Interventional procedures F62Interventional ultrasound based on national registrations of fetal interventions in Japan

Methods Japanese Society of Obstetrics and Gynecology conducted the Registration of Fetal Therapy. One hundred 62 Institutes in Japan join the registration. From 1966 to 1999, totally 584 fetuses treated inutero including interventional procedures were registered from 86 Institutes. Effects of fetal therapies were determined by self‐judgements of reporters. Results One hundred 81 cases of hydrops aspirated their pleural effusion or ascites. The mortality of this group was 38.7%. Totally 47 cases of hydrops were medicated through maternal vein or directly. Thirty‐four (72.3%) cases in 47 of this group judged ineffective or unknown effect. The mortality of the group was 68.1%. Sixteen fetal transfusions were reported, effectiveness of that was 62.5% and the mortality was 31.2%. Shunting operations for hydrothorax or ascites were performed on 28 fetuses. The effectiveness of feto‐amnio shunting for hydropic fetuses was high as 82.1% and the mortality was 46.4%. Medical therapies for tachycardia were performed for 31 fetuses. The effectiveness was 67.7% and the mortality was 12.9%. There were 21 cases of shunting operation for obstuctive uropathies. The effectiveness of urinary shunting operation was 71.4% and the mortality was 47.6%. One hundred 60 fetuses of the amnio‐aspiration for TTTS, 16 fetuses of the rupture of septal membrane, 2 fetuses of closure blood flow and 2 fetuses of selective delivery were reported. After the period of the registration, we performed successfully endoscopic closure of umbilical cord for acardiac twin by the good guidance of ultrasound. Conclusions There are some fetal interventions which we can accept as the general therapy for fetus. They are shunting operation for obstructive uropathy, medication for tachy‐arrythmia, and fetal transfusion. Shunting operation for hydrothorax will be accepted.