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https://www.readbyqxmd.com/read/29027307/transient-amniotic-fluid-leakage-after-fetoscopic-laser-photocoagulation-for-twin-twin-transfusion-syndrome
#1
Shiyo Ota, Keisuke Ishii, Hiroshi Kawamura, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsuda
AIM: Iatrogenic premature rupture of membrane (PROM) is one of the major complications related to fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). However, amniotic fluid leakage (AFL) sometimes spontaneously disappears. This study evaluated the incidence and clinical characteristics of transient AFL after FLP. METHODS: We retrospectively reviewed pregnancies that underwent FLP for TTTS at a single center. Patients with apparent AFL within 2 weeks after FLP were divided into two groups: transient AFL, defined by the disappearance of fluid leakage within a week; and PROM, if AFL persisted continuously for more than a week or premature birth occurred, including miscarriage, within a week of the first symptom of AFL...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28977797/evaluation-of-magnetic-resonance-imaging-safety-and-imaging-issues-associated-with-the-occlusion-balloon-used-during-fetoscopic-endoluminal-tracheal-occlusion
#2
Teresa Victoria, Ann M Johnson, N Scott Adzick, Holly L Hedrick, Frank G Shellock
INTRODUCTION: Congenital diaphragmatic hernias can be successfully treated by fetoscopic tracheal occlusion (FETO), a minimally invasive procedure that may improve postnatal survival. The endoluminal balloon utilized for FETO contains a metallic component that may pose possible risks for the fetus and mother related to the use of magnetic resonance imaging (MRI). The objective of this study is to evaluate MRI-related imaging and safety issues (magnetic field interactions, heating, and artifacts) for the occlusion balloon used in FETO...
October 5, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28964685/shunt-based-interventions-why-how-and-when-to-place-a-shunt
#3
REVIEW
Mark P Johnson, R Douglas Wilson
The broad categories of surgical fetal therapy can be separated into either open surgical techniques or minimally invasive endoscopic/ultrasound-guided techniques that require only puncture of the uterus with single or multiple small ports. Benefits of fetoscopic or ultrasound-guided fetal intervention include decreased uterine irritability, decreased incidence of preterm labor, and avoidance of risks associated with hysterotomy and commitment to cesarean delivery for future pregnancies. Fetal abnormalities potentially amenable to ultrasound-guided drainage techniques include thoracic fluid-filled lesions and lower urinary tract obstruction...
September 27, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28925589/recurrent-twin-twin-transfusion-syndrome-rttts-and-twin-anemia-polycythemia-sequence-taps-after-fetoscopic-laser-surgery-fls-size-of-the-cannula-does-matter
#4
Roopali Donepudi, Joost Akkermans, Lovepreet Mann, Frans J Klumper, Johanna M Middeldorp, Enrico Lopriore, Kenneth J Moise, Michael Bebbington, Anthony Johnson, Dick Oepkes, Ramesha Papanna
OBJECTIVES: Optimal outcomes after fetoscopic laser surgery (FLS) for twin-twin transfusion (TTTS) depend on the successful completion of ablation of all placental anastomoses. Our objective was to determine the incidence and risk factors for the occurrence of recurrent TTTS (rTTTS) or twin anemia-polycythemia sequence (TAPS) after FLS, and focusing on the impact of different diameters of the cannula. METHODS: A secondary analysis of prospectively collected data of 666 consecutive patients undergoing laser surgery for TTTS from 2 centers was performed...
September 19, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28910784/fetal-surgery-for-myelomeningocele-a-systematic-review-and-meta-analysis-of-outcomes-in-fetoscopic-versus-open-repair
#5
Sandra K Kabagambe, Guy W Jensen, Yue Julia Chen, Melissa A Vanover, Diana L Farmer
BACKGROUND/OBJECTIVES: The Management of Myelomeningocele (MMC) Study (MOMS) showed that prenatal repair of MMC resulted in improved neurological outcomes but was associated with high rates of obstetrical complications. This study compares outcomes of open and fetoscopic MMC repair. DATA SOURCES: PubMed and Embase studies reporting outcomes of fetal MMC repair published since the completion of the MOMS. RESULTS: We analyzed 11 studies and found no difference in mortality or the rate of shunt placement for hydrocephalus...
September 15, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28891233/fetoscopic-tracheal-occlusion-for-treatment-of-non-isolated-congenital-diaphragmatic-hernia
#6
Viola Seravalli, Eric B Jelin, Jena L Miller, Aylin Tekes, Luca Vricella, Ahmet A Baschat
Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair...
August 11, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28866670/clinical-outcome-for-congenital-diaphragmatic-hernia-at-the-age-of-1-year-in-the-era-of-fetal-intervention
#7
Eva Van Ginderdeuren, Karel Allegaert, Herbert Decaluwe, Jan Deprest, Anne Debeer, Marijke Proesmans
BACKGROUND: Congenital diaphragmatic hernia (CDH) is an abnormal development of the diaphragm leading to high neonatal mortality and morbidity. Beyond the neonatal period, prospective data on overall long-term outcome in CDH survivors is scarce. In particular, for those treated with fetoscopic endoluminal tracheal occlusion (FETO), a promising new technique to increase survival chances for severe cases, the outcomes are even less documented. AIM: To prospectively document the clinical outcome of CDH at 1 year including FETO-treated infants in relation to ante- and postnatal variables...
September 2, 2017: Neonatology
https://www.readbyqxmd.com/read/28832468/fetoscopic-open-neural-tube-defect-repair-development-and-refinement-of-a-two-port-carbon-dioxide-insufflation-technique
#8
Kenneth J Moise, Alan Flake
No abstract text is available yet for this article.
September 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28764674/arabin-cervical-pessary-for-prevention-of-preterm-birth-in-cases-of-twin-to-twin-transfusion-syndrome-treated-by-fetoscopic-laser-coagulation-the-pecep-laser-randomised-controlled-trial
#9
Carlota Rodó, Sílvia Arévalo, Liesbeth Lewi, Isabel Couck, Bettina Hollwitz, Kurt Hecher, Elena Carreras
BACKGROUND: Fetoscopic LASER coagulation of the placental anastomoses has changed the prognosis of twin-twin transfusion syndrome. However, the prematurity rate in this cohort remains very high. To date, strategies proposed to decrease the prematurity rate have shown inconclusive, if not unfavourable results. METHODS: This is a randomised controlled trial to investigate whether a prophylactic cervical pessary will lower the incidence of preterm delivery in cases of twin-twin transfusion syndrome requiring fetoscopic LASER coagulation...
August 1, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28736902/pseudoamniotic-band-syndrome-after-fetoscopic-laser-ablation-of-placental-anastomoses-for-twin-twin-transfusion-syndrome-two-case-reports-and-systematic-review
#10
Anne Sophie Lafitte, Eric Verspyck, Corinne Jeanne Pasquier, Patricia Dolley, Michel Dreyfus, Guillaume Benoist
Pseudoamniotic band syndrome is a rare complication that occurs after invasive procedures for complicated monochorionic twins. We report 2 cases of intrauterine recipient fetal death after laser therapy for twin-twin transfusion syndrome due to umbilical cord constriction by the amniotic band.
July 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28730318/renal-function-in-neonates-with-twin-twin-transfusion-syndrome-treated-with-or-without-fetoscopic-laser-surgery
#11
Lianne Verbeek, Faiez A Joemmanbaks, Jacoba M E Quak, Ram N Sukhai, Johanna M Middeldorp, Dick Oepkes, Enrico Lopriore
The aim of this study is to investigate the short-term renal function in neonates with twin-twin transfusion syndrome (TTTS), treated with fetoscopic laser surgery (laser group) or conservatively (non-laser group). Creatinine and urea levels and urine output were recorded in the first week after birth. Primary outcome was short-term renal dysfunction, defined as a creatinine level of >100 μmol/L during the first week postpartum. We evaluated 312 twins (laser group, n = 274; non-laser group, n = 38)...
July 20, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28709445/twin-twin-transfusion-syndrome-study-protocol-for-developing-disseminating-and-implementing-a-core-outcome-set
#12
Asma Khalil, Helen Perry, James Duffy, Keith Reed, Ahmet Baschat, Jan Deprest, Kurt Hecher, Liesbeth Lewi, Enrico Lopriore, Dick Oepkes
BACKGROUND: Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice...
July 14, 2017: Trials
https://www.readbyqxmd.com/read/28680967/a-continuum-robot-and-control-interface-for-surgical-assist-in-fetoscopic-interventions
#13
George Dwyer, Francois Chadebecq, Marcel Tella Amo, Christos Bergeles, Efthymios Maneas, Vijay Pawar, Emanuel Vander Poorten, Jan Deprest, Sebastien Ourselin, Paolo De Coppi, Tom Vercauteren, Danail Stoyanov
Twin-twin transfusion syndrome requires interventional treatment using a fetoscopically introduced laser to sever the shared blood supply between the fetuses. This is a delicate procedure relying on small instrumentation with limited articulation to guide the laser tip and a narrow field of view to visualize all relevant vascular connections. In this letter, we report on a mechatronic design for a comanipulated instrument that combines concentric tube actuation to a larger manipulator constrained by a remote centre of motion...
March 8, 2017: IEEE Robotics and Automation Letters
https://www.readbyqxmd.com/read/28641751/fetal-imaging-and-therapy-for-cdh-current-status
#14
Titilayo Oluyomi-Obi, Tim Van Mieghem, Greg Ryan
In congenital diaphragmatic hernia (CDH), herniation of the abdominal organs into the fetal chest causes pulmonary hypoplasia and pulmonary hypertension, the main causes of neonatal mortality. As antenatal ultrasound screening improves, the risk of postnatal death can now be better predicted, allowing for the identification of fetuses that might most benefit from a prenatal intervention. Fetoscopic tracheal occlusion is being evaluated in a large international randomized controlled trial. We present the antenatal imaging approaches that can help identify fetuses that might benefit from antenatal therapy, and review the evolution of fetal surgery for CDH to date...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28617430/physician-views-regarding-the-benefits-and-burdens-of-prenatal-surgery-for-myelomeningocele
#15
R M Antiel, C A Collura, A W Flake, M P Johnson, N E Rintoul, J D Lantos, F A Curlin, J C Tilburt, S D Brown, C Feudtner
OBJECTIVE: Examine how pediatric and obstetrical subspecialists view benefits and burdens of prenatal myelomeningocele (MMC) closure. STUDY DESIGN: Mail survey of 1200 neonatologists, pediatric surgeons and maternal-fetal medicine specialists (MFMs). RESULTS: Of 1176 eligible physicians, 670 (57%) responded. Most respondents disagreed (68%, 11% strongly) that open fetal surgery places an unacceptable burden on women and their families. Most agreed (65%, 10% strongly) that denying the benefits of open maternal-fetal surgery is unfair to the future child...
September 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28588850/case-report-of-myometrial-window-following-fetoscopic-treatment-of-twin-twin-transfusion-syndrome-indications-of-underlying-collagen-vascular-disease
#16
Michael V Zaretsky, David K Manchester, Henry L Galan, Nicholas J Behrendt, Ahmed I Marwan, Kenneth W Liechty, Timothy M Crombleholme
Intraperitoneal amniotic fluid leak is a known complication of fetoscopic procedures that usually resolves spontaneously with expectant management. Intraperitoneal amniotic fluid leak may persist after fetoscopic procedures due to a myometrial window as well as to persistent chorioamniotic membrane disruption, which may be amenable to surgical repair.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28586146/locating-the-level-and-extent-of-congenital-high-airway-obstruction-fluid-in-the-airway-tract-as-reference-points
#17
Mamatha Gowda, Shilpa Gupta, Ashraf Ali, Shanthi Paranthaman
Described here are a series of four cases of congenital high airway obstruction in the fetus. All of the patients presented in the second trimester and all had hydrops fetalis. Three cases had bilateral hyperinflated lungs, midline shift of heart, flattening or inversion of the diaphragm, and fetal ascites. Autopsy was performed in one of these three and showed laryngeal atresia. In one fetus, there was only a unilateral huge enlargement of the lung with mediastinal shift. On autopsy, this fetus had atresia of right main bronchus...
October 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28550526/fetoscopic-patch-coverage-of-experimental-myelomenigocele-using-a-two-port-access-in-fetal-sheep
#18
Lucie Guilbaud, Nathalie Roux, Stéphanie Friszer, Charles Garabedian, Ferdinand Dhombres, Bettina Bessières, Catherine Fallet-Bianco, Federico Di Rocco, Michel Zerah, Jean-Marie Jouannic
PURPOSE: This study aims to assess the feasibility and the effectiveness of a fetoscopic myelomeningocele (MMC) coverage using a sealed inert patch through a two-port access, in the sheep model. METHODS: Forty-four fetuses underwent surgical creation of a MMC defect at day 75 and were divided into four groups according to the MMC repair technique, performed at day 90. Group 1 remained untreated. Group 2 had an open surgery using suture of the defect. Groups 3 and 4 underwent defect coverage using a Gore®-polytetrafluoroethylene patch secured with surgical adhesive (Bioglue®), with an open approach (group 3) and a fetoscopic one (group 4)...
July 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28549467/the-prediction-diagnosis-and-management-of-complications-in-monochorionic-twin-pregnancies-the-ommit-optimal-management-of-monochorionic-twins-study
#19
Fiona L Mackie, R Katie Morris, Mark D Kilby
BACKGROUND: Monochorionic twin pregnancies are at increased risk of complications due to sharing a single placenta and potentially developing unbalanced vascular anastomoses. Complications include twin-twin transfusion syndrome (TTTS) which affects 10-15% monochorionic twins, and if untreated has a 70-90% perinatal loss rate. We are currently unable to predict which twins will develop complications or to what severity. We have previously shown differences in angiogenic and placental growth factors in maternal blood in pregnancies complicated by TTTS compared to twin pregnancies not complicated by TTTS but matched for gestation...
May 26, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28544517/fetoscopic-laser-photocoagulation-for-amniotic-fluid-discordance-bordering-on-twin-twin-transfusion-syndrome-feasibility-perinatal-and-long-term-outcomes
#20
Katsusuke Ozawa, Rika Sugibayashi, Seiji Wada, Masahiro Sumie, Keisuke Ishii, Masahiko Nakata, Takeshi Murakoshi, Yushi Ito, Haruhiko Sago
AIM: This study investigated the feasibility and safety of fetoscopic laser photocoagulation (FLP) for amniotic fluid discordance (AFD) bordering on twin-twin transfusion syndrome (TTTS) with an absent or reverse end-diastolic velocity (AREDV) in the umbilical artery (UA), and evaluated the perinatal and long-term outcomes. METHODS: A prospective intervention study was performed between 20 + 0 and 25 + 6 weeks of gestation (UMIN000004165). AFD bordering on TTTS was defined as maximum vertical pocket (MVP) of amniotic fluid in one twin's sac ≤3 cm and amniotic fluid MVP in the other twin's sac ≥7 cm excluding TTTS...
May 19, 2017: Journal of Obstetrics and Gynaecology Research
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