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New and/or improved aspects of fetal surgery
Author(s) -
Luks François I.
Publication year - 2011
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2706
Subject(s) - hysterotomy , congenital diaphragmatic hernia , medicine , fetal surgery , surgery , fetus , fetoscopy , prenatal diagnosis , intervention (counseling) , diaphragmatic hernia , intensive care medicine , hernia , pregnancy , in utero , genetics , psychiatry , biology
Open fetal surgery through a wide hysterotomy is no longer a real option for prenatal intervention, but a minimally invasive approach has emerged as treatment for a small number of indications. Endoscopic ablation of placental vessels is the preferred treatment for severe twin‐to‐twin transfusion syndrome and it may be the only chance to salvage the most severe forms of congenital diaphragmatic hernia. Several other indications are currently under review and may become justified in the future, provided that diagnostic accuracy and patient selection become more accurate. Before invasive fetal intervention becomes widely accepted, however, we need to better define outcome. It is no longer acceptable to express results in terms of survival at birth. Survival at discharge and long‐term morbidity must be considered as well. Copyright © 2011 John Wiley & Sons, Ltd.