Fetoscopy

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Fetoscopy

• Suellen Yekisa
• OT 712 Dr. Nelson

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What is fetoscopy?

• Fetoscopy is a procedure done during or after the
  18th week of pregnancy.
• It is done at this time, because the structures
  of the placenta and the fetus are developed well
  enough to be able to diagnose any serious
  problems.
• It allows doctors to determine if the fetus has
  any genetic defects or structural malformations.

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• The fetus is seen through a small incision made
  in the belly, and a fetal ultrasound guides the
  placement of the fetoscope.
• A camera can be attached to the fetoscope to take
  pictures.

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Who has the Procedure?

• Mothers who are having their first baby after the
  age of 35.
• Mothers with a family history indicating genetic
  abnormality.
• Mothers who have abnormal ultrasound findings.
• Mothers who have mated with blood relatives
  (consanguinous mating).

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Why is it done?

• Samples of tissue, typically skin, can be taken
  from the fetus to test for hereditary skin
  diseases.
• The fetus can be evaluated for birth defects like
  spina bifida, chronic granulomatous disease,
  galactosaemia, and Tay-Sachs disease.

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• A blood sample can be taken from the umbilical
  cord, the blood is then tested for diseases like
  hemophilia or sickle cell anemia
• Fetoscopy can sometimes cause problems for both
  the mother and the fetus, so it is typically done
  when there is a strong family history of birth
  defects.

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How is it done?

• Before
• The fetus heart rate will be checked, and the
  mother may be given a sedative to help her relax
  and prevent the fetus from moving around a lot.
• During
• The mother will be on her back with her stomach
  muscles relaxed.

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• An injection will be given in the lower abdomen
  to numb the skin where the fetoscope will be
  inserted.
• An ultrasound will be used to determine the
  position of both the fetus and the placenta.

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• The ultrasound is used as a picture guide so the
  doctor can determine where to make the incision.
• Once the fetoscope is in place the doctor can
  look at the fetus, collect blood and skin
  samples, and operate if necessary.

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• After
• The fetoscope is removed and the incision is
  closed.
• Another fetal ultrasound will be done to check
  fetal movement and to evaluate the amount of
  amniotic fluid.
• Mother and fetus are monitored for several hours
  to ensure everything is back to normal.
• The next day the ultrasound will be repeated once
  more to check the fetus and the placenta.

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What are the risks?

• There is a 12 chance of having a miscarriage,
  especially if a surgical procedure is done.
• There can be infections, excessive bleeding, or
  leakage of the amniotic fluid.
• If there is preterm rupture of the membranes
  (PROM) then the fetus must be delivered early.
• There is a chance of mixing the blood of the
  mother and fetus.

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References

• Web MD
• http//www.webmd.com/hw/being_pregnant/hw4744.asp
  
• History of Ultrasound in Obstetrics and
  Gynecology
• http//www.ob-ultrasound.net/amniocentesis.html
• Family N You
• http//www.familynyou.com/channels/index2.php3?id
  1559
• SciELo
• http//www.scielo.br/scielo.php?scriptsci_arttext
  pidS0102-86502005000600015
• U.S. Food and Drug Administration
• http//www.fda.gov/cdrh/mda/docs/h040005.html