OPERATIVE FETOSCOPY — Brief Background

Over the past several decades society has been witness to a transformation in its view of the fetus as a patient. This in part is due to high-resolution obstetrical ultrasound and other prenatal screening and diagnostic techniques that have allowed doctors to better understand fetal conditions. Until recently, there has been limited success in the treatment of fetal and placental problems. Parents were left with few options once a fetal abnormality was diagnosed. Fortunately, recent technological advances in microsurgical instrumentation have allowed surgical access into the womb such that there is minimal disturbance to the pregnancy and the mother. This technique, called operative fetoscopy, is performed under local anesthesia via an incision that is less than half of one centimeter. A wide variety of fetal abnormalities have been addressed via operative fetoscopy. These conditions and others that are amenable to fetal therapy are listed below:

DIAGNOSES

• Twin-Twin Transfusion Syndrome (TTTS) »
• Monochorionic Twins with Selective Intrauterine Growth Restriction »
• Acardiac/Trap Sequence »
• Lower Urinary Tract Obstruction (Posterior Urethral Valves) »
• Congenital Diaphragmatic Hernia »
• Fetal Cardiac Abnormalities (Hypoplastic Left Heart Syndrome with Intact Atrial Septum, Critical Aortic Stenosis) »
• Amniotic Band Syndrome »
• Severe Fetal Anemia (Isoimmunization, Parvovirus, etc.) »
• Alloimmune Thrombocytopenia

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