling (PUBS), in utero fetal blood transfusion and therapies such as fetoscopy and fetal surgery. (ynhh.org)
- We offer a wide range of fetal therapies for your baby, including transfusion for anemia, medical treatment for arrhythmia, echocardiography, fetoscopy and exit procedures for airway management. (trihealth.com)
- Fetoscopy and laser ablation for twin-twin transfusion syndrome. (tekay.fi)
Ultrasonography1
- An open letter to President Reagan, dated February 13, 1984, stated that modern advances in knowledge and technology ("real time ultrasonography, fetoscopy, study of the fetal EKG - electrocardiogram and fetal EEG - electroencephalogram") have proved beyond any scientific doubt that the preborn child can feel pain. (theinterim.com)
Ultrasound2
Surgical4
- Fetoscopy is an endoscopic procedure during pregnancy to allow surgical access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta. (wikipedia.org)
- The field of minimally-invasive surgical fetoscopy has continued to develop since the 2000s. (wikipedia.org)
- Fetoscopy is a surgical procedure which may involve the use of a fibreoptic device called a fetoscope. (wikipedia.org)
- However, despite the success of those interventions, preterm birth due to fetal membrane rupture created by the insertion of the surgical tools during fetoscopy, appears to be the Achille's heel of those surgeries. (evolutioneurope.eu)
Pregnancy1
- Fetoscopy is usually performed in the second or third trimester of pregnancy. (wikipedia.org)
Diagnostic1
- These audio diagnostic tools are also called "fetoscopes" but are not related to visual fetoscopy. (wikipedia.org)
Definition1
- What is the definition of Fetoscopy? (dictionary.net)
Learn1
- Learn more about fetoscopy . (barnesjewish.org)
Surgery2
- Along with a product line for standard gynecological procedures using hysteroscopic and/or laparoscopic techniques, the KARL STORZ portfolio also includes endoscopes and specialized instruments for reproductive surgery and fetoscopy. (karlstorz.com)
- Fetoscopy is a fairly new field of surgery. (evolutioneurope.eu)
Words1
- Find similar words to fetoscopy using the buttons below. (yourdictionary.com)
Website1
- This graph shows the total number of publications written about "Fetoscopy" by people in this website by year, and whether "Fetoscopy" was a major or minor topic of these publications. (ctsicn.org)
Medical2
- Fetoscopy allows for medical interventions such as a biopsy (tissue sample) or a laser occlusion of abnormal blood vessels (such as chorioangioma) or the treatment of spina bifida. (wikipedia.org)
- Fetoscopy" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings) . (ctsicn.org)
Include1
- These criteria include an established natural history, ability to achieve accurate prenatal diagnosis, absence of fully effective perinatal treatment due to prolonged need for neonatal intensive care, experimental evidence that fetoscopic repair may mitigate adverse effects and improve fetal and neonatal outcomes, and demonstration of the maternal and fetal safety of fetoscopy in high-volume expert fetal centers. (isuog.org)
Lower2
- Fetoscopy, cialis is available as a lower strength tablet that can be taken on a daily basis. (njacs.org)
- It appeared evident to us that we had to come up with a method to lower the risk of premature birth following fetoscopy. (evolutioneurope.eu)
Amnioscopy1
- The gynecological surgery instruments is also estimated to account for a major share, as laparoscopy is widely used in obstetrics and gynecology, especially in such procedures as hysterectomy, hysteroscopy, amnioscopy, myomectomy, fetoscopy, and ovarian cyst removal, among others. (24x7mag.com)
Fetal surgery1
- Fetoscopy, or laparoscopic fetal surgery, allows surgeons to perform surgery on a fetus as young as 15 weeks, demonstrating the general improvements in fetal survival. (mygoodpoint.com)
Uterus2
- This is done using a small camera inserted into the uterus (fetoscopy) to allow the specialist to cut the bands. (lebonheur.org)
- Techniques vary from using a complete percutaneous approach to open fetoscopy, which requires laparotomy but is minimally invasive to the uterus. (johnshopkins.edu)
Endoscopic2
- Fetoscopy is an endoscopic procedure during pregnancy to allow surgical access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta. (wikipedia.org)
- The doctors decided to perform a fetoscopy - an endoscopic surgical procedure performed on the fetus. (shardahospital.org)
Minimally-invasive1
- The field of minimally-invasive surgical fetoscopy has continued to develop since the 2000s. (wikipedia.org)
Amniotic1
- Fetoscopy is used when doctors need to gain access to the placenta, amniotic sac, umbilical cord and the baby in utero. (lebonheur.org)
Ultrasound2
- Tracheal balloon placement was achieved with ultrasound guidance and fetoscopy between 26 and 30 weeks of gestation. (elsevierpure.com)
- Fetoscopy/doptone, ultrasound or electronic fetal monitoring aid in confirming fetal distress or death. (targetwoman.com)
Fetus1
- Fetoscopy is a technique that utilizes a small camera to examine and perform procedures on the fetus. (asum.com.au)
Surgical procedure1
- Fetoscopy is a surgical procedure which may involve the use of a fibreoptic device called a fetoscope. (wikipedia.org)
Interventions3
- Fetoscopy allows for medical interventions such as a biopsy (tissue sample) or a laser occlusion of abnormal blood vessels (such as chorioangioma) or the treatment of spina bifida. (wikipedia.org)
- A fetoscopy is usually the first step in many fetal interventions. (lebonheur.org)
- These interventions include procedures performed with needles, endoscopes (fetoscopy), or open surgeries. (dal.ca)
Advances2
- 15] Since then, advances in fetoscopy have eliminated the need for open operations. (medscape.com)
- Insofar as amniocentesis is concerned, I do support it and particularly its outgrowth, fetoscopy, which I think represents one of the most exciting advances in the treatment of fetal disease. (nih.gov)
Tissue1
- Of what value are techniques such as ultrasonography, amniocentesis, chorionic villus sampling, fetoscopy, and fetal blood and tissue sampling for obtaining appropriate biomarkers? (nih.gov)
Treatment2
- On March 31, the FDA approved 3 fetoscopy instrument sets ( Karl Storz Rigid TTTS [with 0- and 12-degree or 30-degree scope] and Semi-Rigid TTTS , made by Karl Storz Endoscopy America, Inc), for the treatment of twin-to-twin transfusion syndrome (TTTS) in fetuses whose gestational age is between 16 and 26 weeks (second trimester). (medscape.com)
- Dr. Palter over at Docinthemachine , has an excellent piece about the FDA's humanitarian device exemption (HDE) program, and how it has recently approved Karl Storz Fetoscopy Instrument Sets for the treatment of twin-to-twin transfusion syndrome (TTTS). (medgadget.com)
Research1
- Having spent my life in the correction of anomalies of the newborn, I can see all sorts of possibilities with fetoscopy and I support its continued use as a research endeavor. (nih.gov)