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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
#1
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/28710882/mid-trimester-preterm-premature-rupture-of-membranes-pprom-etiology-diagnosis-classification-international-recommendations-of-treatment-options-and-outcome
#2
REVIEW
Michael Tchirikov, Natalia Schlabritz-Loutsevitch, James Maher, Jörg Buchmann, Yuri Naberezhnev, Andreas S Winarno, Gregor Seliger
Mid-trimester preterm premature rupture of membranes (PPROM), defined as rupture of fetal membranes prior to 28 weeks of gestation, complicates approximately 0.4%-0.7% of all pregnancies. This condition is associated with a very high neonatal mortality rate as well as an increased risk of long- and short-term severe neonatal morbidity. The causes of the mid-trimester PPROM are multifactorial. Altered membrane morphology including marked swelling and disruption of the collagen network which is seen with PPROM can be triggered by bacterial products or/and pro-inflammatory cytokines...
July 15, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28656648/prenatal-incision-of-ureterocele-causing-bladder-outlet-obstruction-a-multicenter-case-series
#3
Gihad Chalouhi, Anne-Maude Morency, Roland De Vlieger, José Maria Martinez, Thomas Blanc, Ryan Hodges, Alexandra Gueneuc, Greg Ryan, Jan Deprest, Eduard Gratacos, Yves Ville
We reviewed data from a cohort of fetuses with ureterocele diagnosed and operated prenatally in four fetal therapy centers. Inclusion criteria were: (1)ureterocele confirmed on detailed fetal ultrasound examination, (2)absence of additional fetal malformations (3)fetal intervention to decompress the ureterocele with local institutional review boards' approval. Data on sonographic follow-up, obstetrical, neonatal outcome and postnatal evaluation were collected. Ten cases of prenatally treated ureterocele are described...
June 27, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28617430/physician-views-regarding-the-benefits-and-burdens-of-prenatal-surgery-for-myelomeningocele
#4
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/28267443/balloon-removal-after-fetoscopic-endoluminal-tracheal-occlusion-for-congenital-diaphragmatic-hernia
#5
Julio A Jiménez, Elisenda Eixarch, Philip DeKoninck, João R Bennini, Roland Devlieger, Cleisson F Peralta, Eduard Gratacos, Jan Deprest
BACKGROUND: Isolated congenital diaphragmatic hernia defect allows viscera to herniate into the chest, competing for space with the developing lungs. At birth, pulmonary hypoplasia leads to respiratory insufficiency and persistent pulmonary hypertension that is lethal in up to 30% of patients. Antenatal measurement of lung size and liver herniation can predict survival after birth. Prenatal intervention aims at stimulating lung development, clinically achieved by percutaneous fetal endoscopic tracheal occlusion under local anesthesia...
July 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28005161/-epidural-anesthesia-for-fetoscopy-retrospective-analysis-of-a%C3%A2-one-year-cohort
#6
N Kiefer, S F Suter, C Berg, U Gembruch, S U Weber
BACKGROUND: The introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus' intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother's abdominal wall...
January 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/27856007/-diagnosis-evolution-and-prognosis-of-prenatally-diagnosed-suprasellar-cysts
#7
F Di Rocco, A André, T Roujeau, L Selek, Y Ville, C Garel, M Zérah
Suprasellar arachnoid cysts (SAC) in children are considered rare, but the incidence is increasing due to the improvement of prenatal diagnosis. We present 15 cases of SAC diagnosed during the antenatal period between 2005 and 2015. The records were reviewed retrospectively by specifying the radiological characteristics, treatment modalities, outcomes, and long-term monitoring. Mean follow-up was 71 months. The forms (SAC-1) accounted for 2 cases (13%) with hydrocephalus. We observed 8 (53%) lower forms (SAC-2) with interpeduncular cistern expansion without hydrocephalus...
December 2016: Neuro-Chirurgie
https://www.readbyqxmd.com/read/27567969/a-novel-translational-model-for-fetoscopic-intratracheal-delivery-of-nanoparticles-in-piglets
#8
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/27501618/anesthetic-techniques-and-incidence-of-complications-in-fetoscopic-surgery
#9
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/27439783/rapid-initiation-of-fetal-therapy-services-with-a-system-of-learner-centred-training-under-proctorship-the-national-university-hospital-singapore-experience
#10
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 that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-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...
June 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/27157206/-fetoscopic-tracheal-occlusion-for-severe-congenital-diaphragmatic-hernia-retrospective-study
#11
Angélica de Fátima de Assunção Braga, Franklin Sarmento da Silva Braga, Solange Patricia Nascimento, Bruno Verri, Fabio C Peralta, João Bennini Junior, Karina Jorge
BACKGROUND AND OBJECTIVES: The temporary fetal tracheal occlusion performed by fetoscopy accelerates lung development and reduces neonatal mortality. The aim of this paper is to present an anesthetic experience in pregnant women, whose fetuses have diaphragmatic hernia, undergoing fetoscopic tracheal occlusion (FETO). METHOD: Retrospective, descriptive study, approved by the Institutional Ethics Committee. Data were obtained from medical and anesthetic records. RESULTS: FETO was performed in 28 pregnant women...
May 4, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27074241/advances-in-fetal-surgery
#12
Denise Araujo Lapa Pedreira
This paper discusses the main advances in fetal surgical therapy aiming to inform health care professionals about the state-of-the-art techniques and future challenges in this field. We discuss the necessary steps of technical evolution from the initial open fetal surgery approach until the development of minimally invasive techniques of fetal endoscopic surgery (fetoscopy).
January 2016: Einstein
https://www.readbyqxmd.com/read/26995685/-outcome-of-triplet-pregnancies-managed-for-twin-to-twin-transfusion-syndrome-a-single-center-experience
#13
G E Chalouhi, T Quibel, N Benzina, J-P Bernard, M Essaoui, Y Ville
OBJECTIVES: Study the outcomes of triplet pregnancies (GGG) complicated with twin-to-twin transfusion syndrome (TTTS) treated with laser fetoscopy. METHODS: Retrospective study of interventions, outcomes and perinatal follow-up of GGG treated for TTS. RESULTS: Between 2002 and 2013, 25 GGG complicated by TTTS were seen in our center, 20 dichorionic and 5 monochorionic. The mean gestational age (GA) at diagnosis of TTTS was 19.7 GW (±2.4) with 2, 4, 16 and 1 pregnancies at Quintero's stage I, II, III and V, respectively...
October 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
https://www.readbyqxmd.com/read/26940675/re-chorioamniotic-membrane-separation-after-fetoscopy-in-monochorionic-twin-pregnancy-incidence-and-impact-on-perinatal-outcome-j-u-ortiz-e-eixarch-a-peguero-s-m-lobmaier-m-bennasar-j-m-martinez-and-e-gratac%C3%A3-s-ultrasound-obstet-gynecol-2016-47-345-349
#14
COMMENT
https://www.readbyqxmd.com/read/26827875/atypical-twin-to-twin-transfusion-syndrome-prevalence-in%C3%A2-a%C3%A2-population%C3%A2-undergoing-fetoscopic-laser-ablation-of-communicating%C3%A2-placental-vessels
#15
Bettina Paek, Melissa Dorn, Martin Walker
BACKGROUND: The diagnosis of twin-to-twin transfusion syndrome (TTTS) usually relies the presence of polyhydramnios in one sac with concomitant oligohydramnios in the other sac in a monochorionic diamniotic twin pregnancy. However, TTTS does not always show a linear progression and may present with cardiac compromise or critically abnormal Doppler velocimetry in either fetus before fluid measurements meet the typically used cutoff. OBJECTIVE: The aim of this study was to investigate the prevalence of atypical presentations of TTTS in a population undergoing laser fetoscopy...
July 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26659243/self-contained-image-mapping-of-placental-vasculature-in-3d-ultrasound-guided-fetoscopy
#16
Liangjing Yang, Junchen Wang, Takehiro Ando, Akihiro Kubota, Hiromasa Yamashita, Ichiro Sakuma, Toshio Chiba, Etsuko Kobayashi
BACKGROUND: Surgical navigation technology directed at fetoscopic procedures is relatively underdeveloped compared with other forms of endoscopy. The narrow fetoscopic field of views and the vast vascular network on the placenta make examination and photocoagulation treatment of twin-to-twin transfusion syndrome challenging. Though ultrasonography is used for intraoperative guidance, its navigational ability is not fully exploited. This work aims to integrate 3D ultrasound imaging and endoscopic vision seamlessly for placental vasculature mapping through a self-contained framework without external navigational devices...
September 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/26611822/prenatal-interventions-for-congenital-diaphragmatic-hernia-for-improving-outcomes
#17
REVIEW
Rosalie M Grivell, Chad Andersen, Jodie M Dodd
BACKGROUND: Congenital diaphragmatic hernia (CDH), is an uncommon but severe condition in which there is a developmental defect in the fetal diaphragm, resulting in liver and bowel migrating to the chest cavity and impairing lung development and function for the neonate. This condition can be diagnosed during pregnancy and as such, is potentially amenable to in-utero prenatal intervention. Neonatal surgical repair is possible, but even with early surgical repair and improving neonatal management, neonatal morbidity and mortality is high...
November 27, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26522120/hysteroscopic-fetoscopy-a-role-as-virtuopsy-for-parents-who-refuse-full-autopsy-a-case-of-facial-clefting-proboscis-and-limb-deformities
#18
Gabriele Tonni, Enrico Periti, Lucia Rosignoli
OBJECTIVE: To describe the value of hysteroscopic fetoscopy (virtuopsy) at the time of uterine suction in a case of early diagnosis of congenital anomalies in parents refusing conventional full autopsy examination. CASE REPORT: First trimester ultrasound diagnosis of proboscis, median cleft lip and palate and limb deformities. Chorionic villus sampling demonstrated normal karyotype. Parents refused medical induction of termination of pregnancy with subsequent conventional autopsy...
October 2015: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/26445354/training-significantly-improves-fetoscopy-performance-a-pilot-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Stefan Mietzsch, Johannes Boettcher, Sisi Yang, Pierre Chantereau, Philip Romero, Robert Bergholz, Konrad Reinshagen, Michael Boettcher
Background Implementation of complex fetoscopic procedures that included intracorporeal suturing has been limited due to technical difficulties that might be surmounted with adequate training. Evaluating the impact of laparoscopic or fetoscopic training on fetoscopic performance was the aim of this study. Methods To evaluate fetoscopic performance after either laparoscopic or fetoscopic training, subjects were asked to perform four surgeon's square knots fetoscopically prior and post 2 hours of hands-on training...
October 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26426691/thrombin-generation-by-fetoscopic-trauma-to-the-fetal-membranes-an-in-vivo-and-in-vitro-study
#20
Alexander C Engels, Dries Bauters, Rita Rynkevic, Savitree Pranpanus, Jute Richter, Tim van Mieghem, Marc F Hoylaerts, Jan A Deprest
OBJECTIVE: We first aimed to investigate in vivo thrombin generation induced by fetoscopy, and second we used term membrane explants for measurement of thrombin generation, thrombin receptor location and induction of selected matrix metalloproteinases (MMPs) in tissue culture. MATERIALS AND METHODS: In vivo study (37 cases): samples of amniotic fluid were taken at the beginning and end of fetoscopy (mean gestational age 26.7 weeks) and analyzed by ELISA for thrombin-antithrombin complexes...
2016: Fetal Diagnosis and Therapy
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