Maternal outcome after fetal surgery: a review of the first 17 human cases
Article Abstract:
During the past few years it has become possible to treat certain fetal diseases before birth through in utero transfusion techniques, drugs, and fetal drainage catheters. However, other defects require surgical repair, posing risks both to the mother and to the fetus. After extensive animal testing, fetal surgery has now been used to treat 17 human fetuses. This article reports on the mortality, complications, and impact on future childbearing, associated with fetal surgery on these 17 subjects. Four conditions were considered for surgical repair: severe bilateral hydronephrosis (seven cases), congenital diaphragmatic hernia (eight cases), sacrococcygeal teratoma and congenital cystic adenomatoid malformation (one case each). Maternal risks include general anesthesia, blood transfusions, and the operation itself, premature labor, and potential problems for future pregnancies. Maternal risk was comparable to that for caesarian section, with the added risk of a continuing pregnancy. Premature labor was a complication in all 17 cases. There were eight subsequent pregnancies among the total group, and the outcome was favorable for all eight. One pregnancy was complicated by uterine rupture, but the child was normal. Of the 17 fetal operations, 14 were technically successful, with the fetus surviving the operation. Three fetuses were found to be inoperable and were removed. Of the 14 successful procedures, only three fetuses survived. Two are healthy, but the other has declining kidney function. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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A randomized trial of fetal endoscopic tracheal occlusion for severe fetal congenital diaphragmatic hernia
Article Abstract:
Fetal endoscopic tracheal occlusion does not appear to benefit unborn babies who have congenital diaphragmatic hernia, according to a study of 24 pregnant women. A hernia in the diaphragm allows the abdominal organs to move up into the chest. This prevents the baby's lungs from developing properly. During fetal endoscopic trachea occlusion, the baby's windpipe is blocked to stimulate the lungs to grow. This technique was no better than standard care for this condition.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2003
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