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Updated: Jul 18, 2026

Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct

Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct

Published on: January 22, 2010

Cephalocentesis with the modified Smellie's perforator.

B Chanrachakul¹, A Chittachareon, Y Herabutya

¹Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics

|January 31, 2002

Summary

This study presents a safe and simple method for fetal skull decompression using a modified Smellie

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Area of Science:

Maternal-Fetal Medicine
Obstetrics
Fetal Surgery

Background:

Hydrocephalus and polyhydramnios in pregnancy pose significant challenges.
Fetal interventions are considered for severe cases, balancing risks and benefits.

Observation:

A 37-year-old woman at 31 weeks gestation presented with fetal hydrocephalus (BPD=10.3 cm) and polyhydramnios (AFI=31.5).
Esophageal atresia was suspected.
Parents opted against invasive cephalocentesis, choosing a less invasive approach.

Findings:

Fetal skull decompression was successfully performed using a modified Smellie's perforator.
Cervical dilation was achieved with misoprostol.
The postpartum period was uneventful.

Implications:

This modified Smellie's perforator technique offers a useful, simple, and safe option for fetal skull decompression.
The procedure can be performed without prior specialized experience.
It provides an alternative to more invasive fetal interventions.