IMFH | Fetal Therapy | Types of Fetal Treatments | Medical Therapy
Transplacental medical therapy is performed by giving the mother medicine that in turn passes to the fetus by crossing the placenta. The most common transplacental treatment in obstetrics is maternal steroids administration to promote fetal organ maturation in cases of threatening premature birth.
There are many examples of biochemical and endocrine fetal disorders that can be treated by transplacental therapy. One example is 21-hydroxylase deficiency, an inherited enzymatic defect of adrenal steroidogenesis, which results in increased levels of precursor androgens that can result in masculinization of an affected female infant. The masculinization may be reduced or averted by administering steroids to the mother before the 8th week gestation.
Transplacental medical therapy is also utilized to treat life threatening fetal cardiac arrhythmias using antiarrhythmic agents such as digoxin or flecainide. This treatment poses some risks to the mother, and should be done in close collaboration with a cardiologist. A final example of a fetal treatment via the transplacental route is maternal administration of intravenous immunoglobulin and steroids for pregnancies complicated by alloimmune thrombocytopenia.
