Intrauterine Therapy

Area of Science:

• Medical Science
• Fetal Medicine
• Surgical Innovation

Background:

• Intrauterine interventions have evolved since the 1970s, with increased frequency at specialized centers.
• Despite advancements, prenatal procedures carry significant risks for both fetus and mother.
• Interventions are typically reserved for life-threatening fetal conditions with poor postnatal prognosis if untreated.

Purpose of the Study:

• To provide an overview of fetal conditions suitable for intrauterine therapy.
• To review the evidence supporting various prenatal interventions.
• To highlight the limited number of interventions rigorously evaluated in clinical trials.

Main Methods:

• Review of existing literature on intrauterine interventions.
• Analysis of evidence for specific fetal conditions and treatments.
• Identification of conditions with established efficacy through controlled trials.

Main Results:

• The scope and application of prenatal interventions have expanded considerably.
• Controlled clinical trials supporting prenatal interventions remain limited.
• Established successful interventions include laser therapy for feto-fetal transfusion syndrome, spina bifida closure, and tracheal occlusion for congenital diaphragmatic hernia.

Conclusions:

• Careful patient selection is crucial due to the inherent risks of intrauterine interventions.
• Further research and controlled trials are needed to validate more prenatal therapies.
• Laser therapy, spina bifida repair, and tracheal occlusion represent key areas of successful intrauterine intervention.