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https://www.readbyqxmd.com/read/27926636/feasibility-and-outcomes-of-fetoscopic-tracheal-occlusion-for-severe-left-diaphragmatic-hernia
#1
Michael A Belfort, Oluyinka O Olutoye, Darrell L Cass, Olutoyin A Olutoye, Christopher I Cassady, Amy R Mehollin-Ray, Alireza A Shamshiraz, Stephanie M Cruz, Timothy C Lee, David G Mann, Jimmy E Espinoza, Stephen E Welty, Caraciolo J Fernandes, Rodrigo R Ruano
OBJECTIVE: To evaluate feasibility and initial outcomes of fetoscopic tracheal occlusion for severe diaphragmatic hernia compared with a historical cohort who had not received fetal tracheal occlusion. METHODS: Outcomes in a prospective observational cohort who underwent fetoscopic tracheal occlusion for severe fetal left diaphragmatic hernia without associated anomalies were compared with our historical nontreated cohort of matched fetuses of similar severity. Fetuses were classified using the same ultrasonography and magnetic resonance imaging methodology-prospectively in the fetoscopic tracheal occlusion group and retrospectively in the historical nontreated cohort...
December 2, 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27830929/fetal-surgery-for-myelomeningocele-a-review-of-current-clinical-practice-and-translational-research
#2
Sandra K Kabagambe, Yue J Chen, Diana L Farmer
INTRODUCTION: The Management of Myelomeningocele Study (MOMS) showed that prenatal repair of myelomeningocele (MMC) resulted in better neurological outcomes than postnatal closure but was, by necessity, associated with higher rates of obstetrical complications. Fetoscopic MMC repair has been explored as an alternative to reduce complications of the open approach used in MOMS. This review summarizes the trends in fetoscopic and open fetal repair of MMC. EVIDENCE ACQUISITION: We searched PubMed and Embase® for studies on fetal repair of MMC published since the completion of the MOMS trial...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27813120/prediction-of-neonatal-outcome-of-ttts-by-fetal-heart-and-doppler-ultrasound-parameters-before-and-after-laser-treatment
#3
A Delabaere, F Leduc, Q Reboul, F Fuchs, S Wavrant, J C Fouron, F Audibert
OBJECTIVES: To determine the prognostic value of fetal Doppler and echocardiographic parameters for neonatal survival up to 30 days after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHODS: Fetal echocardiography and outcome data of consecutive cases of TTTS treated by laser were retrospectively reviewed. Hemodynamic and cardiac function parameters were collected before and after laser. RESULTS: Between February 2006 and January 2015, 106 fetoscopic laser were performed...
November 3, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27751419/outcome-of-twin-twin-transfusion-syndrome-treated-by-laser-therapy-in-taiwan-s-single-center-role-of-quintero-staging-system
#4
Yao-Lung Chang, An-Shine Chao, Shuenn-Dyh Chang, Peter Cc Hsieh, Sheng-Yuan Su, Kuan-Ju Chen, Po-Jen Cheng, Tzu-Hao Wang
OBJECTIVE: To evaluate the outcome of twin-twin transfusion syndrome (TTTS) treated by fetoscopic laser therapy (FLT) stratified by Quintero staging. MATERIALS AND METHODS: A total of 100 TTTS cases treated by FLT, from October 2005 to August 2014, were included in this study. Cases were divided into first and second half periods to evaluate the learning effect-related outcomes, and logistic regression was applied to determine the independent factors in predicting the perinatal outcomes...
October 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27705970/successful-in-utero-percutaneous-fetoscopic-release-of-a-wrapped-pleuro-amniotic-shunt-around-the-fetal-arm-case-report-and-review-of-the-literature
#5
Ahmed A Nassr, Rodrigo Ruano, Jimmy Espinoza, Alireza A Shamshirsaz
BACKGROUND AND OBJECTIVES: Fetal pleural effusions are either primary or secondary to chromosomal or structural fetal abnormalities. In both cases, thoraco-amniotic shunts may be indicated to prevent life-threatening consequences. In this report, we describe a rare complication of shunts and successful in utero management of this complication. We also summarize the prior reports of shunt wrapping around fetal limbs and successful prenatal release of the shunts. DATA SOURCE: Search including PubMed, MEDLINE and EMBASE databases from inception till November 2015 was conducted for cases with shunt entrapment around fetal limbs with or without prenatal management...
October 6, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27686840/amniopatch-treatment-of-iatrogenic-preterm-premature-rupture-of-membranes-ipprom-after-fetoscopic-laser-surgery-for-twin-twin-transfusion-syndrome
#6
Ramen H Chmait, Eftichia V Kontopoulos, Andrew H Chon, Lisa M Korst, Arlyn Llanes, Rubén A Quintero
OBJECTIVES: Amniopatch is a proposed treatment of iatrogenic preterm premature rupture of membranes (iPPROM). We studied characteristics associated with successful amniopatch treatment of iPPROM after fetoscopic laser surgery for twin-twin transfusion syndrome. METHODS: Patients with iPPROM within 15 days of laser surgery treated with an amniopatch were studied. Factors associated with amniopatch success (i.e. cessation of leakage with normalization of amniotic fluid volume) were tested univariately and in multivariate logistic regression models...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27649392/erratum-procedure-related-complications-and-survival-following-fetoscopic-endotracheal-occlusion-feto-for-severe-congenital-diaphragmatic-hernia-systematic-review-and-meta-analysis-in-the-feto-era
#7
Edward Araujo Júnior, Gabriele Tonni, Wellington P Martins, Rodrigo Ruano
No abstract text is available yet for this article.
September 20, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27647818/prior-uterine-bleeding-is-associated-with-low-visibility-due-to-discolored-amniotic-fluid-on-fetoscopic-laser-photocoagulation
#8
Ryo Yamamoto, Keisuke Ishii, Aki Mabuchi, Shiyo Oota, Kazufumi Haino, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsusda
AIM: To investigate the association between uterine bleeding preceding fetoscopic laser photocoagulation (FLP) and the presence of discolored amniotic fluid that impedes FLP. METHODS: A retrospective review of all multiple gestations requiring FLP at the present institution was conducted. The rate of low visibility because of discolored amniotic fluid at the beginning of FLP was compared between patients with and without a history of uterine bleeding, defined as either genital bleeding or ultrasonographically detected subchorionic hematoma...
September 20, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/27646779/ep21-13-visibility-grade-classification-for-fetoscopic-laser-surgery-for-ttts-relationship-between-visibility-grade-and-necessity-for-irrigation-technique
#9
T Murakoshi, K Ishii, M Matsushita, T Shinno, H Konno, A Hasegawa, S Noguchi, Y Torii
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27645695/ep21-07-termination-of-twin-twin-transfusion-syndrome-within-two-weeks-following-fetoscopic-laser-photocoagulation
#10
S Wada, N Nakamura, S Matsushima, R Sugibayashi, K Ozawa, H Sago
No abstract text is available yet for this article.
September 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27607564/a-new-minimally-invasive-technique-for-cystoscopic-laser-treatment-of-fetal-ureterocele
#11
Nicola Persico, Alfredo Berettini, Isabella Fabietti, Chiara Dallagiovanna, Dario Minoli, Fabio Mosca, Luigi Fedele, Gianantonio Manzoni
Prenatal ultrasound detection of fetal ureterocele with bilateral hydro-ureteronephrosis, obstruction of the bladder outlet and progressive amniotic fluid reduction can be associated with a significant risk of end-stage chronic renal disease after birth. Fetal cystoscopic laser incision of the ureterocele, with the aim of relieving the bladder outflow obstruction to preserve renal function, has been previously reported in one case, with a favourable outcome. This report employed standard 3.5-mm fetoscopic access to the amniotic cavity and the fetal bladder...
September 8, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27597647/twin-anemia-polycythemia-sequence-a-single-center-experience-and-literature-review
#12
REVIEW
Amirhossein Moaddab, Ahmed A Nassr, Jimmy Espinoza, Rodrigo Ruano, Zhoobin H Bateni, Amir A Shamshirsaz, George T Mandy, Stephen E Welty, Hadi Erfani, Edwina J Popek, Michael A Belfort, Alireza A Shamshirsaz
Twin anemia polycythemia sequence (TAPS) is defined by significant intertwin hemoglobin discordance without the amniotic fluid discordance that characterizes twin-twin-transfusion syndrome (TTTS) in monochorionic twin pregnancies. TAPS is an uncommon condition which can either occur spontaneously, or following fetoscopic laser ablation for TTTS. This complication is thought to result from chronic transfusion through very small placental anastomoses; however, the pathogenesis of TAPS remains unknown. Consequently, there is no consensus in the management of TAPS...
October 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27590373/a-prospective-pilot-study-of-fetoscopic-laser-surgery-for-twin-to-twin-transfusion-syndrome-between-26-and-27-weeks-of-gestation
#13
Masahiko Nakata, Keisuke Ishii, Masahiro Sumie, Mayumi Takano, Hiroko Hirata, Susumu Murata, Yuichiro Takahashi, Takeshi Murakoshi, Haruhiko Sago
OBJECTIVE: The aim of this study is to clarify the feasibility and efficacy of fetoscopic laser photocoagulation of placental vascular communicating vessels (FLP) on twin-twin transfusion syndrome (TTTS) after 26 weeks of gestation. MATERIALS AND METHODS: This is a prospective pilot study investigating all cases of TTTS between 26 weeks and 27 weeks during 2012 and 2013 in Japan. The primary endpoints in this study were the feasibility of FLP and rate of harmful complications for the mother's health...
August 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27568096/connexin-43-is-overexpressed-in-human-fetal-membrane-defects-after-fetoscopic-surgery
#14
David W Barrett, Anna L David, Christopher Thrasivoulou, Alvaro Mata, David L Becker, Alex C Engels, Jan A Deprest, Tina T Chowdhury
OBJECTIVE: We examined whether surgically induced membrane defects elevate connexin 43 (Cx43) expression in the wound edge of the amniotic membrane (AM) and drives structural changes in collagen that affects healing after fetoscopic surgery. METHOD: Cell morphology and collagen microstructure was investigated by scanning electron microscopy and second harmonic generation in fetal membranes taken from women who underwent fetal surgery. Immunofluoresence and real-time quantitative polymerase chain reaction was used to examine Cx43 expression in control and wound edge AM...
October 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27567969/a-novel-translational-model-for-fetoscopic-intratracheal-delivery-of-nanoparticles-in-piglets
#15
Marianne S Carlon, Alexander C Engels, Barbara Bosch, Luc Joyeux, Marina G M C Mori da Cunha, Dragana Vidović, Zeger Debyser, Kris De Boeck, Arne Neyrinck, Jan A Deprest
OBJECTIVES: The aim of this study was to assess the feasibility of fetal tracheal injection in the late-gestational pig to target the airways. METHODS: Following laparotomy and hysterotomy, fetoscopy was performed in pregnant sows to access the fetal trachea. Two volumes of fluospheres were injected (1 and 3 mL). Fluosphere distribution to the different lung lobes was investigated by microscopy. Possible fetal airway injury, caused by the surgical procedure or intratracheal injection, was investigated...
October 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27522127/procedure-related-complications-and-survival-following-fetoscopic-endotracheal-occlusion-feto-for-severe-congenital-diaphragmatic-hernia-systematic-review-and-meta-analysis-in-the-feto-era
#16
Edward Araujo Júnior, Gabriele Tonni, Wellington P Martins, Rodrigo Ruano
Introduction This study aims to assess the procedure-related complications and survival following fetoscopic endotracheal occlusion (FETO) for severe congenital diaphragmatic hernia. Materials and Methods A systematic review and meta-analysis of PubMed and Scopus database searching for FETO procedure in severe CDH (lung-to-head ratio [LHR] < 1.0 and/or observed/expected LHR < 0.26 and > 1/3 liver herniation) were performed. The relative risk was assessed and 95% confidence interval (CI) calculated...
August 14, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27501618/anesthetic-techniques-and-incidence-of-complications-in-fetoscopic-surgery
#17
Patchareya Nivatpumin, Pawinee Pangthipampai, Tachawan Jirativanont, Sukanya Dej-Arkom, Namtip Triyasunant, Thongchai Tempeetikul
BACKGROUND: Nowadays, fetoscopic surgery has been accepted to be a procedure to correct numerous congenital anomalies. This operation can be successfully done under general, regional or local anesthesia with sedation. Incidence of complications from anesthesia in fetoscopic surgery has not been reported in Thailand. OBJECTIVE: To describe anesthetic techniques and incidence of complications in fetoscopic surgery. MATERIAL AND METHOD: Data of 152 pregnant women undergoing fetoscopic surgery in a single university hospital was retrospectively chart reviewed from June 2005 to November 2015...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27486655/fetoscopic-endoluminal-tracheal-occlusion-in-fetuses-with-severe-diaphragmatic-hernia-a-three-year-single-center-experience
#18
Nicola Persico, Isabella Fabietti, Fabrizio Ciralli, Valerio Gentilino, Francesco D'Ambrosi, Simona Boito, Manuela Wally Ossola, Mariarosa Colnaghi, Valentina Condò, Francesco Macchini, Ernesto Leva, Fabio Mosca, Luigi Fedele
OBJECTIVE: To report on our experience in the prenatal treatment of severe congenital diaphragmatic hernia (CDH) by fetoscopic endoluminal tracheal occlusion (FETO). METHODS: Between 2012 and 2014, FETO was performed at our center in 21 cases of CDH considered to be severe based on sonographic measurement of observed/expected lung-to-head ratio (O/E LHR) and side of the defect. We reported pre- and postoperative ultrasound findings, procedure-related complications, pregnancy outcome and survival at 1-3 years of age...
August 4, 2016: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/27452432/carbohydrate-and-fatty-acid-perturbations-in-the-amniotic-fluid-of-the-recipient-twin-of-pregnancies-complicated-by-twin-twin-transfusion-syndrome-in-relation-to-treatment-and-fetal-cardiovascular-risk
#19
Warwick B Dunn, J William Allwood, Tim Van Mieghem, R Katie Morris, Fiona L Mackie, Caroline E Fox, Mark D Kilby
INTRODUCTION: Twin-twin transfusion syndrome (TTTS) complicates 15% of monochorionic twin pregnancies, often being associated with recipient cardiac dysfunction. Untreated, it has a fetal mortality rate of at least 90%; although treatment by fetoscopic laser coagulation significantly improves prognosis. Measurement of recipient amniotic fluid metabolites, such as cardiac Troponin T and atrial natriuretic polypeptide, correlate with cardiac function in this fetus. The aim of this study is to describe the amniotic fluid metabolomic profile in TTTS, relate this to fetal recipient cardiac function and assess the metabolomic changes induced by fetoscopic laser coagulation...
August 2016: Placenta
https://www.readbyqxmd.com/read/27439783/rapid-initiation-of-fetal-therapy-services-with-a-system-of-learner-centred-training-under-proctorship-the-national-university-hospital-singapore-experience
#20
Arundhati Gosavi, Pradip D Vijayakumar, Bryan Sw Ng, May-Han Loh, Lay Geok Tan, Nuryanti Johana, Yi Wan Tan, Dedy Sandikin, Lin Lin Su, Tuangsit Wataganara, Arijit Biswas, Mahesh A Choolani, Citra Nz Mattar
INTRODUCTION: Management of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities still lacking advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-twin transfusion syndrome (TTTS) and present the latter as a potential model for aspiring fetal therapy units. METHODS: Five pregnancies with fetal complications were identified for RFA...
July 21, 2016: Singapore Medical Journal
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