Today we are going to talk about a special medical procedure that can help you learn more about your baby during pregnancy, or treat a complex problem your baby has while still in the womb. This is called a fetoscopy . The name may sound a bit complicated, but let's keep it simple. Because this can be very important for you and your baby.
So, what is fetoscopy? To put it simply...
Simply put, fetoscopy is a procedure during pregnancy that allows your doctor to directly view your baby growing inside your uterus. Think of it like putting a small camera into your belly to see how your baby is doing and how his or her organs are developing. This can help diagnose and sometimes treat certain congenital disorders in your baby.
This is done using a thin, flexible tube called a fetoscope or endoscope . This tube has a small camera attached to one end. This allows the doctor to see clearly what is inside your uterus and the amniotic sac where your baby is. Because the fetoscope is hollow, it allows very fine surgical instruments to be passed through it, allowing the baby to be treated while it is still in the womb, and to take a sample of tissue for examination ( a biopsy) .
Most of the time, the fetoscope is inserted through a very small incision in your abdomen. However, in some special cases, the instrument can also be inserted through the cervix.
When is this fetoscopy test performed?
A fetoscopy is usually done in the second or third trimester of pregnancy, after the baby has developed a little. It is used to treat some complex conditions in the baby, and sometimes to take a biopsy to confirm the diagnosis.
Now let's see what are the main conditions treated with this method:
1. Twin-to-twin transfusion syndrome (TTTS)
This is a rare, but potentially dangerous, condition that occurs when identical twins do not share blood equally through the placenta. One baby gets too much blood, while the other baby gets too little.
In this case, the surgeon uses a fetoscope to look closely at the placenta and the blood vessels that are causing this uneven blood flow. Then, a laser is sent through the fetoscope to close off the problematic blood vessels. This procedure is called fetoscopic laser photocoagulation . This has a great chance of saving the lives of both twins.
2. Amniotic band syndrome
This is when the baby gets caught in the thin bands of membranes inside the amniotic sac. These bands can become rope-like and wrap around the baby's hands and fingers. This can cut off blood flow to those areas, sometimes causing damage to those organs or stunting. The surgeon can use a laser to cut the membranes that are holding the baby free through the fetoscope.
3. Congenital Diaphragmatic Hernia (CDH)
This occurs when a hole forms in the baby's diaphragm (the muscle that separates the chest and abdomen). Then, organs in the abdomen, such as the liver and intestines, are pushed through the hole and into the chest. This prevents the lungs from developing properly. This can even affect the baby's life.
To treat this, surgeons use a fetoscopy to insert a small balloon into the baby's trachea. This balloon creates pressure inside the lungs, helping them develop. After a few weeks, the balloon is removed again using the same procedure. This treatment is called Fetoscopic Endoluminal Tracheal Occlusion (FETO) .
Imagine how amazing it would be to be able to perform such complex surgeries while the baby is still in the womb! This technology has saved the lives of many babies and given them a healthy future.
In addition to these major conditions, fetoscopy is also used to treat certain types of tumors that develop in the placenta and other congenital conditions such as spina bifida .
So, what is the purpose of performing a fetoscopy?
Simply put, the main purpose of fetoscopy is to detect congenital conditions in the baby during pregnancy and treat them if necessary. In many cases, if this treatment is not given, the pregnancy can end or the baby can have serious health problems. So, this method is used when doctors need to treat such a condition while the baby is still developing in the womb.
How should you prepare for this?
If you are scheduled to have a fetoscopy, your doctor will explain to you exactly how to prepare for it. This depends on many things, including the type of test or procedure being performed, whether the fetoscope is inserted through the abdomen or vagina, the type of anesthesia you will be given (i.e., sedation or total sleep), and the type of medication you will be given to reduce the baby's movements during the procedure. Therefore, it is important to talk to your doctor about how to prepare for your situation.
How is a fetoscopy performed?
This is usually done in an operating room. You will be given anesthesia (local anesthesia or general anesthesia) so that you will not feel any pain and that you and your baby will not move during the procedure.
The surgeon follows these steps:
1. If done from the stomach:
- First, a very small incision is made in your abdomen.
- Then, through that incision, a fetoscope is passed into the uterus and into the amniotic sac where the baby is.
- The images from the camera on the fetoscope appear on a screen, allowing the surgeon to see the baby and placenta clearly.
- Depending on the nature of the surgery to be performed, the surgeon will pass fine surgical instruments through the fetoscope and perform the necessary treatment or take a tissue sample (biopsy).
2. If done through the cervix:
- First, a device called a speculum is inserted into the vagina to stretch the walls of the vagina and make the cervix clearly visible.
- Then, a fetoscope is passed through the cervix and into the uterus.
Is this fetoscopy a major incision surgery?
No. Fetoscopy is a minimally invasive procedure. That is, it is done through a very small incision or natural opening, without causing any major damage to the body. Compared to other methods of performing surgery while the baby is still in the womb (for example, open abdominal procedures), this procedure has less impact on the body and a lower risk of complications.
Are there any risks with fetoscopy?
As with any surgical procedure, fetoscopy carries some risks. However, these risks are relatively low. The main risks are:
- Preterm birth .
- Premature labor .
- Preterm premature rupture of membranes (PPROM) .
- Pregnancy loss (this is very rare).
- Infection .
- Excessive bleeding .
Your doctor will explain all of these risks to you, and they will take all necessary steps to minimize these risks.
What can we learn from a fetoscopy?
Fetoscopy is a tool and procedure used to diagnose and treat diseases. So, the information you get from it will depend on the reason you are having it done.
This gives your baby's doctors very important information about the baby's condition. It also helps treat conditions that may cause complications during the rest of your pregnancy or when your baby is born.
After a fetoscopy, doctors consider the following:
- Method of delivery: Depending on the baby's condition, doctors may decide that a cesarean section (C-section) is the safest method.
- Place of delivery: Depending on the baby's condition, doctors will determine whether special equipment or specialized care will be needed during delivery. Accordingly, an appropriate hospital can be selected.
- Timing of delivery: Doctors will decide whether the pregnancy can be continued or whether the baby needs to be delivered a little earlier.
How long does it take to know the results of a fetoscopy?
This also depends on the reason for which the fetoscopy was performed. This is not really a test, but a method used by doctors to diagnose and treat diseases while the baby is still in the womb.
For example, if a fetoscopy was performed to take a piece of tissue for examination (biopsy), it may take a few days for the results to come back. However, if your baby's surgeon used something like a laser to seal off abnormal blood vessels, you won't know for sure until after the surgery whether the procedure was successful.
How long does it take to recover after a fetoscopy?
Even though this is a minimally invasive procedure, if you have an incision in your abdomen, it will take some time to heal. Most people can return to their normal activities the same day, but you will need to take extra care of the area where the incision was made, or if it was done vaginally. Your medical team will give you detailed instructions on how to heal quickly, what to do, and what not to do. So it's important to follow those instructions exactly.
Fetoscopy is a valuable medical procedure that allows doctors to identify, evaluate, and treat congenital conditions while the baby is still developing in the womb. It is most often performed after 18 weeks of pregnancy, when many birth defects can be detected. Some conditions can be treated, corrected, and even saved the baby's life.
It's normal to feel scared and anxious about this type of test. But remember, your doctor and medical team are doing everything they can to keep you healthy during your pregnancy and to give your baby the best possible care. Talk to them about any questions or concerns you may have. They will provide you with the support and information you need.
The most important things for you to remember (Take-Home Message)
- Fetoscopy is a special method that allows you to see the baby while it is still in the womb and treat certain medical conditions.
- In this, a thin tube with a small camera (fetoscope) is inserted through a small incision in the abdomen or through the cervix.
- It treats conditions such as twin-to-twin transfusion syndrome (TTTS), amniotic band syndrome, and congenital diaphragmatic hernia (CDH).
- Since this is a minimally invasive procedure, no major incisions are made.
- Although there are minor risks, as with all surgeries, this method has saved the lives of many babies and improved their health.
- If you have any questions or concerns about this, be sure to talk to your doctor.
We wish you and your baby a healthy and happy life!
` fetoscopy, pregnancy, baby, intrauterine surgery, congenital disorders, twin-to-twin transfusion syndrome, amniotic band syndrome, congenital diaphragmatic hernia, fetal surgery, pregnancy, prenatal diagnosis, prenatal treatment
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