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Toward fetal therapy using needle embryofetoscopy

E A Reece1, C Homko, I Goldstein

  • 1Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University School of Medicine, Haifa, Israel.

Ultrasound in Obstetrics & Gynecology : the Official Journal of the International Society of Ultrasound in Obstetrics and Gynecology
|April 1, 1995
PubMed
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Transvaginal and transabdominal needle embryofetoscopy are feasible for early prenatal diagnosis. This technique allows for early visualization and verification of fetal anomalies in the first trimester.

Area of Science:

  • Reproductive Medicine
  • Prenatal Diagnostics
  • Minimally Invasive Surgery

Background:

  • Early prenatal diagnosis is crucial for managing congenital anomalies.
  • Current diagnostic methods have limitations in the first trimester.
  • Endoscopic visualization offers a potential advancement in prenatal assessment.

Purpose of the Study:

  • To evaluate the feasibility of transvaginal and transabdominal needle embryofetoscopy for early prenatal diagnosis.
  • To assess the safety and efficacy of these endoscopic techniques in the first trimester.
  • To explore potential applications in diagnosing and treating congenital diseases.

Main Methods:

  • Utilized transvaginal endoscopy with a 1.5 mm rigid fiberoptic endoscope.
  • Employed transabdominal needle embryofetoscopy using a 16-gauge needle sheath with a 0.8 mm endoscope.

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  • Procedures were performed under ultrasound guidance, visualizing the embryo/fetus in the exocelomic space.

    • Main Results:

    • Successfully performed over 300 transvaginal procedures with 95% fetal visualization.
    • Verified sonographically suspected anomalies in all five studied cases.
    • Completed 20 transabdominal procedures without adverse effects in both terminating and continuing pregnancies.

    Conclusions:

    • First-trimester diagnostic endoscopy, including transvaginal and transabdominal approaches, is feasible.
    • This technique enables early visualization and diagnosis of fetal anatomy and anomalies.
    • Potential future applications include gene and stem-cell therapy for congenital diseases in early pregnancy.